Adductor Tears Treatment Options

What are adductor tears?

Adductor tears, also known as groin strains or pulls, are common injuries involving the muscles of the inner thigh. These tears typically occur due to sudden or excessive stress placed on the adductor muscles, often during activities that involve rapid changes in direction, acceleration, or deceleration. Common causes include overuse, direct trauma, poor conditioning, or sudden movements during sports activities such as soccer, hockey, or sprinting. Symptoms of adductor tears include pain, swelling, bruising, decreased range of motion, and weakness in the inner thigh or groin region. Diagnosis involves a physical examination, often supplemented by imaging studies such as ultrasound or MRI to assess the extent of muscle damage.

What nonoperative treatment options are available?

The treatment of adductor tears aims to alleviate pain, reduce inflammation, restore muscle function, and prevent recurrent injury through a combination of conservative measures, physical therapy interventions, and, in severe cases, surgical intervention. Treatment options for adductor tears include:

1. Rest and Activity Modification: Temporary cessation of activities that exacerbate groin pain, such as running, cutting, jumping, or kicking, is essential to prevent further muscle damage and promote tissue healing. Individuals may need to modify their training regimens, reduce training intensity, or cross-train with low-impact activities to maintain cardiovascular fitness and muscle conditioning while allowing the injured adductor muscles to recover.
2. Ice Therapy: Application of ice packs or cold therapy modalities to the affected groin region can help reduce pain, swelling, and inflammation associated with adductor tears. Ice therapy should be applied for 15-20 minutes at a time, several times a day, during the acute phase of injury to facilitate vasoconstriction, minimize tissue edema, and alleviate discomfort.
3. Compression and Elevation: Compression garments, elastic bandages, or compression wraps may be utilized to provide external support, reduce swelling, and promote lymphatic drainage in the affected groin area. Elevation of the lower extremity above heart level can help minimize edema and facilitate venous return, particularly during periods of rest or immobilization.
4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Oral NSAIDs such as ibuprofen or naproxen may be prescribed to alleviate pain, reduce inflammation, and improve functional tolerance during the acute phase of adductor tears. NSAIDs should be used judiciously and under medical supervision to minimize gastrointestinal side effects, renal toxicity, and adverse drug interactions.
5. Physical Therapy: A structured physical therapy program focusing on progressive rehabilitation exercises, manual therapy techniques, and neuromuscular retraining can help restore muscle strength, flexibility, and functional mobility in individuals with adductor tears. Physical therapists may prescribe specific exercises targeting the adductor muscles, hip stabilizers, core muscles, and lower extremity kinetic chain to improve biomechanical efficiency and reduce the risk of recurrent injury.
6. Modalities: Therapeutic modalities such as ultrasound, electrical stimulation, laser therapy, or dry needling may be incorporated into the rehabilitation program to enhance tissue healing, reduce pain, and improve soft tissue extensibility. These modalities can complement exercise-based interventions and accelerate the recovery process in individuals with adductor tears.

What operative treatment options are available?

In cases of severe adductor tears with significant muscle disruption, tendon avulsion, or refractory symptoms despite conservative management, surgical intervention may be considered to repair the torn muscle fibers, reattach avulsed tendons, or address associated intra-articular or intra-abdominal pathology. Surgical techniques for adductor tears may include:

1. Adductor Tenotomy: Surgical release or lengthening of the adductor muscle tendons may be performed to alleviate chronic muscle tightness, improve hip joint mobility, and reduce the risk of recurrent adductor tears. Tenotomy procedures can be performed arthroscopically or through open surgical approaches, depending on the extent of tendon involvement.
2. Tendon Repair: Direct repair of torn or avulsed adductor muscle tendons may be indicated in cases of acute traumatic injuries or complete tendon ruptures. Surgical techniques such as tendon reattachment, suture fixation, or anchor placement may be utilized to restore tendon continuity, optimize muscle function, and facilitate rehabilitation.
3. Muscle Flap Reconstruction: In cases of extensive adductor muscle tears or chronic avulsion injuries, muscle flap reconstruction procedures using autologous tissue grafts or allografts may be performed to restore muscle bulk, strength, and function. Muscle flap reconstruction aims to reconstruct the adductor muscle complex, reinforce the muscle-tendon unit, and promote tissue healing while preserving neurovascular structures and joint integrity.

Surgical intervention for adductor tears requires careful preoperative evaluation, surgical planning, and postoperative rehabilitation to optimize outcomes and minimize the risk of complications. Rehabilitation protocols following surgical intervention should focus on early mobilization, progressive strengthening, and functional restoration to facilitate return to pre-injury activity levels.

What does return to activity look like?

The decision to return to sports or physical activities following an adductor tear depends on various factors, including the severity of the injury, the individual’s pain tolerance, functional capacity, and biomechanical readiness. Athletes should undergo a progressive return-to-sport protocol under the guidance of Dr. Shane J. Nho and a physical therapist, focusing on gradual reintroduction of sport-specific activities, neuromuscular training, and performance optimization. Close monitoring of symptoms, functional progression, and biomechanical efficiency is essential to prevent premature return to activity and minimize the risk of recurrent adductor tears or secondary injuries.

Dr. Shane J. Nho is a board-certified fellowship trained sports medicine orthopaedic surgeon who specializes in the treatment of adductor tears If you believe you are affected by an adductor tear, schedule a consultation today with our experienced orthopaedic care team.