Adductor tendinopathy: Definition, Uses, and Clinical Overview

Posted on February 27, 2026 | by drhip

Adductor tendinopathy Introduction (What it is)

Adductor tendinopathy is pain and dysfunction that comes from irritation or degeneration of an adductor tendon near the groin.
It most often involves the adductor longus tendon where it attaches to the pubic bone.
People commonly describe it as “groin pain,” especially with running, cutting, or squeezing the legs together.
In orthopedics and sports medicine, it is used as a clinical diagnosis within the broader category of athletic groin pain.

Why Adductor tendinopathy used (Purpose / benefits)

In clinical practice, the term Adductor tendinopathy is used to describe a specific and common source of groin pain: the adductor tendon and its attachment (the tendon “enthesis”) near the front of the pelvis. Using this diagnosis serves several purposes:

Clarifies the likely pain generator. The groin has multiple structures packed into a small area (hip joint, tendons, abdominal wall, nerves). Labeling a condition as adductor tendon–related helps narrow the focus.
Guides evaluation. Clinicians can prioritize history details and exam maneuvers that stress the adductor tendon, while also screening for other causes of groin pain.
Frames management options. Many care pathways differ depending on whether pain is thought to be tendon-related versus joint-related (for example, hip osteoarthritis or femoroacetabular impingement).
Improves communication. A shared term helps patients, physical therapists, athletic trainers, and physicians coordinate around the same working diagnosis.
Sets expectations about pacing. Tendon problems often behave differently than acute muscle strains. Tendinopathy can be more persistent and influenced by cumulative load rather than a single injury event.

Importantly, Adductor tendinopathy is a descriptive diagnosis, not a single test result. It is usually determined by a combination of symptoms, physical exam findings, and—when needed—imaging or additional testing to rule out other conditions.

Indications (When orthopedic clinicians use it)

Orthopedic and sports medicine clinicians commonly consider Adductor tendinopathy in situations such as:

Groin pain that is worse with adduction (bringing the leg toward the midline), cutting, pivoting, sprinting, or kicking
Pain near the pubic bone or upper inner thigh, sometimes described as “high groin” discomfort
Tenderness over the adductor tendon origin and pain with resisted adductor testing on exam
Symptoms that developed gradually with training load changes, or that persist after an apparent “groin strain”
Athletes in field sports (soccer, hockey, football), runners, or active individuals with repetitive hip loading
Recurrent groin pain with activity despite normal or near-normal basic hip range of motion

Contraindications / when it’s NOT ideal

Because Adductor tendinopathy is a diagnosis (not a medication or device), “contraindications” mainly mean situations where another diagnosis is more likely or must be considered first, or when certain commonly discussed interventions may not fit the case. Examples include:

Red flags or systemic symptoms (fever, unexplained weight loss, severe night pain): these prompt evaluation for infection, inflammatory disease, or other non-mechanical causes
Acute traumatic injuries with significant bruising, sudden loss of function, or a clear “pop,” where an acute muscle/tendon tear or avulsion may be more likely
Hip joint–driven pain patterns, such as prominent pain with hip flexion/rotation, mechanical catching/locking, or significant stiffness, which may suggest intra-articular pathology (varies by clinician and case)
Inguinal or abdominal wall conditions, including suspected hernia or “athletic pubalgia” patterns, where pain localizes more to the lower abdominal wall or inguinal canal region (terminology and definitions vary)
Stress fracture concern (for example, femoral neck or pubic ramus stress injury) in higher-risk contexts, which may require different imaging priorities and activity modification strategies
Nerve-related pain (burning, tingling, numbness) that may point toward lumbar spine, pelvic, or peripheral nerve involvement
When considering procedures (such as injections), skin infection at the site, bleeding risk factors, or other procedure-specific concerns may make an intervention less suitable (varies by clinician and case)

How it works (Mechanism / physiology)

Mechanism and tendon biology (high level)

A tendon connects muscle to bone. In tendinopathy, the tendon becomes painful and less tolerant to load. Modern understanding often describes tendinopathy as a load-related tendon disorder, where repeated stress over time outpaces the tendon’s ability to adapt.

In Adductor tendinopathy, the adductor tendon—commonly the adductor longus—is stressed during activities that demand:

Rapid direction changes
Powerful hip adduction (squeezing the legs together)
Stabilization of the pelvis during running, skating, or kicking
Eccentric control (tendon resisting lengthening under load)

Symptoms may reflect a combination of altered tendon structure, sensitized pain pathways, and local tissue irritation at the tendon or its attachment. The exact balance of these factors can vary by clinician and case.

Relevant hip and groin anatomy

Key structures involved or commonly discussed include:

Adductor longus, adductor brevis, and adductor magnus muscles/tendons: inner-thigh muscles that pull the leg toward midline and help stabilize the pelvis
Pubic symphysis: the joint at the front of the pelvis; nearby tissues can refer pain into the groin
Rectus abdominis and abdominal wall structures: adjacent anatomy that may contribute to overlapping pain presentations
Hip joint (ball-and-socket): can refer pain to the groin and may coexist with tendon conditions
Iliopsoas tendon and hip flexors: another common source of anterior hip/groin pain that can mimic adductor symptoms

Because the groin is a convergence point for multiple tissues, clinicians often use exam findings and, when appropriate, imaging to differentiate tendon pain from joint or abdominal wall sources.

Onset, course, and reversibility

Adductor tendinopathy often has a gradual onset, especially when training volume, intensity, or frequency increases. Some cases follow an acute strain-like event and then become persistent. Recovery and symptom duration vary by individual, severity, sport demands, and associated conditions. “Reversibility” is not like a switch; instead, symptoms often improve as the tendon’s load tolerance improves over time (varies by clinician and case).

Adductor tendinopathy Procedure overview (How it’s applied)

Adductor tendinopathy is not a single procedure. It is a diagnostic label and clinical framework used to evaluate and manage a pattern of groin pain. A typical high-level workflow may include:

Evaluation / history – Location of pain (high groin vs inner thigh vs hip crease)
– Activity triggers (cutting, sprinting, kicking, skating, getting out of a car)
– Timeline (sudden vs gradual), training changes, prior injuries
– Associated symptoms (clicking, catching, numbness, abdominal symptoms)
Physical exam – Palpation for tenderness along the adductor origin and tendon
– Strength testing, especially resisted hip adduction
– Range-of-motion assessment of the hip joint
– Screening for abdominal wall, pubic symphysis, lumbar spine, and neurologic contributors
Testing / imaging (when needed) – Imaging is not always required for initial recognition, but may be used when the diagnosis is unclear, symptoms persist, or alternative diagnoses must be excluded.
– Common options include ultrasound or MRI for tendon assessment (choice varies by clinician and case).
Initial management discussion (general) – Education about tendon load tolerance and symptom drivers
– Rehabilitation-oriented planning, often centered on progressive strengthening and functional retraining (specifics vary)
Immediate checks – Confirmation that concerning features are not present (for example, red flags or severe functional loss)
– Baseline measures for monitoring (pain behavior, function, sport participation tolerance)
Follow-up – Reassessment of function, symptoms, and contributing movement patterns
– Consideration of additional testing or interventions if progress is limited (varies by clinician and case)

Types / variations

Adductor tendinopathy can be described in several practical ways. These “types” are not always strict categories, but they help clinicians communicate.

By location
Proximal adductor tendinopathy: near the pubic bone (commonly discussed)
Mid-tendon pain: along the inner thigh, less common than proximal symptoms
Enthesopathy/enthesitis language: sometimes used when the tendon-bone attachment is emphasized (terminology varies)
By time course
Acute-on-chronic: a flare on top of longer-standing symptoms
Persistent/chronic: symptoms lasting weeks to months (definitions vary)
By primary driver
Load-related overuse pattern: gradual onset with training changes
Post-strain persistence: symptoms that continue after an apparent muscle strain
By associated conditions (mixed presentations)
Adductor-related groin pain with pubic symphysis involvement: overlap can occur because of shared anatomy and forces across the pelvis
Coexisting hip joint pathology: adductor pain may coexist with femoroacetabular impingement (FAI), labral issues, or early osteoarthritis (varies by clinician and case)
Overlap with abdominal wall/inguinal pain patterns: sometimes discussed in “athletic groin pain” frameworks, where multiple structures contribute
By clinical purpose
Diagnostic label: used to explain symptoms and guide evaluation
Rehabilitation target: used to structure exercise progression and return-to-sport planning
Procedure-planning context: occasionally used when discussing image-guided injections or surgical options in select cases (varies by clinician and case)

Pros and cons

Pros:

Provides a clear, anatomy-based explanation for a common pattern of groin pain
Helps distinguish tendon-related pain from hip joint or abdominal wall causes
Supports a structured evaluation (history, exam, selective imaging)
Aligns well with rehabilitation models focused on restoring tendon load tolerance
Useful for communication among clinicians, therapists, and patients
Encourages consideration of contributing factors like training load and movement demands

Cons:

Groin pain is complex; adductor symptoms can overlap with other conditions
Imaging findings and symptoms do not always match neatly in tendons
The term can be used inconsistently (tendinitis vs tendinopathy vs enthesopathy)
Coexisting hip or pelvic issues can make diagnosis and monitoring more complicated
Symptom timelines vary widely, which can be frustrating for patients and teams
Some cases require broader workup to avoid missing non-tendon causes

Aftercare & longevity

Because Adductor tendinopathy is a condition rather than a one-time treatment, “aftercare” usually refers to how symptoms and function are monitored over time and what factors tend to influence recovery and recurrence risk.

Common factors that affect outcomes include:

Severity and duration at presentation: long-standing symptoms may take longer to settle (varies by clinician and case)
Activity demands: cutting/pivoting sports and high-volume running can place higher repetitive loads on the adductors
Load management and progression: tendon symptoms often fluctuate with spikes in training volume or intensity
Strength, coordination, and pelvic control: adductors work with the abdominal wall, hip abductors, and trunk to stabilize movement
Hip mobility and coexisting hip joint conditions: restricted motion or intra-articular pain sources may alter mechanics
Overall health factors: sleep, nutrition, and systemic inflammatory conditions can influence recovery capacity (varies by individual)
Follow-up and reassessment: ongoing monitoring can help confirm the working diagnosis and adjust the plan if symptoms don’t follow an expected course (varies by clinician and case)

Longevity, in this context, means how durable symptom improvement is once function returns. Durability often depends on whether the tendon’s load tolerance and contributing movement patterns have been addressed, and whether future load increases are gradual and sustainable (details vary by clinician and case).

Alternatives / comparisons

Because “groin pain” has many possible sources, the main alternatives are often alternative diagnoses and alternative management approaches.

Diagnostic comparisons (what else it could be)

Adductor tendinopathy vs adductor muscle strain: strains are often more sudden with acute pain and functional loss; tendinopathy is often more gradual and load-related, though overlap occurs
Adductor tendinopathy vs hip joint pathology: intra-articular hip problems can present as groin pain and may be associated with clicking, catching, or motion-related pain (varies)
Adductor tendinopathy vs iliopsoas-related pain: pain may localize more to the front of the hip crease and be triggered by hip flexion activities
Adductor tendinopathy vs pubic symphysis pain: pain may be more central at the pubic bone with tenderness at the symphysis and pain across multiple tests
Adductor tendinopathy vs inguinal/abdominal wall pain patterns: pain may be more related to the inguinal canal region or abdominal wall loading (terminology varies)
Adductor tendinopathy vs stress fracture: bony stress injuries can mimic groin pain and may require imaging for confirmation

Management comparisons (high level)

Observation/monitoring vs active rehabilitation: mild or improving cases may be monitored, while persistent functional limitations often lead to structured rehabilitation (varies by clinician and case)
Physical therapy-focused care vs injection-based options: rehabilitation aims to improve strength and load tolerance; injections may be considered in select cases to help with pain and participation in rehab, but the choice depends on diagnosis certainty and clinician judgment (varies)
Imaging choices (ultrasound vs MRI): ultrasound can assess superficial tendon structure dynamically; MRI can evaluate deeper structures and rule out other causes. Selection depends on the question being asked and local resources (varies by clinician and case).
Non-surgical vs surgical pathways: most tendon-related groin pain is managed non-surgically; surgical approaches may be discussed only in specific, persistent, well-defined cases or when other pathology is present (varies by clinician and case)

Adductor tendinopathy Common questions (FAQ)

Q: What does Adductor tendinopathy feel like?
It often feels like aching or sharp discomfort in the high inner thigh or groin, especially with squeezing the legs together, sprinting, or changing direction. Some people notice pain near the pubic bone when getting in and out of a car or during quick pivots. Symptoms can fluctuate with activity load.

Q: Is Adductor tendinopathy the same as a groin strain?
They are related but not identical. A groin strain typically refers to an acute muscle injury, often with a sudden onset during a specific movement. Adductor tendinopathy usually emphasizes tendon-related pain that is more persistent or load-related, though an acute strain can transition into a tendinopathy-like pattern in some cases.

Q: How do clinicians diagnose Adductor tendinopathy?
Diagnosis usually combines symptom history with a focused physical exam, including tenderness at the adductor origin and pain with resisted adduction. Imaging is not always required, but may be used when symptoms persist, when the diagnosis is uncertain, or when other causes of groin pain must be ruled out. The exact approach varies by clinician and case.

Q: What imaging tests are used, and what can they show?
Ultrasound and MRI are commonly used when imaging is needed. Ultrasound can evaluate tendon appearance and guide injections in some settings, while MRI can also assess adjacent structures like the pubic symphysis, hip joint, and bone marrow. Imaging findings must be interpreted alongside symptoms because tendon changes can exist with or without pain.

Q: How long does Adductor tendinopathy last?
Time course varies. Some cases improve over weeks, while others last longer—especially if symptoms have been present for months or if activity demands remain high. Recovery is often described in terms of gradually improving load tolerance and function rather than a single “cure date.”

Q: What treatments are commonly discussed for Adductor tendinopathy?
Commonly discussed options include education about load-related symptoms, progressive strengthening and functional rehabilitation, and addressing contributing movement patterns. Some cases involve medications for pain control, or image-guided injections, depending on the overall diagnosis and goals (varies by clinician and case). Surgical options are typically reserved for select situations and require careful diagnostic confirmation.

Q: Is it safe to keep working out, running, or playing sports with this condition?
This depends on symptom severity, sport demands, and how symptoms behave during and after activity. Clinicians often use function and symptom response to guide whether activity is continued, modified, or paused. Decisions are individualized and vary by clinician and case.

Q: Will I need crutches or restrictions on weight-bearing?
Adductor tendinopathy itself does not automatically require crutches. However, if pain is severe, function is significantly limited, or another diagnosis is suspected (such as a stress injury), temporary restrictions may be considered while evaluation continues. The need for weight-bearing limits varies by clinician and case.

Q: How much does evaluation or treatment typically cost?
Costs vary widely by region, clinic type, imaging use, and insurance coverage. A basic evaluation is usually different in cost from an evaluation plus imaging or procedures. For many people, rehabilitation visits are a significant part of overall cost, and pricing models differ across systems.

Q: When do clinicians worry it’s something other than Adductor tendinopathy?
Concern increases when symptoms include fever, unexplained weight loss, severe night pain, neurologic symptoms (numbness/tingling), inability to bear weight, or a clear traumatic event with major weakness or bruising. Persistent pain that does not match expected patterns may also prompt reconsideration of the diagnosis and additional testing. In complex groin pain, overlapping conditions are possible, so reassessment is common.