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Adductor Strain Differential Diagnoses

  • Author: Marlon P Rimando, MD; Chief Editor: Consuelo T Lorenzo, MD  more...
Updated: Feb 10, 2016

Diagnostic Considerations

Diagnostic considerations include the following:

  • Iliopsoas bursitis
  • Iliopsoas tendinitis
  • Rectus femoris tendinitis
  • Urologic disorders
  • Sacroiliac dysfunction
  • Nerve entrapment
  • Malignant/nonmalignant tumors
  • Sportsman's hernia
  • Avulsion fracture
  • Hip disorders (eg, osteoarthritis [OA], degenerative joint disease [DJD], slipped capital femoral epiphysis [SCFE])
  • Gastrointestinal disorders
  • Sexually transmitted diseases
  • Gynecologic complaints

Differential Diagnoses

Contributor Information and Disclosures

Marlon P Rimando, MD Assistant Clinical Professor, Department of Medicine, University of Hawaii, John A Burns School of Medicine

Marlon P Rimando, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, National Strength and Conditioning Association

Disclosure: Nothing to disclose.


Bruce B Fry, DO Director, Division of Physical Medicine and Rehabilitation, Knoxville Orthopedic Clinic, St Mary's Hospital

Bruce B Fry, DO is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, North American Spine Society, American Society of Interventional Pain Physicians, International Spine Intervention Society

Disclosure: Nothing to disclose.

Robert Brunner, MD Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine

Robert Brunner, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Physiatric Association of Spine, Sports and Occupational Rehabilitation, American Medical Association, Southern Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD Medical Director, Senior Products, Central North Region, Humana, Inc

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.


Michael T Andary, MD, MS Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Martin K Childers, DO, PhD Associate Professor, Department of Neurology, Wake Forest University Health Services

Martin K Childers, DO, PhD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Congress of Rehabilitation Medicine, American Osteopathic Association, Christian Medical & Dental Society, and Federation of American Societies for Experimental Biology

Disclosure: Allergan pharma Consulting fee Consulting

Francisco Talavera, PharmD, PhD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

  1. Feeley BT, Powell JW, Muller MS, et al. Hip injuries and labral tears in the national football league. Am J Sports Med. 2008 Nov. 36(11):2187-95. [Medline].

  2. Hanna CM, Fulcher ML, Elley CR, et al. Normative values of hip strength in adult male association football players assessed by handheld dynamometry. J Sci Med Sport. 2009 Jun 30. [Medline].

  3. Davis JA, Stringer MD, Woodley SJ. New insights into the proximal tendons of adductor longus, adductor brevis and gracilis. Br J Sports Med. 2011 Oct 17. [Medline].

  4. Hureibi KA, McLatchie GR. Groin pain in athletes. Scott Med J. 2010 May. 55(2):8-11. [Medline].

  5. LeCroy CM, Reedy MK, Seaber AV. Limited sarcomere extensibility and strain injury in rabbit skeletal muscle. Trans Orthop Res Soc. 1989. 14:316.

  6. Estwanik JJ, Sloane B, Rosenberg MA. Groin Strain and other Possible Causes of Groin Pain. Sports Med. 1990. 18:59-65.

  7. Ziprin P, Williams P, Foster ME. External oblique aponeurosis nerve entrapment as a cause of groin pain in the athlete. Br J Surg. 1999 Apr. 86(4):566-8. [Medline].

  8. Rassner L. Lumbar plexus nerve entrapment syndromes as a cause of groin pain in athletes. Curr Sports Med Rep. 2011 Mar-Apr. 10(2):115-20. [Medline].

  9. Ryan J, DeBurca N, Mc Creesh K. Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med. 2014 Jul. 48(14):1089-96. [Medline].

  10. Serner A, Tol JL, Jomaah N, et al. Diagnosis of Acute Groin Injuries: A Prospective Study of 110 Athletes. Am J Sports Med. 2015 Aug. 43 (8):1857-64. [Medline].

  11. Lovell G. The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport. 1995. 27:76-79.

  12. Renstrom P, Peterson L. Groin injuries in athletes. Br J Sports Med. 1980 Mar. 14(1):30-6. [Medline]. [Full Text].

  13. Kalebo P, Karlsson J, Sward L. Ultrasonography of chronic tendon injuries in the groin. Am J Sports Med. 1992 Nov-Dec. 20(6):634-9. [Medline].

  14. Briggs RC, Kolbjornsen PH, Southall RC. Osteitis pubis, Tc-99m MDP, and professional hockey players. Clin Nucl Med. 1992 Nov. 17(11):861-3. [Medline].

  15. Falvey EC, King E, Kinsella S, Franklyn-Miller A. Athletic groin pain (part 1): a prospective anatomical diagnosis of 382 patients-clinical findings, MRI findings and patient-reported outcome measures at baseline. Br J Sports Med. 2015 Nov 30. [Medline].

  16. Dahan R. Rehabilitation of Muscle-Tendon Injuries to the Hip, Pelvis, and Groin Areas. Vol 5. 1997:326-333.

  17. DePalma B, Prentice WE, eds. Rehabilitation of groin, hip, and thigh injuries. In: Rehabilitation Techniques in Sports Medicine. 3rd ed. 1999:411-443.

  18. Lynch SA, Renstrom PA. Groin injuries in sport: treatment strategies. Sports Med. 1999 Aug. 28(2):137-44. [Medline].

  19. Swain R, Snodgrass S. Managing groin pain: even when the cause is not obvious. Phys Sports Med. 1995. 23(11):55-66.

  20. Weir A, Jansen JA, van de Port IG, Van de Sande HB, Tol JL, Backx FJ. Manual or exercise therapy for long-standing adductor-related groin pain: a randomised controlled clinical trial. Man Ther. 2011 Apr. 16(2):148-54. [Medline].

  21. Weir A, Jansen J, van Keulen J, Mens J, Backx F, Stam H. Short and mid-term results of a comprehensive treatment program for longstanding adductor-related groin pain in athletes: a case series. Phys Ther Sport. 2010 Aug. 11(3):99-103. [Medline].

  22. Renstrom PA. Tendon and muscle injuries in the groin area. Clin Sports Med. 1992 Oct. 11(4):815-31. [Medline].

  23. Schilders E, Talbot JC, Robinson P, et al. Adductor-related groin pain in recreational athletes: role of the adductor enthesis, magnetic resonance imaging, and entheseal pubic cleft injections. J Bone Joint Surg Am. 2009 Oct. 91(10):2455-60. [Medline].

  24. Akermark C. Surgery of the adductor longus. In: Proceedings of the American Academy of Orthopaedic Sports Medicine. Lake Tahoe:. 1982.

  25. Neuhaus P, Gabriel T, Maurer W. [Adductor insertion tendopathy, operative therapy and results]. Helv Chir Acta. 1983 Jan. 49(5):667-70. [Medline].

  26. Randin EL, Simon SR, Rose RM. Practical Biomechanics for the Orthopaedic Surgeon. NY:. John Wiley & Sons Inc. 1979:165.

  27. Martens MA, Hansen L, Mulier JC. Adductor tendinitis and musculus rectus abdominis tendopathy. Am J Sports Med. 1987 Jul-Aug. 15(4):353-6. [Medline].

  28. Schlegel TF, Bushnell BD, Godfrey J, et al. Success of nonoperative management of adductor longus tendon ruptures in National Football League athletes. Am J Sports Med. 2009 Jul. 37(7):1394-9. [Medline].

  29. Glik JM. Muscle strains: prevention and treatment. In: The Physician and Sportsmedicine. Vol 11. 1980:73-77.

  30. Upton PA, Noakes TD, Juritz JM. Thermal pants may reduce the risk of recurrent hamstring injuries in rugby players. Br J Sports Med. 1996 Mar. 30(1):57-60. [Medline].

  31. Hrysomallis C. Hip adductors' strength, flexibility, and injury risk. J Strength Cond Res. 2009 Aug. 23(5):1514-7. [Medline].

  32. Wiktorsson-Moller M, Oberg B, Ekstrand J. Effects of warming up, massage, and stretching on range of motion and muscle strength in the lower extremity. Am J Sports Med. 1983 Jul-Aug. 11(4):249-52. [Medline].

Lateral lunge.
Lateral lunges.
Lateral lunges.
Lateral lunges.
Lateral lunges.
X lunges. Starting position.
X lunges.
X lunges. Back to the starting position.
X lunges.
Hip flexor stretch.
Hip flexor stretch, isolation of the rectus femoris.
Elastic bandage applied to give pain relief from an adductor strain.
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