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Hip

Adductor Tears

What are the hip adductor muscles?

They are a group of groin muscles that attach the pubic bone and the thigh and function to move the leg toward the midline of the body and rotate the thigh inward (internally rotate). When injured, they can be a source of pain. However, the hip joint is complex and groin pain is often caused by both bone and soft tissue injuries.

What causes an adductor tear?

An adductor tear is caused by groin strain resulting from a sudden muscle contraction such as that which might accompany a quick change in direction like pivoting, or a rapid acceleration like sprinting. This can overstretch or tear the muscles. The most common site of injury is the junction between the adductor muscle and the tendon. The adductor longus muscle is the most commonly injured muscle, which pulls the leg toward the midline.

Groin injuries are common in many sports such as ice hockey, soccer, football, tennis, gymnastics, ballet, rugby, wrestling, distance running, basketball, high-jump, and hurdling, and account for significant time off of play.  Among all sports, adductor/groin strains are the most common injury accounting for almost 25% of all hip injuries.

Risk factors include a previous hip or groin injury, age, weak muscles, muscle fatigue, decreased range of motion, and inadequate stretching of the adductor muscles. Additionally, recent research suggests there is a genetic predisposition toward hip abnormalities that contribute to adductor tears.

What are the symptoms?

Hip and groin strain and related pain account for 5-6% of all sports injuries. Groin muscle strains are graded according to their severity. A Grade 1  strain causes some pain and tenderness, but stretching and tearing are minimal. A Grade 2 strain is a partial tear that causes pain, tenderness, bruising and muscle weakness. Grade 3 is a severe tear with significant pain, bruising, loss of muscle strength, and range of motion. In the most severe cases, the athlete may experience a snapping sensation when the tendon ruptures, and a complete loss of muscle function.

How is an adductor tear diagnosed?

Dr. Jorge Chahla will review your medical history and ask you to describe the circumstances that caused the sudden onset of pain. He will perform a physical examination, test muscle strength, and may observe bruising and swelling in moderate and severe injuries. Initial x-ray imaging will help to evaluate the cause of pain and adductor strain, and rule out other possible causes of groin pain. An MRI will show increased signal at the site of injury and a possible retracted tendon (when there is a full thickness tear) and whether there is also a bony injury. Ultrasound may be employed to visualize the tendons, muscles, and ligaments.

How is an adductor tear treated?

The best results are achieved when the strain is treated within 24 to 48 hours after injury.

Most adductor strains are treated with conservative measures including rest, icing, compression, elevation, anti-inflammatory medications and after 48 hours, gentle stretching and strengthening exercises. However, progression depends upon pain. Physical therapy may be indicated. When necessary, injections under ultrasound guidance can improve the condition. Generally, healing from a grade 2 strain can take 3-6 weeks. Healing from a grade 3 rupture can take up to 4 months.

Platelet rich plasma therapy (PRP) uses your own blood to create a concentrated solution of platelets to heal muscle strains. It is a minimally invasive procedure that may be recommended along with conservative measures to treat pain and facilitate quicker return to play in athletes with grade 1 and 2 acute muscle strains.

A grade 3 tear such as a traumatic rupture of the adductor longus tendon may require surgery.  When there is also an avulsion injury, meaning the tendon is torn along with a piece of bone, surgery to reattach the tendon (and bone) may be considered. Surgery many be recommended for active and professional athletes when conservative measures fail to relieve pain, or if time lost to conservative treatment is too costly to the athlete. The procedure involves reattaching the muscle to the bone.

The hip is very complex. Dr. Jorge Chahla is an expert in the complexities of hip injuries. Located in Chicago, Illinois, Dr. Chahla is an internationally recognized expert in the treatment of knee and hip conditions and all sports injuries. Dr. Chahla is a renowned authority in the use of biological treatments that promote healing including platelet rich plasma (PRP), bone marrow aspirate (BMA & BMAC), and stem cells. Contact Dr. Chahla to receive the correct diagnosis and compassionate state-of-the-art care.

 


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