NULL

Adductors – Pain & Trigger Points

The adductors are a muscle group on the medial (inner) side of your thighs.

They often cause problems and pain in the thigh, groin or genitals. Especially when they carry trigger points.

The good news is that it’s possible to treat these trigger points with a self-massage.

Exactly, you can massage yourself. This is very effective, and it has already helped thousands before you!

On this page you will learn everything you need to know for a successful massage.

I will explain step by step how you feel the muscles (palpation) in the first place, and then how to massage them.

You will also learn more details about this important muscle group. I‘ll explain …

  • what exact pain they can cause.
  • where they are located.
  • which functions they provide.
  • how you might have overloaded them.

1. Pain Patterns & Symptoms

The adductors consist of several muscles. Each of these muscles can cause different types of pains and ailments.

In the following you will find the pain zones for the respective muscles.

Please do not be scared by the Latin names if you are not familiar with them. You’ll still understand the essentials.

1.1 Pain patterns of the adductor longus and adductor brevis

Trigger points in the adductor longus and brevis lead to local sensitivity of pressure of the inner thigh, but can also cause pain in other areas.

  • Groin pain
  • Pain above the medial side of the knee
  • Thigh pain
  • Shin pain

1.2 Pain patterns of the adductor magnus

Trigger points in the adductor magnus can lead to pain in the following areas

  • Groin
  • Vagina
  • Rectum
  • In the pelvis in general
  • Medial side of the thigh

Pelvic pain is often described as pain in the vagina, rectum, bladder or pubic bone.

Sometimes it arises spontaneously or only during sexual intercourse.

When the pain occurs, it’s usually perceived as a sharp, violent pain in the pelvis that runs from bottom to top.

1.3 Pain patterns of the gracilis

Trigger points in the gracilis can result in pain on the medial side of the thigh.

The pain caused by this muscle is usually described as hot and stabbing.

Light exercise, especially walking, usually provides relief.

1.4 Pain zones of the pectineus

Trigger points in the pectineus often lead to deep-seated pain in the groin and hip.

This pain can also radiate to the anterior part of the thigh.

2. Attachment Points

2.1 Pectineus

The pectineus runs from your pubic bone to the superior medial side of your thigh bone.

Origin: Os pubis/pubic bone

Insertion: Linea pectinea & aspera of the femur

Innervation: The muscle is innervated by the nervus femoralis & obturatorius.

2.2 Adductor longus & brevis

The adductor longus and brevis stretch from your pubic bone to the superior medial side of your femur.

Origin: Os pubis/pubic bone

Insertion: Lina aspera of the femur

Innervation: These muscles are innervated by the nervus obturatorius.

2.3 Adductor magnus

The adductor magnus extends from your pubic bone and ischium to the medial side of your thigh bone.

Origin: Os pubis & tuber ischiadicum

Insertion: Linea aspera & epicondylus medialis of the femur

Innervation: The muscle is innervated by the nervus obturatorius and the nervus tibialis.

2.4 Gracilis

The Gracilis runs from your pubic bone down to the medial side of your shin bone.

Origin: Os pubis

Insertion: Pes anserinus at the tibia

Innervation: The muscle is innervated by the nervus obturatorius.

3. Functions

The main function of the adductors is, as the name implies, adduction.

This muscle group moves the leg toward the midline of the body or moves it towards the other leg, respectively.

In everyday life, this function is important for stabilization of your knee during gait, assuring it wouldn’t move outwards or to the side.

The pectineus also helps to flex the hip.

The adductor magnus contributes to the function of your large buttock muscle/gluteus maximus and prevents the upper body from “tilting forward” when you bend forward.

1

Adduction

2

Flexion

3

Forward bend

4. Adductors – Trigger Point Activation

Tensions and trigger points in the adductors arise when you overload these muscles.

In everyday life, this might happen in many different ways. In the following, I will give you some examples.

Please note that overload is always relative and very individual.

What overloads you, may not be a problem for someone else. Please never compare yourself with other people. Your circumstances are probably very different.

  • Slipping or falling
  • Sitting with crossed legs
  • Horseback riding
  • Sexual intercourse
  • Jogging
  •  …

4.1 Slipping or falling

If you slip on a smooth surface and your leg slips sideways, your adductors will contract reflexively to cushion the fall.

Thus, they contract and get stretched at the same time. This often leads to activation of trigger points.

4.2 Sitting with crossed legs

When sitting with crossed legs, the adductors of the upper leg are held in a shortened position.

If you do this over longer periods of time, the muscles will shorten, and trigger points may arise.

4.3 Horseback riding

When riding, the adductors are strongly strained in order to give the horse certain commands through the legs.

This active load can lead to tension and trigger points. Especially if you are not used to the strain or if you increase it too quickly.

4.4 Sexual intercourse

You can also overload the adductors during sex. The overload can be passive or active.

Passive overloading: Spreading the legs strongly stretches the adductors, which can lead to problems under certain circumstances.

Active overload: On the other hand, strong compressions of the legs during sex can also overload the adductors.

4.5 Jogging

When jogging, your adductors contract with every step to stabilize your knee. They work particularly hard when you’re running uphill.

Overload occurs mainly when you change your habits abruptly and severely.

  • New entry into the sport – after a long break.
  • Increase of the running distance.
  • Change of terrain
  • Increase in the number of runs per week.
  • Increase of speed.

5. Palpation

It is not easy to feel and distinguish the adductors from each other. Nevertheless, we will try it together in this chapter.

Patience is the key to success here. You will probably need a few sessions before you can really feel these muscles.

Don’t despair over it. Especially the lower parts of the muscle can easily be massaged with a foam roller, and it’s not necessary to feel the muscles in order to perform the massage.

In the next sections of this chapter, I will show you the palpation of the individual adductors.

5.1 Palpation of the Pectineus

The fibers’ origin of the pectineus is situated in the lower half of the space between your pubic symphysis and the anterior iliac spine (picture 1).

You can feel your pubic bone near the pubic symphysis (picture 2).

The front iliac spine is the bony protrusion at the front of your pelvis (picture 3).

To feel the pectineus, proceed as followed.

1
2
3
1

Shift your weight onto one leg. Turn your "free" leg outwards and place one or two fingers deep in the groin against your pubic bone.

2

Press your "free" leg minimally into the ground and then move your thigh obliquely forward, but only a little bit.

The foot must not come off the ground or move.

Can you feel the tendons and muscles contracting with every movement? Very good. However, these are not the tendons of the pectineus, but those of the adductor longus and magnus.

3

Starting from this spot, move your fingers a few centimeters higher in your groin.

Now press slowly but deeply into the "new" area and perform the movement with your leg again (as described above).

Try to feel with patience the muscle contracting with every movement.

If you feel a pulse under your finger, you've caught your leg artery. Just let it go and place your finger again.

5.2 Palpation of the adductor longus and brevis

The adductor longus lies over the adductor brevis and covers it, so you can’t feel the latter.

How to feel the tendon’s origin of this muscle has already been described in point 5.1. Let us now begin to feel the muscle.

  • Lie down on the floor, bend the knee and draw up your foot. Feel the tendons of the adductors.
  • Try to grasp the underlying muscle tissue with your thumb and index finger.
  • Follow these muscle fibers to about the middle of your thigh.
  • Down lower you won’t be able to feel them anymore, because they are covered by your quadriceps.
1
2

5.3 Palpation of the adductor magnus

The adductor magnus is a very large and thick muscle. It lies a little further inside “or” behind the adductor longus.

Palpate this muscle in the same way as the adductor longus (point 5.2). The only difference is that you place your fingers a little bit further back.

1

This is the place where you will find the adductor longus.

2

This is the place where you will find the adductor magnus.

5.4 Palpation of the gracilis

The gracilis is difficult to palpate, because it is very thin and runs close to the large adductor magnus. But it’s worth a try.

To be successful here, it is very important to experiment a lot with the position of your hands and to take your time!

If you don’t feel this muscle, then simply massage this area as described in the chapter “Self-massage” and treat the painful tensions.

1

Feel the tendons of the adductors on the pubic bone.

2

Grasp the area of the adductor magnus with your thumb and index finger. However, do not penetrate deeply into the muscle, but only grasp superficial fibers.

3

Once you have such a bundle of muscle fibers between your fingers, lift your leg slightly off the floor and flex and extend your knee a few times. During these movements you can feel the gracilis moving under your fingers.

6. Self-massage of the Adductors

You can massage your adductors with your hands or a foam roller. The massage with a foam roller is extensive but not very precise. Nevertheless, you possibly achieve good results, especially if the adductors are very tense.

You should work the upper half of the adductors with your hands. Of course, this is more strenuous, and you have to take care of your fingers.

However, you should take it slowly in the upper area of the adductors and be careful. Many nerve plexuses and large blood vessels run in the area of your groin and inner thigh.

I therefore advise against massaging this area roughly or with high intensity.

In the following, you will find instructions for a “general massage” with a foam roller.

You will also find massage instructions for each muscle of the adductors in picture and written form.

6.1 General self-massage of the adductors with a foam roller

  • Lie face down on the floor.
  • Move the leg of the side to be massaged outwards and flex your knee.
  • Place your leg on the foam roller so that it is directly above your knee.
  • Now roll over the roller by pushing your knee outwards.
  • This way, seek for tension in the muscles.

Massage each tense point with slow rolling movements.

To exert more pressure and massage the higher areas of the adductor, lean on your elbows and shift a little more weight onto the roller.

6.2 Self-massage of the pectineus

  • Palpate the muscle as described in point 5.1.
  • Seek for painful spots in the pectineus.
  • Shape your hand like a shovel.
  • Press into the muscle and stroke from bottom to top over it. You move skin over muscle, but do not slide with the fingers over the skin.

Take your time, because this muscle is not easy to massage. If you want to make sure you are still on the muscle, contract it as described in point 5.1.

1

Shape of the hand during the massage. Exert pressure with your fingertips.

2

Massage position (example).

6.3 Self-massage of the adductor longus & brevis

The best way to massage the upper half of these muscles is with your fingers. The lower half is not accessible to them, because it is covered by your large thigh muscle.

For this reason, I recommend massaging the lower area with a foam roller, as described in chapter 6.1.

  • Lay down on the ground and support yourself with your elbow.
  • Draw your lower leg up a little bit.
  • Feel the tendons’ origins of the adductors by slightly lifting your leg.
  • Grasp the muscle between thumb and index finger and seek for painful points by rolling the muscle back and forth between the fingers.
  • Roll each of these points a few times between your fingers.

Tip: If your adductors are very tense, you may not be able to grasp the adductor longus between with your fingers.

In this case, place a blanket under your thigh – this will relax the adductors and make it easier for you to grasp the muscle.

6.4 Self-massage of the adductor magnus & gracilis

The adductor magnus is located just behind the adductor longus.

Massage its parts situated on the medial side of the thigh as described in chapter 6.3, with the difference that you grasp a little further back.

6.4.1 Self-massage of the medial side of the thigh

In this area, you may also find the gracilis, even if you probably cannot distinguish it from the magnus.

That’s not a problem. Simply massage all painful tensions with small rolling movements.

In the right picture, my index finger indicates the approximate area of the adductor longus and my middle finger the area of the adductor magnus.

6.4.2 Self-massage in the area of your ischium:

Since the adductor magnus is also connected to your ischium, you should also examine this area and massage if necessary.

For the massage use a massage ball or the Body Back Buddy. I’ll show you the massage with the ball.

  • Sit on a chair and place the ball directly under your ischial tuberosity.
  • This is the thick bony prominence on your buttocks.
  • You can feel it when you push your hand from below onto your buttock.
  • Shift some weight onto the ball and seek for painful tensions in the muscles.
  • Experiment a little with the position of the ball and move it a few centimeters every now and then.
  • Massage tensions by moving your thigh slightly and letting the muscle “slide” over the ball.

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. The Lower Extremities. Baltimore, MD: Williams & Wilkins, 1993. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print