The adductor longus proximal tendon originates from the anterior surface of the pubic body just below the pubic crest, with fibres interdigitating with the rectus abdominis insertion and the contralateral adductor longus at the pubic symphysis — the pubic plate enthesis shared between these structures. It is the most anteriorly positioned adductor tendon and the most commonly strained in groin injuries.
Adductor longus proximal tendon tears are the most common groin muscle injury in football and ice hockey players, producing acute medial thigh pain during explosive kicking or change of direction. MRI grading distinguishes muscle belly tears (Grade 1-2, treated conservatively) from complete proximal avulsions (Grade 3, may require surgical repair). Adductor enthesopathy — chronic pain at the pubic plate enthesis shared between adductor longus and rectus abdominis — is the hallmark of athletic pubalgia and produces both adductor and inguinal pain. Ultrasound-guided corticosteroid injection and PRP injection target the inflamed enthesis.
Explosive hip adduction against resistance during kicking avulses the adductor longus from the pubic body, producing acute medial groin pain with palpable gap at the pubic symphysis; MRI confirms the complete proximal avulsion with retraction; surgical repair within 2 weeks with suture anchor fixation to the pubic body restores adductor strength for return to sport.
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