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Adductor Tendinopathy

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Introduction

Adductor tendinopathy affects the tendon complex of the muscles that run along the inside of the leg. The longer Adductor muscles attach at the pelvis and extend to the knee and the shorter Adductor muscles also attach at the pelvis but extend to the thigh bone (as seen in Fig 1). This group of muscles help stabilise the pelvis and draw the legs across the body.

 

There is some differing of opinion regarding how tendinopathy develops and what happens to the tendon itself is a topic of debate. The consensus according to Khan et al. (1999) is that changes occur within the structure of the tendon which is predominately composed of collagen.

Signs & Symptoms

  • Pain in the groin which can radiate down the inside of the thigh to the inside of the knee.
  • Symptoms may occur from an acute stretch/overload of the adductor muscles or may develop over time.
  • There may be a palpable lump or swelling in the symptomatic area.
  • The inner thigh muscles may feel stiff and can hurt when you squeeze your knees together or pull your knees apart.
  • Pain with high-speed running and change of direction actions.

Causes

The development of Adductor tendinopathy is multifactorial. Adductor tendinopathy can develop after repetitive movements and/or sudden changes of direction which is one reason this condition is prevalent amongst sportsmen and women. For those not taking part in sport, a sudden change in physical activity in terms of intensity, duration or type could lead to the onset of a tendinopathy.

 

Other factors that may contribute to Adductor tendinopathy include altered movement patterns which can place increased stress on tendons and muscular length and strength deficits in the lower limb or abdominals. Finally, a lack of warming up, inactivity, fatigue and obesity might also play a role in the development of this condition.

Assessment & Diagnosis

Seeking advice from a Musculoskeletal Specialist is recommended. At Pure Physiotherapy, our clinicians complete a thorough assessment which facilitates in making an accurate working diagnosis and the subsequent development of an individualised, condition specific rehabilitation protocol.

Self-Management

Following assessment, if an Adductor tendon has been found to be the source of pain, your clinician will likely inform you of the suspected ‘stage’ of your injury of which there are 3 stages according to Cook and Purdam (2009) – reactive tendinopathy, tendon dysrepair and degenerative tendinopathy. The stage of tendinopathy will help guide the Physiotherapist’s allocation of treatment.

 

Treatment will depend on the stage of injury. During the reactive stage, it is important to modify activities of daily living as to avoid excessive load on the affected tendon whilst remaining active within the limitations of your condition. Your Physiotherapist might suggest liaising with the appropriate medical professional to discuss medication options (Naproxen or Ibuprofen has been shown to have a positive impact upon tendon related disorders).

Physiotherapy

Your Physiotherapist may allocate isometric exercises (tension without movement) which have been shown to help reduce pain in reactive conditions. As your symptoms improve, isometric exercises can be phased out and treatment should look at restoring muscle strength and function which is essential for the long-term health of the tendon. You will be given ongoing support and guidance so that you can effectively manage your symptoms and prevent re-occurrence.

References

Cook, J.L. and Purdam, C.R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British journal of sports medicine. 43(6), pp.409-416.

 

Khan, K.M, Cook, J.L, Bonar, F, Harcourt, P. and Åstrom, M. (1999). Histopathology of common tendinopathies. Sports medicine. 27(6), pp.393-408.

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