Adductor Strain

Excerpt

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 three adductor muscles (longus, magnus, and brevis) of which the adductor longus is most commonly injured. All three muscles primarily provide adduction of the thigh. Adductor longus provides some medial rotation. The adductor magnus also has an attachment on the ischial tuberosity, giving it the ability to extend the hip. In open chain activation, the primary function is hip adduction. In closed chain activation, they help stabilize the pelvis and lower extremity during the stance phase of gait. They also have secondary roles including hip flexion and rotation.

Adductor Magnus

1. Origin: Inferior pubic ramus, ischial tuberosity

2. Insertion: Linea aspera, adductor tubercle

Adductor Brevis

1. Origin: Inferior pubic ramus

2. Insertion: Linea aspera, pectineal line

Adductor Longus

1. Origin: Anterior pubic ramus

2. Insertion: Linea aspera

The primary adductor complex is accompanied by three additional muscles with adduction activity including the gracilis, which also participates in internal rotation and hip flexion; obturator externus, which can also externally rotate; and pectineus, which additionally assists in hip flexion.

Gracilis

1. Origin: Inferior pubic symphysis, pubic arch

2. Insertion: Proximal medial tibia, pes anserine

Pectineus

1. Origin: Pectineal line of the pubis

2. Insertion: Pectineal line of femur

Obturator Externus

1. Origin: Obturator foramen

2. Insertion: Posterior aspect of the greater trochanter

The obturator nerve (L2 to L4), arising from the lumbar plexus, innervates all three. The adductor magnus also is innervated by the tibial nerve (L4 through S3).