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Adductors: the Forgotten Muscles
By Bryan Cobb, Advanced Remedial Massage Therapist

Bryan Cobb, Advanced Remedial Massage Therapist
Precision Touch Massage Therapy, Winnipeg MB
204 688 1777

When we think of leg muscles, we think Quads and Hamstrings. These are the muscles that make up the front and back of the upper legs, respectively.

Most of the exercises and stretches done for the lower body are actually for these two muscle groups. This focus can lead to overdevelopment of these muscles at the expense of another set of muscles on the inside of the leg, namely the Adductor group, or more commonly, the groin.

The Adductors play a very important role in movement and stabilization of the leg and pelvis. Problems that arise from injury or overuse can be severe, even crippling. Care of the Adductors is as important as care of the Quads and Hamstrings.

Meet the Adductors

The Adductor group consists of 5 muscles

- The Pectineus originates on the pubis and inserts on the femur (pectineal line)

- The Adductor Longus also originates on the pubis and inserts on the femur

- The Gracilis is a thin strap muscle that originates on the pubis but travels the length of the leg to just below
the knee joint on the inside of the leg.

- The Adductor Brevis goes from the pubis to the linea aspera of the femur

- The Adductor Magnus comprises most of the "meat" of the inner leg. It travels from the pubis and ischial
tuberosity of the pelvis down the linea aspera of the femur.

What the Adductors Do

The Adductor group functions to pull the leg toward the midline of the body, to rotate the knee inward (medial rotation), dip the pelvis downward and forward (anterior rotation), and flex the leg at the hip joint.

Some Adductor muscles have independent actions, as well. For example, the Gracilis can help flex the knee. The Adductor Magnus rotates the front of the pelvis upward (posterior rotation instead of anterior rotation). It will also extend the femur back instead of flexing it.

Aside from these basic movement actions, the Adductor group has a very important stability function. During a normal walking gait, these muscles function to keep your leg from buckling outward when your weight is on that leg (i.e., they restrain abduction of the stance limb and control lateral shifting of the leg).

With every step you take - whether walking or running - the Adductor group is working hard to keep your legs straight and keep you upright. In fact the adductor group works closer to it's maximal capacity more frequently than any other thigh muscles.

Trigger Points in the Adductors

Trigger Points in the Adductor group arise, just like any other area, from overload of the tissue. This overload can be chronic (i.e., from repeated movements done over a long period of time) or it can be acute (e.g., from a work injury or a fall). These Trigger points can cause pain and weakness which lead to improper movement mechanics, which, in turn, lead to propagation of Trigger points in other areas of the body.

Having weak, overused, or injured Adductors will lead to a multitude of movement and postural problems and will set the stage for chronic injury and pain.

If you have Trigger points in the Adductors, the type of pain you feel will depend on the location of the Trigger points and which specific muscles are affected.

Trigger points in the Adductor Longus and Adductor Brevis, for example will refer pain deep into the groin and downward to the knee and shin.


Pectineus Trigger points cause pain in the groin, just in the crease where the leg joins the body. This pain can be sharp or it can be a deep ache. In the latter case, it will often feel like it is in the hip joint.


Gracilis Trigger points can cause superficial pain along the inside of the leg, up or down.

Adductor Magnus Trigger points in the upper part of the muscle cause pain to be felt inside the pelvis. It can be quite diffuse or a very sharp explosion of pain in the pubic bone, vagina, rectum, prostate, or bladder. Trigger points in the middle of the muscle cause pain in the inner thigh from the groin almost to the knee. Pain is increased by extreme abduction of the thigh (i.e., spreading of the thigh outward).

When these muscles become tight from Trigger points, they can entrap the femoral artery, the femoral vein, and the saphenous nerve. This can compromise circulation of the lower extremities and cause neurological problems.

In addition to pain, Trigger points in the Adductors cause weakness and decreased flexibility. When this occurs, the Adductor group can no longer function properly to stabilize the femur. As a result, the leg will want to buckle outward (deviate laterally) which causes the muscles on the outside of the hip and thigh to become contracted and shortened. This will result in pain down the outside of the leg and hip.

Adductor Trigger points are also one of the main causes of Persistent IT Band Friction Syndrome in the feet. This is a persistent problem that seems to return even after treatment. (More information on this Syndrome can be found on Wikipedia.)

Taking Care of Your Adductors

In order for full resolution of pain and dysfunction on the outside of the hip and leg, the Adductor Group must be treated for Trigger points and then strengthened. Proper treatment will return normal standing and movement mechanics.

If pain is felt on the inside of the leg, in the pelvis, or on the outside of the hip and leg, proper biomechanical assessment of posture and movement, as well as strength testing, must be done to determine the source of the pain and any factors that will perpetuate the problem.

For balance to be achieved and proper mechanics to be restored, Trigger Point release techniques must focus on the Adductor Group as well as the Gluts and the Quads. Once the Trigger points are released, proper strengthening of the Adductors (as well as the Abductors and Gluts) should begin, in order to prevent overload, fatigue and injuries in the future. Proper strengthening is also necessary to achieve lasting results.

If you are an athlete, or very active physically, then regular massage is also necessary. The very nature of training (repetitive movements, duration and intensity of movements, etc.) will cause problems. Regular massage will decrease the severity of those problems, prevent existing problems from getting worse, and keep your performance high.

Self care is also important for prevention and management of dysfunction. Good practices include proper warm-up before activity and thorough cool-down with stretching, post-activity. Hot baths, saunas, whirlpools, etc. and self-massage of the Adductors are also good self care practices.

Finding and releasing Trigger points in your own Adductors can be a bit awkward because of the angles involved, but is well worth the time and effort. You can access the Adductor area by sitting in a chair with your legs spread apart. Use your fingers, thumbs or even elbows to search for sensitive knots or taut bands of tissue. Once a point has been found, apply deep steady pressure until symptoms and pain referral subside. You may have to make subtle movements and adjustments to continue reproducing the pain until the pain is reduced.

Remember that the Adductors are a big group. To make sure you work the area completely, make sure to work from the inside of the knee up to the pubic bone. This can be done daily or even from time to time throughout the day. If the area that you worked is tender from your last session, then take a day off before trying it again.

The Adductor muscle group is one of the most overlooked areas of the body and is often neglected in training, as well as in diagnosis and treatment of pain. Hopefully, this article has helped make you aware of the importance treating this area well, and strengthening it, for management and prevention of pain and dysfunction in the hips and lower body.


For more information on Trigger Points in general, see my article "What the Heck is a Trigger Point?
"

Bryan Cobb

 



 

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