Hip Adduction

Hip Adduction

Liz Kerrigan

I. Description of Motion:
Hip adduction involves bringing the hip towards the midline of the body. The hip adductor muscles include the adductor longus, adductor brevis, adductor magnus, pectineus, gracilis, and obturator externus. They are innervated by the obturator nerve, made up of L2-L4 nerve roots.

II. Mobilizing – Increasing Range of Motion :

Piriformis Stretch:

• Start supine on the table
• Bring one knee in towards your chest keeping the other leg flat on the table
• Then pull the flexed knee toward the opposite shoulder
• You should feel a stretch in your gluts
• Hold for 30 seconds and repeat 3 times on each leg daily

ITBand Stretch in Supine:

• Lie on your back with a belt looped around one foot
• Pull that leg straight up while keeping the other leg flat on the table
• Then pull your leg across your body until you feel a stretch on the outside of your leg
• Hold for 30 seconds and repeat 3 times on each leg daily

ITBand Stretch in Standing:

• Stand upright with your right leg crossed behind your left
• Lean to the left until you feel a stretch on the outside of your right leg
• You can use a chair or a wall for support during this stretch
• Hold for 30 seconds and repeat 3 times on each leg daily

III. Indications for Stretching:
A groin strain is one of the most common injuries to the hip adductor muscles in athletes, especially soccer and ice hockey players.¹ A groin strain happens during quick motions such as a sudden change in direction while running or kicking a ball.² Specific protocol needs to be followed with an acute injury in order to prevent it from reoccurring.² Ice is the initial form of treatment that should be used in the acute stage followed by a stretching and strengthening program.^1,2,3 In order to improve ROM in the adductor muscles stretches must be performed to the antagonist muscles (hip abductors and external rotators) along with the hip adductors. A decrease in ROM of hip IR and ER has been correlated with reoccurring groin injuries.³

IV. Strengthening:

Supine Hip Adduction Squeezes:

• Start supine with bent knees and feet flat on the table
• Place a ball, pillow, or rolled up towel in between your knees
• Press your knees together and hold for 5 seconds
• Perform 3 sets of 10 repetitions 2-3 times per week
• To increase the intensity of this exercise you can add a bridge to the squeezes

Hip Adduction Straight Leg Raise:

• Begin in side lying and bring your top leg in front of the bottom leg and rest the foot flat on the table
• Keep the bottom leg straight and slowly lift it off the table toward the ceiling
• Slowly lower the leg back down to the table
• Make sure your hips remain stacked while performing this exercise
• Perform 3 sets of 10 repetitions 2-3 times per week
• To increase the intensity of this exercise you can add a small ankle weight

Standing Hip Adduction with Theraband:

• Start with your target leg out to the side with a theraband wrapped around the ankle
• You can use a chair for support during this exercise
• Slowly bring the target leg in toward the other leg against the resistance of the band
• Slowly return the same leg to the starting position
• Perform 3 sets of 10 receptions for each leg 2-3 times per week
• To increase the intensity of this exercise you can use a theraband with greater resistance

V. Potential Clinical Syndromes or Etiologies:
The above techniques for strengthening and stretching have been proven effective with groin pain and strain injuries.¹ Strengthening the hip adductors increases the strength ratio between the adductors and abductors, which research has shown is a common contributing factor these types of injuries.^1,3 Stretching the hip adductors/IR as well as hip abductors/ER is essential in order to improve ROM at the hip and prevent future injuries.^1,3

VI. Additional Web Based Resources:
More information on groin injuries can be found here: http://www.sportsinjuryclinic.net/sport-injuries/hip-groin-pain/groin-strain

VII. References (AMA format)
1. Tyler TF, Fukunaga T, Gellert J. Rehabilitation of soft tissue injuries of the hip and pelvis. Int J Sports Phys Ther. 2014;9(6):785-97.
2. Available at: http://www.sportsinjuryclinic.net/sport-injuries/hip-groin-pain/groin-strain. Accessed December 5, 2014.
3. Hrysomallis C. Injury incidence, risk factors and prevention in Australian rules football. Sports Med. 2013;43(5):339-54.