TRIGGER POINT OF THE WEEK – ADDUCTOR MAGNUS
The Adductor Magnus is a large tripartite muscle which wraps around the other adductors. It is composed of three parts, an Adductor Minimus part, a middle part and an ischiocondylar or "hamstring" part; It also forms an important opening towards its insertion – the saphenous opening it is located just superior to the adductor tubercle of the femur. The femoral artery and vein pass through the adductor hiatus, as they do so their names change into the popliteal artery and vein.This opening importantly allows also for lymphatic vessels to drain the lower extremity. Any trigger points in the Adductor Magnus or congestion around the saphenous opening have the potential to induce a back pressure in the lymph. Check for trigger points here if there is oedema. Adductor Magnus trigger points are also, often seen in patients with Osteitis pubis.
Osteitis pubis occurs commonly in soccer players and distance runners and is a frequent cause of groin pain. It is characterized by symphysis pain and joint disruption. It may be difficult to distinguish from adductor strains, and the two conditions may occur concomitantly in the same patient. Factors, such as limitation of internal rotation of the hips or fixation of the sacroiliac joint, also place excessive stresses on the joint. Leg length discrepancy and valgus or varus of the hip or knee may also play a factor as well as abnormal Q-angles. Clinically, the patient often reports exercise-induced pain in the lower abdomen and medial thigh. Symptoms are gradual in onset, slowly increasing in severity if activities are not stopped. The pain may present in differing areas:
Osteiitis Pubis Presenting Symptom Area
Adductor pain 80 percent
Pubic symphysis 40 percent
Lower abdominal pain 30 percent
Hip pain - 12 percent
Referred scrotal pain 8 percent
American Family Physician October 15, 2001, Vol 64, No 8
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.