The pectineus is the most superior adductor, lying in the floor of the femoral triangle and forming the medial wall of the femoral triangle alongside the adductor longus. Its dual innervation by both the femoral (primary) and obturator (occasional) nerves makes it the bridge between the adductor and anterior compartments. The pectineus is stretched in the figure-4 position and is a common site of adductor-related groin pain in athletes.
| Origin | Pectineal line of the superior pubic ramus (between the inguinal ligament and the pubic tubercle) |
|---|---|
| Insertion | Pectineal line of the femur — between the lesser trochanter and the linea aspera |
| Nerve Supply | Femoral nerve (L2, L3) — and occasionally the obturator nerve (dual innervation in 30%) |
| Blood Supply | Medial circumflex femoral artery |
| Actions | Hip adduction; Hip flexion; Hip internal rotation (minor) |
|---|
Pectineus muscle tears produce anteromedial groin pain reproduced by resisted hip adduction with the hip flexed. Ultrasound or MRI confirms the muscle injury. Its proximity to the femoral triangle makes pectineus injuries challenging to differentiate from hip flexor and adductor longus pathology without imaging.
The pectineus is palpable in the femoral triangle medial to the femoral pulse and lateral to the adductor longus, becoming firm during resisted hip adduction with the hip flexed.
Groin muscle injury from hip adduction overload producing anteromedial groin pain managed with progressive loading rehabilitation.
