The Anatomy of the Pectineus Muscle

Flexor of the Thigh

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The pectineus muscle, a flat, quadrangular muscle located in the middle of the thigh, helps to flex or move your leg towards your body. Running, skating, kicking a soccer ball, playing basketball, or exercising with fatigued muscles can strain or pull this muscle, resulting in a painful injury. If that happens, be patient because time and prudent care can get you back “on your game” relatively quickly.

The pectineus muscle may be strained in a groin pull injury
Panuwat Dangsungnoen / iStock / Getty Images

Anatomy

The pectineus originates from the pectineal line of the pubic bone, which is also known as the pectin pubis. The pectineus muscle continues downward and in a posterolateral direction (behind and to the side) and inserts into the pectineal line of the femur (thigh bone).

The pectineus muscle is a hip adductor, one of a group of five large muscles on the medial (middle) thigh that adduct the leg. The other hip adductors include the adductor longus, adductor brevis, adductor magnus, and gracilis muscles. The pectineus muscle is the most anterior (closest to the front) adductor of the hip.

Most hip adductors are stimulated (innervated) by the obturator nerve and supplied by blood mainly via the branches of the femoral and obturator arteries. The pectineus receives its main blood supply from the medial circumflex femoral artery and contributions from the femoral and obturator arteries.

Similar to the adductor magnus muscle, the pectineus frequently has dual innervation; the anterior (front) part of the muscle is innervated by the femoral nerve while the posterior (back) part is supplied by obturator nerve.

Function

The main functions of the pectineus muscle are flexion, adduction, and external rotation of the hip. The pectineus muscle both flexes and adducts the thigh at the hip joint when it contracts. Adduction is the movement of a limb or other part toward the midline of the body or toward another part.

In the limbs, flexion decreases the angle between the bones (bending the joint) and brings the thigh forward and upward to flex at the hip joint.

Flexion can go as far as the thigh being at a 45-degree angle to the hip joint. At that point, the angulation of the fibers allows the contracted muscle fibers to pull the thigh towards the midline, producing thigh adduction.

Associated Conditions

The pectineus muscle can become injured by overstretching one or both legs too far out to the side or front of the body. Pectineus injuries can also be caused by rapid movements and the following: 

  • Kicking or sprinting
  • Changing directions too quickly while running
  • Sitting with a leg crossed for too long.
  • Previous hip or groin injury
  • Age
  • Weak adductors
  • Muscle fatigue
  • Decreased range of motion
  • Inadequate stretching of the adductor muscle complex

The most common symptoms of an injured pectineus muscle are pain, bruising, swelling, tenderness, and stiffness.

Pain in the front hip area can mean that you may have strained the primary hip flexor muscles or the hip adductor muscles, or a combination of the two. This is generally referred to as a groin strain or groin pull.

When this happens, you may even hear a pop or snapping sound. Afterward, you may feel pain when closing your legs or raising your knee.

There are three degrees of groin strains:

  • Grade 1: Overstretched or torn muscle, damaging up to 5 percent of muscle fibers. With this strain, walking may not be painful, but running, jumping, or stretching may cause pain.
  • Grade 2: As a result of more significant damage to muscle fibers caused by a tear, walking might cause pain. With this grade, you may need crutches to move around.
  • Grade 3: This tear, through most or all of the muscle or tendon, can cause immediate severe pain, swelling, and bruising. As a result of this severe injury, you might actually feel the space where muscle fibers have been torn. In this case, it is important to avoid any running or jumping that would worsen the injury and seek medical attention immediately.

Treatment

If a pectineus muscle injury occurs, avoid movements that might cause further injury, and minimize activities that use the pectineus muscle, like walking and running, to allow time for the muscle to heal. Ice the injury every 15-20 minutes to decrease and prevent swelling and decrease pain.

Groin strains from mild to more severe could range from three weeks to six weeks of rest or even longer to heal. A complete tear could require surgery (which is rare) and up to a three-month recovery period. Initially, a pain management plan will usually include acetaminophen and non-steroidal anti-inflammatory medications.

Standard procedure regarding home care of this type of strain can be remembered by the initials P.R.I.C.E. — protection, rest, ice, compression, and elevation.

Ice reduces swelling and pain. Put ice or a cold pack on the injured area for 10 to 20 minutes at a time every one to two hours for three days or until the swelling is relieved. Put a thin cloth between the ice and your skin for protection.

After two or three days, if the swelling is gone, apply heat by putting warm water bottle, a heating pad set on low, or a warm cloth on your groin area. Do not go to sleep with a heating pad on your skin, as it can cause burns.

After healing, physical therapy can provide exercises focusing on strength, the range of motion, and stretching of the affected muscle group.

Even though you may want to care for the injury yourself, seek medical attention immediately if:

  •    You have new or severe pain or swelling in the groin area.
  •    Your groin or upper thigh is cool or pale or changes color.
  •    You have tingling, weakness, or numbness in your groin or leg.
  •    You cannot move your leg.
  •    You cannot put weight on your leg.
  •    Your condition does not improve as expected in your doctor visits.

Any of the symptoms of a groin strain are similar to symptoms of bursitis of the hip, hip strain, or stress fracture so it’s best to have the pain checked out by a doctor, who may recommend magnetic resonance imaging (MRI) to view the extent of the injury.

Musculoskeletal ultrasound can further visualize the tendon and bony attachment sites, muscles, ligaments, and nerves to identify the area and extent of the injury and evaluate periodically during the recovery phase.

Most athletes with adductor strains can return to their sport with minimal pain and normal function after following doctor’s orders regarding rehabilitation. An active training program directed at strength and conditioning of muscles of the pelvis and the adductor muscles is very effective at treating patients with long-standing, adductor-related groin pain.

While sports-related injuries are relatively common, even among athletes, surgery is usually rare. Your recovery can be quick and comfortable thanks to the doctors, nurses, and physical or occupational therapists that can be a part of your treatment team.

A Word from Verywell

It is vital to be a “patient patient” because returning to activity too soon after a pectineus muscle issue may lead to a repeat injury. Remember to pay the P.R.I.C.E., and contact your doctor if you suspect that your injury needs professional help and care.

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Article Sources
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