Adductor Strains in Athletes.
Malachy P McHugh, Stephen J Nicholas, Timothy F Tyler
PMID 37020448WHAT IT FOUND
Adductor strains require distinguishing muscle from tendon injury, as treating a tendon issue as a muscle strain is counterproductive.
Rehabilitation should progress from short-length isometrics to long-length eccentrics. Return-to-play testing must assess adductor strength unilaterally, as bilateral squeeze tests are invalid.
Key findings
01Adductor strains can be differentiated from tendon injuries by symptom timing, location of tenderness, and provocation, with resisted adduction being more specific than passive stretch or squeeze tests.
02Rehabilitation should progress from low-intensity isometric contractions at short muscle lengths to high-intensity eccentric contractions at long muscle lengths, with caution required when introducing isotonic exercises due to reinjury risk during the transition phase.
03Bilateral adductor squeeze tests are invalid for assessing strength symmetry due to Newton's third law and the bilateral deficit phenomenon; unilateral testing with proper stabilization is required.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative review, not a systematic review or clinical trial, so it lacks a defined search strategy and may reflect author bias. The review explicitly states there are no randomized clinical trials testing different treatment programs for adductor strains, so recommendations are based on described protocols rather than tested efficacy. The Copenhagen exercise is described as primarily beneficial for prevention in healthy adults, with its role in rehabilitation being less established.
Declared interests
Not reported.
The easy way to misread this
Do not use bilateral adductor squeeze tests to assess strength symmetry or readiness for return to play. These tests are invalid because Newton's third law forces equal reaction on both sides and the bilateral deficit phenomenon alters force generation, meaning they cannot detect unilateral weakness.