Anatomy & Exam
Top High-Yield Topics
Glenohumeral Joint Anatomy, Stabilizer, and Biomechanics
Phases of Throwing
Impingement & Rotator Cuff
Outlet (subacromial) Impingement
Rotator Cuff Tears
Rotator Cuff Arthropathy
Proximal Biceps Tendonitis
Acromio-Clavicular Injuries (AC Separation)
Distal Clavicle Osteolysis
Traumatic Anterior Shoulder Instability (TUBS)
Posterior Instability & Posterior Dislocation
Multidirectional Shoulder Instability (MDI)
Luxatio Erecta (Inferior Glenohumeral Joint Dislocation)
Injuries in throwing athlete
Glenohumeral Internal Rotation Deficit (GIRD)
Little Leaguer's Shoulder
Posterior Labral Tear
Adhesive Capsulitis (Frozen Shoulder)
Avascular Necrosis of the Shoulder
Brachial Neuritis (Parsonage-Turner Syndrome)
Thoracic Outlet Syndrome
Quadrilateral Space Syndrome
Pectoralis Major Rupture
Latissimus Dorsi Rupture
Total Shoulder Arthroplasty
Reverse Shoulder Arthroplasty
Elbow Anatomy & Biomechanics
Medial UCL Injury & Valgus Instability
Posterolateral Elbow Rotatory Instability (PLRI)
Valgus Extension Overload (Pitcher's Elbow)
Distal Biceps Avulsion
Lateral Epicondylitis (Tennis Elbow)
Medial Epicondylitis (Golfer's Elbow)
Osteochondritis Dissecans of Elbow
Little League Elbow
Olecranon Stress Fracture
Elbow Stiffness and Contractures
Elbow Total Arthroplasty
Elbow Partial Arthoplasty
Ligaments of the Knee
History and Physical Exam of the Knee
MCL Knee Injuries
LCL Injury of the Knee
Posterolateral Corner Injury
Proximal Tib-Fib Dislocation
Knee Overuse injuries
Prepatellar Bursitis (Housemaid's Knee)
Iliotibial Band Friction Syndrome
Knee Extensor Mechanism
Lateral Patellar Compression Syndrome
Idiopathic Chondromalacia Patellae
Quadriceps Tendon Rupture
Patella Tendon Rupture
Articular Cartilage Defects of Knee
Osteonecrosis of the Knee
Spontaneous Osteonecrosis of the Knee (SONK)
Osgood Schlatter's Disease (Tibial Tubercle Apophysitis)
High Tibial Osteotomy
Iliac Crest Contusion (Hip Pointer)
Anterior Superior Iliac Spine (ASIS) Avulsion
Anterior Inferior Iliac Spine Avulsion (AIIS)
Athletic Pubalgia & Adductor strain
Thigh Nerve Entrapment Syndromes
Piriformis Muscles Syndrome
Snapping Hip (Coxa Saltans)
Hip Labral Tear
Rectus Femoris Strain
Exertional Compartment Syndrome
Popliteal Artery Entrapment Syndrome
Tibial Stress Syndrome (Shin Splints)
Femoral Neck Stress FX
Femoral Shaft Stress FX
Tibial Shaft Stress FX
Rib Stress Fracture
Head and Spine
Concussions & Head Injuries
Neck Injuries in Athletes
Burners & Stingers
Heat Illness and Stroke
Ear, Eye, Mouth Injuries
Visceral Blunt Trauma
Infectious Diseases in Athletes
The Female Athlete
Steroids & Stimulants
Sports Study Plans
2015 SPORTS MOC 89-Day Study Plan
2016 MOC Sports 89-Day Study Plan
Topic updated on
A common injury to the adductor muscle group
occurs in 10-30% of soccer and hockey players due to strong eccentric contraction of adductors during play
a “pulled groin,” is caused by forceful external rotation of an abducted leg.
pain with minimal loss of strength and motion
complete disruption with loss of muscle function
Hip joint adductor complex
adductor longus (most common muscle injured in complex)
All have obturator nerve innervation
pain is immediate and severe in the groin region.
tenderness is at the site of injury along the subcutaneous border of the pubic ramus.
pain and/or decreased strength with resisted leg adduction compared to the other leg
lateral of hip
if injury is due to an avulsion then fleck of bone may be visible
may show avulsion injury of the adductor muscle from the pubic ramus with muscle edema and hemorrhage.
rest, ice, protected weight bearing as needed
mainstay of treatment
dictated by the severity of the symptoms but generally consists of of a period of rest
follow with a rehabilitation program that begins with gentle stretching and progresses to resistance exercise and core strengthening with a gradual return to sports
immobilization should be avoided because this promotes muscle tightness and scarring
no data exist to suggest that open repair yields a better outcome than nonsurgical management.
Please Rate Educational Value!
Qbank (1 Questions)
A professional rugby player has acute groin pain after an awkward collision with an opponent. MRI shows an avulsion injury of his adductor muscle. Which of the following is an appropriate treatment to provide?
Strict immobilization with the leg in flexion and adduction
Immediate rehabilitation consisting of increasing passive and active motion
Tendon repair with adjunctive allograft reconstruction
Select Answer to see Preferred Response
PREFERRED RESPONSE ▶
Adductor muscle avulsions are caused by muscle failure in tension as the leg is abducted. Symptoms are localized to the groin along the medial aspect of the pubic ramus. Treatment based on rest, ice, and mobilization with protected weight bearing is recommended to avoid muscle scarring and contractures. Muscle rehabilitation should include progressive gentle range of motion, followed by progressive active muscle strengthening. There is no high level evidence that surgical repair of adductor strains yields better outcomes than nonsurgical management.
Gilmore provides a review of groin pain that occurs commonly in soccer athletes. Causes of such groin injuries include: muscle injuries such as adductor strains, direct trauma, osteitis pubis, fractures, bursitis, hip problems, hernia and referred pain.
Irshad et al discusses the "hockey groin syndrome," marked by tearing of the external oblique aponeurosis and entrapment of the ilioinguinal nerve, which is a cause of groin pain in professional hockey players. They recommend ilioinguinal nerve ablation and reinforcement of the external oblique aponeurosis for treatment of this injury.
Illustration A shows a T2 pelvic MRI with a left sided adductor tear, evidenced by the increased fluid signal. Arrow 1 points to the tendon origin on the pubic rami, and arrow 2 is pointing to the avulsed adductor tendon.
Groin pain in the soccer athlete: fact, fiction, and treatment.
Clin Sports Med. 1998 Oct;17(4):787-93, vii.
PMID: 9922902 (Link to Abstract)
Vote for CME
Operative management of "hockey groin syndrome": 12 years of experience in National Hockey League players.
Irshad K, Feldman LS, Lavoie C, Lacroix VJ, Mulder DS, Brown RA.
Surgery. 2001 Oct;130(4):759-64; discussion 764-6.
PMID: 11602909 (Link to Abstract)
Vote for CME
David Abbasi MD
Michael Hughes MD
Ben Taylor MD
Please Rate Educational Value!
to view and post comments.
Adductor Longus Avulsion (C2557)
HPI - Patient with pain in his groin for 6 months. He has abnormal gait pattern. Pain...
See More Cases
Oral Boards: Adductor Strain
Oral Boards Review
See More Groups
to add comment.