Adductor Tendinopathy: Overview and More

Your adductor muscles are the inner thigh muscles that help squeeze your legs together. Adductor tendinopathy is a chronic use injury that develops within the tendons of the adductor muscles, causing pain and breakdown of the tendons' collagen fibers.

This article will describe the causes and symptoms of adductor tendinopathy, plus how it's diagnosed and treated.

Adductor Muscles

Causes

Adductor tendinopathy is often caused by long-term overuse of the adductor muscles. The adductor muscles can be stressed by repetitive movements and changes in direction as a result of sports and activities like running, soccer, football, gymnastics, martial arts, and horseback riding. Adductor tendinopathy can also develop from strength imbalances in which the adductor muscles overwork to compensate for weaker muscle groups.

Sometimes referred to as the groin, the adductor muscles are located at the inner thigh and work to stabilize the pelvis and squeeze the legs together. The adductor group consists of the following five muscles:

• Adductor magnus
• Adductor longus
• Adductor brevis
• Gracilis
• Pectineus

While tendinopathy can affect any tendon, adductor tendinopathy most commonly affects the adductor longus tendon.

Tendonitis vs. Tendinopathy

Tendonitis and tendinopathy are both types of tendon injuries, and they share many of the same symptoms. Tendonitis is characterized by acute inflammation to a muscle’s tendon, resulting in pain and tenderness that worsens with contraction of the associated muscle. 

People with tendinopathy may not have any inflammation. Tendinopathy is marked by a deterioration of the collagen fibers within a tendon, causing pain and decreased muscle strength.

While both conditions result from overuse, tendonitis is typically more of an acute issue, while tendinopathy tends to be more chronic. 

Symptoms

Symptoms of adductor tendinopathy include a soreness or deep ache in the groin that worsens after physical activity. Other symptoms include:

• Tender to the touch
• Adductor weakness
• Increased pain when the adductors are contracted, such as moving the leg in toward the body or squeezing the legs together

Diagnosis

To diagnose adductor tendinopathy, a healthcare provider will review your symptoms, conduct a physical examination, and possibly order imaging tests such as a magnetic resonance imaging test (MRI) or an X-ray. They will rule out other possible causes of your groin pain, such as a hernia (when an organ pushes through a weak spot in a muscle or tissue).

Treatment

Initial treatment for adductor tendinopathy involves rest from aggravating activities and applying ice. You'll likely begin physical therapy, with a focus on returning to a full range of motion, followed by strengthening exercises.

Your healthcare provider may also recommend you wear compression shorts, take nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil or Motrin (ibuprofen) or Aleve (naproxen), and/or get a cortisone injection into the affected area in order to reduce pain as you resume physical activities. You'll need a healthy dose of patience, too: It can take six months or longer for your symptoms to fully resolve. 

Surgery

If your symptoms don't improve after three to six months of dedicated treatment, surgery may be performed to surgically release the adductor longus tendon. Up to 45% of people with tendinopathy will ultimately need surgery.

One such surgical procedure is called a tenotomy. It's performed by cutting into the adductor longus to release the tendon from where it attaches to the pelvis. This decreases chronic tension and pain. The tendon will then heal by reattaching to your other adductor muscle rather than attaching back to the pelvis.

In the initial stage postsurgery, you will need to use crutches to help you walk and place a pillow between your legs when sleeping to prevent reattachment of the cut tendon. You will also need to stretch your inner thighs every two hours during the first week after your operation.

You typically will need to attend physical therapy for the weeks after your surgery to restore your range of motion and strength and decrease your pain. Most patients meet these goals by week eight of rehabilitation and can return to full participation in sports and exercise after week 12.

Summary 

Adductor tendinopathy is a condition that results from irritation and injury to any of the adductor tendons of the inner thigh muscles that help squeeze the legs together. It's often caused by activities that stress the adductor tendons with repetitive motions and changes in direction. These include running, soccer, football, and horseback riding. Symptoms include groin pain that worsens with movement.

Treatment for adductor tendinopathy involves rest, ice, and physical therapy. Chronic cases that do not improve over time may require a surgical release of the tendon to decrease tightness and pain.

A Word From Verywell

Adductor tendinopathy can cause nagging pain that limits your ability to comfortably perform everyday activities and engage in your favorite forms of exercise. And it may take several months of dedicated treatment before your symptoms resolve. But if you stay the course, resting when your healthcare provider recommends it and participating in regular physical therapy, your prognosis should be very good. Even if you ultimately require surgery, you'll likely be able to return to your usual activities within three months.