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Published on: May 26, 2020
Adductor Injuries in Athletes: Evidence-Based Treatment
Alexander R Markes1, Craig Mauro, James P Bradley
1From the California Pacific Orthopedics and Sports Medicne, University of Pittsburgh Medical Center, Pittsburgh, PA.
The Journal of the American Academy of Orthopaedic Surgeons
|August 5, 2026
Summary
Adductor injuries are common in athletes, particularly in soccer and basketball. Treatment varies from conservative care for partial tears to surgery for severe cases, with repair often favored for professional athletes.
Area of Science:
- Sports Medicine
- Orthopedic Surgery
- Musculoskeletal Injuries
Background:
- Adductor injuries are a significant cause of groin pain in athletes, especially in soccer and basketball.
- The adductor longus is the most frequently injured muscle within the pyramidalis-anterior pubic ligament-adductor longus complex.
- Clinical diagnosis relies on the Doha agreement classification, using tenderness and resisted adduction to distinguish adductor-related groin pain.
Purpose of the Study:
- To review the diagnosis, management, and prevention of adductor injuries in athletes.
- To provide an overview of current treatment strategies, including surgical and nonsurgical options.
- To discuss return-to-play timelines and recurrence rates associated with different management approaches.
Main Methods:
- Review of clinical evaluation methods, including the Doha agreement classification.
- Discussion of magnetic resonance imaging (MRI) for injury characterization and prognosis.
- Analysis of non-surgical and surgical treatment outcomes, including repair, partial tenotomy, and complete tenotomy.
Main Results:
- Nonsurgical management yields return-to-play averages of 2-3 weeks for partial tears and 8-12 weeks for complete tears, with recurrence rates up to 19%.
- Surgical intervention is reserved for acute avulsions with significant retraction (>2 cm) or chronic injuries unresponsive to conservative treatment.
- Surgical options (repair, partial/complete tenotomy) show good outcomes, with return-to-play averaging 10-14 weeks; repair is often preferred for traumatic complete avulsions in professional athletes.
Conclusions:
- Adductor injuries require a comprehensive approach, integrating clinical evaluation, advanced imaging, and tailored treatment strategies.
- Prevention focuses on addressing modifiable risk factors like adductor weakness and limited hip mobility.
- While nonsurgical management is common, surgical repair may offer advantages for specific severe injuries, particularly in high-level athletes, though evidence comparing it to structured conservative care is limited.
