Groin pain (adductor syndrome)

Abstract

Groin injuries are recognized as one of the most difficult problems in sports medicine and they are most commonly sustained in sports such as fencing, karate, and soccer. A chronic tendinitis of the adductor muscles/tendons, especially that of the adductor longus, is the most frequently diagnosed cause of groin pain and takes place near the myotendinous junction of the involved muscle. The diagnosis of the adductor syndrome is often difficult because of the wide variety of different diseases that can cause pain to the groin area. In the beginning a complete clinical examination should be performed for every patient with groin pain. Imaging techniques like ultrasonography, computed tomography, and magnetic resonance imaging are useful for diagnosing groin pain and for providing valuable information about the most suitable treatment. Sometimes even plain radiographs reveal the condition responsible for the pain at the groin area. The treatment of musculotendinous groin injuries is generally conservative. Surgical treatment in acute groin injuries is rarely indicated but should be performed if there is a complete tear of a muscle-tendon unit or if a partial rupture results in intramuscular haematoma impairing the function of the adductor complex. In chronic cases, surgical treatment is recommended if there is pathological granulation tissue inside the tendon. The devitalized tissue should be excised without any additional delay. The return to sporting activities after surgery generally takes 3 to 6 months.