3 Exercise Tips for Runners with Adductor Tendinopathy

Adductor tendinopathy is a common cause of groin pain in runners. In this article, we discuss what three exercises may not be useful during the early stages of your rehab. These are exercises that are commonly prescribed by physios but often just end up making the pain worse. Remember, if you need more help with an injury, you're welcome to consult our team of sports physios online via video call.

Some of the links in this article are to pages where you can buy products or brands discussed or mentioned here. We earn a small commission on the sale of these products at no extra cost to you.

In this article:

• Exercise 1: Side Lying Adduction

• Exercise 2: Adductor Squeezes

• Exercise 3: Adduction With Bands

Check out the video below if you would like more detailed advice about the treatment and rehabilitation of adductor tendinopathy.

Exercise 1: Side Lying Adduction

This exercise is, in my opinion, a pretty useless one to do and extremely likely to make your pain worse. I wish therapists would stop prescribing this for adductor injuries. Here’s why I say this:

1. When you have an injury in your adductor tendons (like adductor tendinopathy), it usually hurts when you compress your groin, e.g. when your leg crosses the mid-line of your body. These patients will usually report pain with crossing their legs while sitting, or if they sleep at night and the injured leg is on top, or if they sit in soft chairs that allow their hips to flex a lot. This exercise takes the leg into that position and then also contracts the adductors, which increases the compression even more. It’s like pressing on a bruise – the more you do it, the more sensitive the bruise (tendons) becomes and the worse your pain gets.

2. It’s a very low load exercise, so you won’t be getting much strength gains from it. There are plenty of other low load exercises to choose from during the early rehab stages.

3. It works the muscle in a position that we actually want to avoid in sport – excessive adduction of the leg has been linked to all sorts of injuries. There are plenty of other exercises where you can work the adductors in more functional positions.

Exercise 2: Adductor Squeezes

This can be a useful exercise, but I find that patients can make themselves worse if they either squeeze too hard or bring the legs together so that their groin compresses. If you do want to do this as an exercise, make sure that you:

1. Start by placing an object between your legs that will keep them either in neutral or in slight abduction when you squeeze. A football works well.

2. Don’t squeeze as hard as you can. Start off by just squeezing at 60% to 70% of maximum and slowly build the intensity over time.

I tend to use progressive side planks instead of this exercise – I explain how this works in the video above.

Exercise 3: Adduction With Exercise Bands

Again, this is a useful exercise which I use often, but I find that it is better to add it into the programme during the later stages of the rehab process. During the first few weeks of a rehab programme, I find that doing any exercise that really isolates the adductor muscles tend to flare them up. In my experience, it works much better if you do global exercises that work the adductors in combination with the hamstrings or quads, and then add in more targeted work once the tendons have calmed down a bit.

This is a brilliant exercise for when your tendon has calmed down, as it not only works the adductors when you pull the exercise band in, but it also works the adductors of the leg that is supporting you. So make sure you do it on both legs!

Need more help?

Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.

We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.

About the Author

Maryke Louw is a chartered physiotherapist with more than 15 years' experience and a Masters Degree in Sports Injury Management. Follow her on LinkedIn, ResearchGate, Facebook, Twitter or Instagram.

Reference:

1. Brukner, P, et al. Brukner & Khan's Clinical Sports Medicine. Vol 1: Injuries. (2017) McGraw-Hill Education. (Links to Amazon)

2. Yousefzadeh, A., et al. (2018). "The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol." Rehabilitation research and practice 2018.