Another one to add to your list of common hip/groin pain culprits.
This muscle is the most anteriorly positioned muscle in the medial compartment of the thigh and acts to adduct the hip. However, forceful hip adduction in isolation is a rare movement. Depending on the starting position of the femur/hip joint it is possible for the adductor group to act as flexors, internal and external rotators of the hip.
More common is the synergistic activation of the adductor muscle group during complex gait patterns in order to provide stability throughout flexion and extension moments at the hip (Ie. when sprinting, change of direction, jumping and landing).
Related pathology: Adductor-related groin pain, muscle strains, tendinopathy (most likely at origin), pubic apophysitis.
Origin: pubic body in between the pubic crest and the pubic symphysis.
Insertion: middle ⅓ of the linea aspera (posterior longitudinal crest of the femur).
Innervation: Obturator nerve, anterior branch (roots L2-4).
Blood supply: profunda femoris.
Actively test using the supine adductor squeeze test typically with knees extended. Also try this in more function positions such as bent knee or modified Thomas test (note: some clinicians will extend the knee to bias the long adductors (longus, magnus and gracilis) and flex the knee to 90 degrees to bias the short adductors (brevis and pectineus) but this has has not been confirmed empically.
Length test with bent-knee fallout test (supine knees 90deg flexed, heels touching, then passive hip abduction). You can measure distance of knee to plinth/ground as an outcome measure. Also test length with passive hip abduction.
Palpate: Because adductor longus is most anterior in the medial compartment you may first visualise it’s muscle belly by passively abducting the thigh or by asking your client to resist adduction in supine. Alternatively you can palpate the body of the pubic bone then trace inferolateral into the medial compartment of the thigh and onto adductor longus, medial to sartorius and rectus femoris.
What’s your experience with assessing and treating adductor related groin pain? Please share any clinical pearls in the comments below!