Adductor Strain

Excerpt

An adductor strain or injury to the adductor muscle group is a common cause of medial leg and groin pain, especially among athletes. The adductor complex includes the 3 adductor muscles (magnus, longus, and brevis), of which the adductor longus is most commonly injured. All 3 muscles primarily provide adduction of the thigh. The adductor longus also provides some medial rotation. In open-chain movement, the adductor magnus primarily adducts the hip, while in closed-chain movement, it helps stabilize the pelvis and lower extremity during the stance phase of gait (see Image. Medial Compartment of the Thigh). Because the adductor magnus attaches to the ischial tuberosity, the muscle also contributes to hip extension.

The adductor muscle complex:

1. Adductor Magnus

   1. Origin: Inferior pubic ramus, ischial tuberosity

   2. Insertion: Linea aspera, adductor tubercle

2. Adductor Longus

   1. Origin: Anterior pubic ramus

   2. Insertion: Linea aspera

3. Adductor Brevis

   1. Origin: Inferior pubic ramus

   2. Insertion: Linea aspera, pectineal line

The adductor complex is supported by 3 additional muscles that contribute to hip adduction:

1. Gracilis

   1. Also assists with internal rotation and hip flexion

   2. Origin: Inferior pubic symphysis, pubic arch

   3. Insertion: Proximal medial tibia, pes anserine

2. Obturator Externus

   1. Contributes to external rotation

   2. Origin: Obturator foramen

   3. Insertion: Posterior aspect of the greater trochanter

3. Pectineus

   1. Aids in hip flexion

   2. Origin: Pectineal line of the pubis

   3. Insertion: Pectineal line of the femur

The obturator nerve (L2 to L4), arising from the lumbar plexus, innervates most of the adductor musculature. The adductor magnus is also innervated by the tibial nerve (L4 through S3), and the pectineus is often innervated by the femoral nerve (L2 to L3).