The adductor magnus has two distinct insertions: the main adductor portion inserts on the linea aspera and medial supracondylar line, while the hamstring portion has a separate tendon inserting on the adductor tubercle at the medial femoral epicondyle. This hamstring portion functions as a short hip extensor and is palpable at the adductor tubercle. Adductor magnus hamstring portion tears produce posteromedial knee pain that is easily confused with MCL or medial meniscal pathology.
Hip extension force transmission (hamstring portion); knee adductor force at the medial epicondyle
Adductor magnus tendon injuries at the adductor tubercle produce medial knee pain that is reproduced by resisted hip adduction and hip extension rather than by valgus stress (which provokes MCL) or joint line palpation (which provokes meniscal pathology). MRI distinguishes the tendon injury location from medial knee ligamentous and meniscal pathology.
Hamstring portion tear at the adductor tubercle producing posteromedial knee pain confirmed by MRI and managed with progressive loading rehabilitation.
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