The proximal adductor longus tendon at the pubic origin is the most common site of adductor-related groin pain in football, hockey, and sprinting. The tendon inserts into a fibrocartilaginous enthesis on the pubic body — this is the site of acute avulsion (rare) and the more common overuse enthesopathy. MRI shows high T2 signal at the enthesis in acute injuries.
Transmits adductor force from the pubic origin; the primary site of adductor-related groin pain enthesopathy
Proximal adductor longus tendinopathy produces deep medial groin pain reproduced by resisted hip adduction in 0-30 degrees of hip flexion. Return-to-sport criteria require pain-free resisted adduction at full strength. Complete proximal avulsion tears (rare) require surgical reattachment in athletes within 3 weeks.
Pubic enthesis overuse from repetitive adductor loading producing medial groin pain managed with eccentric adductor strengthening.
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