The adductor longus tendon is the most palpable structure at the medial groin, arising from the pubic body as a clearly defined cord that is easily palpated at the pubic symphysis. It is the most commonly strained groin tendon in kicking sports, with the proximal musculotendinous junction and pubic insertion being the two most frequent injury sites. Adductor longus pubic symphysis insertional pathology in the context of athletic pubalgia or sports hernia represents a specific clinical entity distinct from the more common myotendinous strain.
Groin force transmission; hip adduction; medial femoral triangle boundary
The pubic aponeurosis where the adductor longus, rectus abdominis, and inguinal canal structures converge is the site of athletic pubalgia (sports hernia), where repetitive shear forces at the pubic symphysis cause pain from aponeurosis pathology. The adductor squeeze test in varying hip flexion angles allows localisation of the adductor pain to the adductor longus versus hip flexor versus pubic symphysis origin.
Proximal musculotendinous junction or pubic insertion tear producing medial groin pain with resisted adduction, managed with progressive adductor loading rehabilitation.
Pubic aponeurosis pathology at the combined adductor-rectus abdominis insertion producing exertional groin pain without a true hernia, managed with physiotherapy and occasionally surgical exploration for refractory cases.
