Adductor Tendinopathy: Difference between revisions
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Revision as of 09:38, 12 May 2017
Original Editors - Gaëlle Vertriest
Top Contributors - Scott Cornish, Gaëlle Vertriest, Admin, Mariam Hashem, Wanda van Niekerk, Amanda Ager, WikiSysop, Kim Jackson, Rachael Lowe and Chloë Van Stichel
Search Strategy[edit | edit source]
Keywords:
Adductor tendinitis, adductor tendonitis, groin injuries, adductor injuries, adductor tenosynovitis, inflammation adductor muscles (tendons)
Databases searched:
Medscape, Pedro, Google Scholar, Pubmed, Cochrane library, Web of Knowledge, Library of the VUB
Description
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Adductor tendinitis is the inflammation of the tendons in the adductor muscles. We can divide them into long and short adductors: the long adductors (Gracilis & Adductor Magnus) go from the pelvis to the knee and the short adductors (Pectineus, Adductor Brevis & Longus) go from the pelvis to the thigh bone.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title These adductor muscles stabilize the pelvis and pull the legs together (= adduction).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Clinically Relevant Anatomy[edit | edit source]
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Epidemiology /Etiology[edit | edit source]
We use the adductors a lot in sports like running, football, horse riding, gymnastics, swimming,… These are sports in which we repeat movements, change of direction or stress the adductor tendon quite heavily.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Adductor tendinitis and also groin injuries are more prevalence among athletes. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Another cause is the overstretching of the adductor tendons.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
The development of adductor tendinitis is influenced by a lot of factors. Especially leg length difference has consequences: it affects the way you walk.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title While performing wrong movements during physical activity, one may influence the tendinitis in a negative way. Also length and strength differences in the muscles or weakness can result in adductor tendinitis. Other factors can be lack of warming up, the absence of sport, fatigue, obesity, age-related weaknesses, degeneration and genetics.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Characteristics/Symptoms[edit | edit source]
We can perceive adductor tendinitis with groin pain: this pain occurs by touching the adductor tendons on the pelvis, by closing the legs or effectuating abduction from the affected leg. The pain can grow gradually or sudden sharp pains may appear.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
The patient can notice swelling or lump in the adductor muscles, stiffness in the groin or inability to contract or stretch the adductors.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title In severe cases the patient may be unable proceed with physical activities.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Differential Diagnosis[edit | edit source]
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Diagnostic Procedures[edit | edit source]
We can make an objective diagnosis of adductor tendinitis by the examination from a physiotherapist. There is also the possibility to take an X-ray, Ultrasound, MRI- or CT-scan.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Prevention[edit | edit source]
To prevent the development of adductor tendinitis, the patient must work on most factors mentioned. But remember that they must avoid doing too much too soon!Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
The patient has to develop his muscles and stabilize his groin, pelvis and hip area by doing exercises with different levels of difficulty. These exercises train the balance, strength, speed, jumping…
Another important object is stretching: the muscles have to be flexible.
Tools like mobility and muscle supports also help by alleviating high impacts.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Medical Management
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Physical Therapy Management
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In order that the patient has a good rehabilitation, he must quickly have a good treatment of physiotherapy. Normally the patient will return to a normal health in a few weeks. With a more serious case, the rehabilitation will take a few months before the patient will come back to a normal function.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Treatment[edit | edit source]
For treating the adductor tendinitis, the patient must rest. It’s important to rest until the patient is capable to do physical activities without pain! Apply cold therapy ‘RICE’: 3times a day 10-20minutes, during 3days. This cold therapy will help to reduce the swelling and inflammation.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title When the swelling has decreased, blood flow stimulation therapy may start to increase the blood flow and accelerate the healing process.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Another way to reduce the inflammation is by corticosteroid injections, steroid drugs, surgery, anti-inflammatory medication… As such pay attention to the risks for undesirable effects (e.g. rupture of tendon).Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
When the patient is able to do his physical activities without pain, he may resume them gradually by being careful. Physiotherapy is necessary: flexibility and strengthening programs will influence the healing process and avoid the reappearance.
The stretching exercises should be executed 3 times daily, complementary to the physiotherapeutic sessions; and the patient may only execute them if they do not cause or increase symptoms. The patient can start with them from day 1, but only if they can be done without pain!
The strengthening exercises should be executed daily, and when the patient got back to full activity, he may do them 3times a week. These exercises can begin after the acute phase, when the pain has diminished in time: this may take 5days.
The stretching exercises must be done throughout the strengthening program: before and after the session.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
A few examples: stretching exercises:
- The short adductors:
- sit down like the person on the picture.
- The patient must quietly press the elbows onto the knees until he feels the stretch.
- This may not be painful!
- Hold for 20-30secondsCite error: Invalid
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2. The long adductors:
- stand and open the legs.
- The patient must bend the non-stretching knee and lean to the side of this knee until he feels the stretch
- This may not be painful!
- Hold for 20-30secondsCite error: Invalid
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Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Strengthening exercises:
- Stand near a table with the blessed leg, with a resistance band around the ankle.
He must keep his back and knee straight. Slowly move you leg away from the table.Cite error: Invalid<ref>tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid<ref>tag; name cannot be a simple integer. Use a descriptive title - A variant: the patient sits down on a chair with the resistance band above the knee.
Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
Resources
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add appropriate resources here
Clinical Bottom Line[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
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References[edit | edit source]
1. Tonsoline, P.A., chronic adductor tendinitis in a female swimmer, Buffalo Physical Therapy and Sports Care Services, Williamsville, NY 14221, J Orthop Sports Phys Ther. 1993 Nov;18(5):629-33.
(http://www.ncbi.nlm.nih.gov/pubmed/8268966)
(http://www.jospt.org/issues/articleID.1466/article_detail.asp)
Level of evidence: C
2. http://www.sportnetdoc.com/injury/09-06.htm; http://www.sportnetdoc.com/injury/09-03.htm
Level of evidence: D
see adding references tutorial.
