Adductor Longus Strain/Tear

[andymassey]

Hi all,

Looking for a bit of insight here. I have a patient (an ice hockey player)who complained of bilateral groin pain following a training session where he volunteered for net minder. He went to a beauty therapist to get a massage (all very innocently) but ended up with extensive bruising over the musculotendinous junction of the add mag on both sides. He then played a match and had to leave the ice because of intense pain on his right groin associated with swelling and bruising.

I then saw him and treated with PRICE, U/sound and laser. There is a palpable tear in he muscle, visable also to the naked eye.

My query is this. How do you tell if it is a grade 3 tear? If it is a grade 3, how successful is surgery vs conservative treatment? And, what is the estimated recovery time post surgery vs conservative treatment.

Thanks

[injuryupdate]

The major indication for adductor longus surgery is chronic painful traction of the adductor longus tendon on the pubic symphysis. Ironically a grade 3 tear (if by grade 3 you mean a complete tear) doesn't generally lead to this problem, because there is no intact part of the M/T unit to pull excessively on the bone.

The adductor longus problem that is often best treated with surgery is the partial (undersurface) tear with a very tight superficial portion of A.L. tendon pulling excessively on the bone. On examination the major features are pain on resisted adduction at neutral position and restricted range of passive abduction/ER. Usually the superficial portion of A.L. tendon can be palpated as very tight.

Bottom line is that in the early stages of a groin problem, don't consider surgery, but if a chronic groin problem appears to be as a result of very tight adductors then a release may be justified.