Adductor Tendonitis

Introduction

The hip joint is a ball-and-socket joint where the top of the thigh bone (femur) fits into the socket of the pelvis. The hip is surrounded by many muscles that work together to move and stabilize the leg. On the inside of the thigh is a group of muscles called the hip adductors, which include the adductor longus, adductor brevis, adductor magnus, gracilis, and pectineus. These muscles are attached to the pelvis and thigh bone by strong bands of tissue called tendons. The adductor muscles pull the leg toward the body’s midline and help stabilize the pelvis during walking, running, jumping, and changing direction. They also play an important role in activities such as kicking, skating, and climbing stairs. With overuse these tendons can become inflammed and painful.

Why Does Adductor Tendonitis Develop?

Adductor tendonitis is irritation or inflammation of one or more of the adductor tendons, usually where they attach to the pelvis near the groin (Figure 1). It most often develops from overuse rather than a single injury. Repeated running, kicking, sprinting, skating, or sudden changes in direction can place excessive stress on these tendons, causing tiny areas of damage that lead to pain and inflammation. Athletes who play soccer, hockey, football, basketball, tennis, or track and field are particularly susceptible, although anyone can develop the condition. Patients typically experience a gradual onset of pain in the groin or upper inner thigh that worsens with exercise, especially when squeezing the legs together, running, pivoting, or kicking. The area may also feel stiff or tender, particularly after activity or first thing in the morning.

How is Adductor Tendonitis Diagnosed?

Doctors usually diagnose adductor tendonitis by reviewing the patient’s symptoms and performing a physical examination. Tenderness is often present where the tendon attaches to the pelvis (Figure 1), and pain is commonly reproduced when the patient squeezes their legs together against resistance or stretches the adductor muscles. Imaging studies are not always necessary if the diagnosis is straightforward. However, they may be helpful when symptoms are severe, persist despite treatment, or another injury is suspected. X-rays can help rule out fractures, arthritis, or an avulsion injury where the tendon pulls off a small piece of bone. Ultrasound can evaluate the tendon for inflammation or partial tearing, while MRI provides the most detailed images of the tendons, muscles, and surrounding structures. MRI is particularly useful when doctors need to distinguish adductor tendonitis from other causes of groin pain, such as a muscle tear, sports hernia, hip joint problem, or stress fracture.

Treatment of Adductor Tendonitis

Most patients with adductor tendonitis improve without surgery. Treatment begins by reducing activities that aggravate the symptoms while allowing the tendon time to heal. Ice may help relieve pain after activity, and anti-inflammatory medications can be useful for short-term pain relief when appropriate. Physical therapy is the cornerstone of treatment and focuses on restoring flexibility, gradually strengthening the adductor muscles, improving hip and core strength, and correcting movement patterns that may have contributed to the problem. As symptoms improve, patients gradually return to sports and other activities under the guidance of their healthcare provider or physical therapist. In some cases, shockwave therapy or an ultrasound-guided injection may be considered if symptoms persist despite several months of rehabilitation. Surgery is rarely necessary and is generally reserved for patients with long-standing symptoms that have not improved after an extensive course of non-operative treatment.

Summary

Adductor tendonitis is a condition that causes pain where the muscles on the inside of the thigh attach to the pelvis. It usually develops from overuse during activities such as running, kicking, or changing direction quickly. Doctors can often diagnose it with a physical examination, although an MRI or ultrasound may be needed if the diagnosis is uncertain. Most people recover with rest, physical therapy, and a gradual return to activity. Surgery is rarely needed because the condition usually improves with non-surgical treatment.

Edited by Stephen Pinney MD, July 25th 2026.