Diagnosis and Treatment
Treatment > Adductor Longus Release
Many sportsmen and women will experience pain or discomfort of the groin or inner thigh throughout their sporting life. The adductor longus are muscles that help make up the inner thigh, so called as the main function of this muscle is to adduct the thigh.
These types of injuries can either be classed as acute or chronic.
Acute adductor injuries
An acute adductor strain usually occurs during sporting activities - kicking a ball or stretching a leg. A sharp pain is felt on the inside of the leg and bruising can occur. In the majority of cases the tissues tear where the muscle connects to the tendon (musculo tendinous junction). Ultrasound or MRI can be used to localise the tear and determine its extent.
Treatment of acute adductor injuries
Acute injuries are treated by relative rest. Ice packs and gentle stretching can be started shortly after. Once the patient is more comfortable, he can begin a strengthening and walking programme, followed soon after by a return to gentle running.
When the adductor longus tendon is torn away (avulsion) from its attachment on the pubic bone this can be indication for surgery. Adductor longus repair surgery consists of re-anchoring the tendon where it is has come away from the bone. This is done by a minimalist open approach, with a small incision to the inner thigh/groin.
When would I be able to return to training?
This depends on the anatomic location of the tear. A tear at the musculotendinous junction usually gives a return to sport between 3 to 6 weeks.
An avulsion of the tendon from the pubic bone takes longer to recover and will take between 8 to 12 weeks, regardless of whether it is treated conservatively or surgically. Although with conservative treatment the loss of strength can be a problem in certain types of sports activities, with surgery the strength of the muscle is always fully restored.
How do I prevent this type of injury?
For athletes conditioning during the preseason is very important. There are several studies demonstrating that the risk of an acute injury to the adductor muscles is 17 times less if the adductors are strengthened.
Chronic adductor Injuries
With a longstanding adductor problem there usually is a gradual onset of pain in the inside of the thigh. The pain can be felt where the muscle or the tendon attaches to the pubic bone or slightly further down by the musculotendinous junction. Activities such as sprinting and accelerating or even kicking a ball are painful.
Treatment of chronic adductor injuries and return to sports.
It is important to consider the level of the athlete. In most cases treatment consists initially of an adductor stretching and strengthening programme with a sport specialist physio. An MRI scan helps to determine the severity of the condition and in moderately severe cases, a single injection can successfully treat the problem. Surgical treatment is indicated for those cases which do not respond to conservative management.
Historically surgeons have cut the adductor tendon (tenotomy) to treat this condition, but lots of athletes were not able to return to sports because of loss of adductor strength.
Professor Schilders has developed a surgical technique that allows the vast majority of recreational and professional athletes to return to their pre-injury level of sports at around 6 to 8 weeks and without loss of strength. The adductor longus is partially released through a small incision made to the inner thigh. Our audit results for this technique demonstrate good/excellent satisfaction in the majority of the patients.