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
©
2009 Cris LaBossiere Rhino Fitness
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