Adductor Longus

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The Adductor Longus is a muscle of the medial thigh.

Anatomical Attachments:

• Origin: Attaches to the anterior surface of the pubis near the pubic symphysis.
• Insertion: Attaches to the medial half of the medial lip of the linea aspera

Action: Adducts and assists in flexing the thigh

Synergist:

• Prime Movers: Iliopsoas, Pectineus, Tensor fasciae latae, Adductor brevis, Sartorius.
• Accessory Movers: Adductor longus and magnus (anterior part), Gracilis, Gluteus minimus.

Antagonist: Gluteus maximus, Adductor magnus (posterior part).

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Nerve Supply: Obturator nerve (L3, L4).

Vascular supply: Femoral Circumflex and Obturator arteries.

• Primary: Travell and Simons make no distinction in the TrPs located in the Adductor longus and brevis, the pain is experienced proximally in the genitalia and the superior medial aspect of the thigh to the inguinal region. Distally, the pain is experienced slightly superior and medial to the knee in the vicinity of Hunter’s canal, and spills over into the anterior superior aspect of the tibia.
• Satellite or associated triggers: Adductor Magnus, Pectineus and Vastus Medius.

Authors' note: There is a commonality between triggers exhibited in the adductors and the pelvic floor. Therefore, when the adductors are dysfunctional, the practitioner should examine the Obturator externus and should the Obturator externus be dysfunctional, the adductors should be examined. Additionally, the piriformis usually is hypertonic either as a result of a compensatory gait or as a part of a myotatic unit.

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Trigger Point Signs and Symptoms: Muscle stiffness or restriction of abduction. Pain in the groin and the thigh during activity, pain increases on weight bearing or sudden hip rotation. Usually the individual notices difficulty as it pertains to lateral rotation rather than adduction, however, when the legs are significantly abducted, this may initiate severe groin pain and possible hip locking. This additionally serves to demonstrate the relationship between the adductors and the pelvic floor.

Trigger Point Activating and Perpetuating Factors: Trauma, persistent emotional stress, sudden overload of the muscle (improper stretching), running on unleveled ground, sitting for long periods of time with hips flexed and legs crossed.

Differential Diagnosis: Neuralgia, inguinal hernia, Prostate cancer, Prostatitis, Testicular cancer, (Segmental, Subluxation, Somatic dysfunction) L2 L3 or L4 radiculopathy, Floating Patella, Knee effusion, Patella fracture, Charcot’s arthropathy, Obturator or Genitofemoral nerve entrapment, Pubic stress fracture, Pubic stress symphysitis, Muscle strain (groin pull), Osteoarthritis, Lymphedema, Lymphogranuloma venereum, Lymphatic cancer, Coxa Plana, Polymyalgia rheumatica, Eosinophilic fasciitis, Tetanus, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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