Adductor Longus and Adductor Brevis Trigger Points

Introduction

The adductor longus and adductor brevis are key muscles of the inner thigh that play a crucial role in hip adduction, stability, and gait. Trigger points in these muscles can cause pain in the groin, medial thigh, and even the knee, often mimicking conditions like hip joint dysfunction or nerve entrapment. Proper identification and treatment of trigger points in these muscles can significantly improve mobility and reduce discomfort.

Name and Area

  • Name: Adductor Longus and Adductor Brevis

  • Area: Medial thigh, running from the pubic bone to the femur.

    • Adductor Longus: More superficial and longer, spanning from the pubis to the middle of the femur.

    • Adductor Brevis: Lies deeper, originating from the pubis and inserting onto the upper femur.

Indications

Adductor longus and brevis trigger points may contribute to:

  • Inner Thigh Pain (especially near the groin)

  • Groin Pain that Radiates Toward the Knee

  • Hip Joint Discomfort During Walking or Running

  • Pain During Side-to-Side Movements (e.g., pivoting, cutting sports like soccer or basketball)

  • Difficulty Sitting Cross-Legged or Prolonged Sitting Pain

  • Medial Knee Pain Without Apparent Knee Injury

Pain may be felt more prominently during activity or when stretching the inner thigh.

Muscle Action

  • Hip Adduction: Moves the thigh inward toward the midline.

  • Hip Flexion (Assists): Helps bring the thigh forward during walking.

  • Hip Rotation: Contributes to both medial and lateral rotation depending on leg position.

Signs and Symptoms

Individuals with adductor longus and brevis trigger points often report:

  • Deep, Aching Pain in the Groin or Inner Thigh

  • Pain That Increases During Running, Squatting, or Climbing Stairs

  • Inner Knee Discomfort, Often Mistaken for Knee Problems

  • Difficulty Stretching the Inner Thigh Without Sharp Pain

  • Pain While Getting Out of a Car or Moving the Legs Apart

Perpetuating Factors

Common causes of adductor longus and brevis trigger points include:

  • Sudden Side-to-Side Movements (e.g., soccer, tennis, basketball, skating)

  • Overuse from Running or Cycling Without Adequate Recovery

  • Prolonged Sitting with the Legs Abducted (e.g., sitting with knees spread apart)

  • Pelvic Asymmetry or Leg Length Discrepancy

  • Tight Hamstrings or Weak Gluteal Muscles Leading to Overcompensation

Trigger Point Referral Pattern

Trigger points in the adductor longus and brevis typically refer pain to:

  • The groin area

  • The medial thigh

  • The inner knee, sometimes confused with knee joint issues

  • The pelvic region, potentially mimicking hip joint dysfunction

Pain from these trigger points can be mistaken for obturator nerve entrapment or hip joint pathology.

Differential Diagnosis

Because adductor longus and brevis trigger points often cause groin and thigh pain, they can be mistaken for:

  • Hip Osteoarthritis

  • Obturator Nerve Entrapment

  • Groin Strain or Sports Hernia

  • Medial Meniscus Injury (Inner Knee Pain)

  • Femoral Acetabular Impingement (FAI)

  • Pelvic Floor Dysfunction

A thorough examination is necessary to differentiate between muscle-related pain and joint or nerve-related conditions.

Associated Trigger Points

Adductor longus and brevis trigger points often co-exist with:

  • Pectineus (Groin Pain and Hip Flexion Restrictions)

  • Gracilis (Pain Extending Down the Inner Leg)

  • Quadriceps (Particularly Vastus Medialis, Which Affects the Knee)

  • Iliopsoas (Hip Flexion Tightness and Discomfort)

Anatomy and Innervation

  • Adductor Longus

    • Origin: Pubis (just below the pubic crest)

    • Insertion: Middle third of the femur (linea aspera)

    • Innervation: Obturator nerve (L2–L4)

  • Adductor Brevis

    • Origin: Pubis (near the inferior ramus)

    • Insertion: Upper part of the femur (linea aspera)

    • Innervation: Obturator nerve (L2–L4)

The obturator nerve plays a key role in motor control and sensory function in the medial thigh.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify tender nodules along the medial thigh and groin.

  • Adduction Strength Tests: Assess hip adduction strength and pain response.

  • Stretching Assessment: Evaluate discomfort when stretching the inner thigh.

  • Pelvic and Hip Alignment Check: Assess for asymmetry or compensatory movement patterns.

Corrective Actions

Manual Therapy

  • Trigger Point Release: Apply sustained pressure over active trigger points.

  • Soft Tissue Mobilization: Improve mobility and reduce fascial restrictions.

Stretching

  • Butterfly Stretch: Sit with the soles of the feet together and gently press the knees downward.

  • Standing Adductor Stretch: Extend one leg to the side while keeping the other bent.

Strengthening Exercises

  • Side-Lying Hip Adduction: Lift the lower leg against resistance.

  • Adductor Squeeze with a Ball or Yoga Block: Engage inner thigh muscles for stability.

Postural and Biomechanical Adjustments

  • Check for Leg Length Discrepancy: Address with shoe inserts if needed.

  • Improve Hip Mobility: Reduce compensatory strain on the adductor muscles.

Field Details
Name & Area Adductor Longus & Adductor Brevis; Medial thigh, pubis to femur
Indications Groin pain, inner thigh pain, medial knee pain
Muscle Action Hip adduction, assists in hip flexion and rotation
Signs & Symptoms Discomfort with walking, side-to-side movements, sitting cross-legged
Perpetuating Factors Side-to-side sports, prolonged sitting, weak glutes, tight hamstrings
Trigger Point Referral Groin, medial thigh, inner knee, pelvic region
Differential Diagnosis Hip arthritis, nerve entrapment, meniscus injury, pelvic dysfunction
Associated TrPs Pectineus, gracilis, vastus medialis, iliopsoas
Anatomy & Innervation Obturator nerve (L2–L4)
Corrective Actions Manual therapy, stretching, strengthening, hip mobility improvement

Summary Table: Adductor Longus and Brevis Trigger Points

Sources:

  • Travell, J. G., & Simons, D. G. (1983). Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.). Williams & Wilkins.

  • Simons, D., & Travell, J. (1999). The Trigger Point Manual, Volume 2: The Lower Extremities. Williams & Wilkins.