Adductor Tendinopathy

Adductor tendinopathy is an injury where the tendons on the inside of the thigh (adductors) become overloaded. These tendons connect the adductors to the pubic bone and the inside of the knee. They play an important role in stabilising the pelvis and knee, and in adducting the thigh.

When overloaded, pain can occur on the inside of the hip, near the pubic bone. This pain can radiate to the abdominal muscles. This condition is often also referred to as ‘pubalgia’. However, it is important to know that pubalgia is not a specific diagnosis, but a collective term for pain in the pubic bone (os pubis).

Pubalgia can have various causes, including:

• overload of the adductors
• overload of the abdominal muscles
• specific injuries, such as a tear in the tendon attachment (PLAC lesion)

An accurate diagnosis is important to determine the correct treatment and work towards recovery in a targeted manner.

How does adductor-related groin pain develop?

This problem usually develops gradually and is a typical consequence of overuse. The risk of injury depends on the load-bearing capacity of the tendon: how well the tendon can withstand the force applied to it. When the load is greater than what the tendon can handle, overuse can occur.

In response to overuse, the body sends an alarm signal by producing inflammatory fluid at the affected site. This causes pain, which automatically prompts you to slow down to prevent further damage. This natural reaction gives the tendon time to recover and adapt better to the load.

It is essential to listen to these warning signs. With a combination of adjusted rest and a controlled build-up of load, you can strengthen the tendon and prevent a recurrence of symptoms.

Adductor-related groin pain typically manifests as pain at the pubic bone, where the adductors attach. The pain can radiate to the inside of the thigh.

It is important to distinguish this complaint from an inguinal hernia (hernia inguinalis). Although an inguinal hernia can also cause pain near the pubic bone, the pain is usually slightly higher, towards the groin area. An inguinal hernia can also radiate to the pubic bone, abdominal muscles, and even the testicle. Typical symptoms include pain when coughing, sneezing, or straining.

With adductor-related groin pain, you often experience discomfort during activities such as:

• Adducting the leg
• Coughing, sneezing, or straining
• Getting out of bed
• Kicking, for example during football
• Lifting the leg
• High-impact sports

An accurate diagnosis is essential to determine the cause of the pain and initiate appropriate treatment.

The treatment for this injury is tailored to the severity of the complaint. The approach usually consists of:

• Adjusting load and lifestyle
• Exercise therapy
• Injections
• Additional imaging to rule out a PLAC lesion

Together, we will determine which treatment option best suits your situation and needs, so you can work towards recovery in a targeted manner.