Adductor Magnus Trigger Points

Introduction

The adductor magnus is the largest and deepest of the adductor muscles, playing a critical role in hip stability, adduction, and power generation during walking, running, and squatting. When trigger points develop in this muscle, they can cause deep inner thigh pain, groin discomfort, and even pain radiating to the knee and buttock. Because of its broad attachment points, adductor magnus trigger points can be mistaken for hip joint dysfunction, hamstring issues, or nerve entrapment.

Name and Area

  • Name: Adductor Magnus

  • Area: Medial thigh, spanning from the pubis and ischial tuberosity to the femur.

Indications

Adductor magnus trigger points may contribute to:

  • Deep Groin and Inner Thigh Pain

  • Pain in the Ischial Tuberosity (Sitting Bone)

  • Referred Pain to the Medial Knee

  • Stiffness or Discomfort During Hip Flexion

  • Difficulty with Walking, Running, or Climbing Stairs

  • Pain When Sitting on Hard Surfaces

Pain can feel deep and diffuse, often described as an ache rather than a sharp pain.

Muscle Action

  • Hip Adduction: Brings the thigh inward toward the body’s midline.

  • Hip Extension (Posterior Fibers): Assists in pulling the thigh backward.

  • Hip Flexion (Anterior Fibers): Assists in forward thigh movement.

  • Stabilization of the Hip and Pelvis: Helps control lateral movement.

This dual function makes it both a hip flexor and an extensor, depending on which portion of the muscle is engaged.

Signs and Symptoms

Patients with adductor magnus trigger points often report:

  • Pain Deep in the Inner Thigh or Groin

  • Pain at the Ischial Tuberosity (Common in Cyclists and Runners)

  • Medial Knee Pain that Feels Like a Ligament Issue

  • Stiffness When Moving from Sitting to Standing

  • Difficulty Spreading the Legs Apart (Hip Abduction Restriction)

Pain often worsens after prolonged sitting or intense lower body workouts.

Perpetuating Factors

Common causes of adductor magnus trigger points include:

  • Sudden Side-to-Side Movements (Common in Soccer, Tennis, or Basketball)

  • Long-Distance Running or Cycling (Overuse of Inner Thigh Muscles)

  • Prolonged Sitting with Legs Crossed or in a Wide Stance

  • Heavy Squats or Deadlifts Without Proper Hip Mobility

  • Pelvic Imbalances (Such as a Leg Length Discrepancy or Hip Tilt)

Trigger Point Referral Pattern

Trigger points in the adductor magnus can refer pain to:

  • The deep inner thigh and groin

  • The ischial tuberosity (sitting bone)

  • The medial knee

  • The lower buttock region

This referral pattern can sometimes mimic hamstring injuries or sciatic nerve pain.

Differential Diagnosis

Because adductor magnus trigger points can cause pain in multiple areas, they may be mistaken for:

  • Hamstring Tendinopathy (Pain at the ischial tuberosity)

  • Hip Osteoarthritis (Stiffness and pain in the groin and medial thigh)

  • Medial Collateral Ligament (MCL) Injury (Inner knee pain)

  • Sciatica or Piriformis Syndrome (Pain in the lower buttock)

  • Pelvic Floor Dysfunction

A thorough assessment of muscle tightness, strength, and movement patterns can help differentiate between these conditions.

Associated Trigger Points

Adductor magnus trigger points often co-exist with:

  • Hamstring (Biceps Femoris and Semimembranosus) – Referral Pain to the Ischial Tuberosity

  • Gluteus Maximus – Hip Stability and Posterior Chain Function

  • Quadriceps (Vastus Medialis) – Inner Knee Pain

  • Iliopsoas – Hip Flexion Tightness and Discomfort

Anatomy and Innervation

  • Origin:

    • Adductor Part: Inferior pubic ramus and ischial ramus

    • Hamstring Part: Ischial tuberosity

  • Insertion:

    • Adductor Part: Linea aspera of the femur

    • Hamstring Part: Adductor tubercle of the femur

  • Innervation:

    • Adductor Part: Obturator nerve (L2–L4)

    • Hamstring Part: Tibial portion of the sciatic nerve (L4–S1)

This dual innervation explains its mixed function as both a hip adductor and extensor.

Patient Examination

A comprehensive examination should include:

  • Palpation: Identify taut bands and tender spots along the medial thigh and near the ischial tuberosity.

  • Adduction Strength Testing: Evaluate hip adductor function and any pain reproduction.

  • Stretching Response: Check for discomfort when performing adductor stretches.

  • Postural Assessment: Look for pelvic tilt or asymmetry.

Corrective Actions

Manual Therapy

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

  • Soft Tissue Mobilization: Loosen fascia and improve blood flow.

Stretching

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

  • Standing Lateral Lunge Stretch: Step to the side while keeping the opposite leg straight.

Strengthening Exercises

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

  • Copenhagen Plank: A side plank with the top leg supported on a bench to engage the adductors.

Postural and Movement Adjustments

  • Hip Mobility Drills: Improve joint range of motion to prevent excessive adductor tightness.

  • Check for Pelvic Imbalances: Address muscle asymmetries that may overload the adductor magnus.

Field Details
Name & Area Adductor Magnus; Medial thigh, spanning pubis to femur
Indications Groin pain, inner thigh discomfort, ischial tuberosity pain
Muscle Action Hip adduction, extension (posterior fibers), flexion (anterior fibers)
Signs & Symptoms Deep inner thigh pain, medial knee pain, difficulty sitting or walking
Perpetuating Factors Running, cycling, heavy squats, side-to-side sports, prolonged sitting
Trigger Point Referral Inner thigh, groin, medial knee, lower buttock
Differential Diagnosis Hamstring strain, hip osteoarthritis, MCL injury, sciatica
Associated TrPs Hamstrings, gluteus maximus, quadriceps, iliopsoas
Anatomy & Innervation Obturator nerve (L2–L4), sciatic nerve (L4–S1)
Corrective Actions Manual therapy, stretching, strengthening, pelvic alignment correction

Summary Table: Adductor Magnus 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.