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MuscleThighsuperficialDraft

AdductorsMusculi adductores

Group of five muscles on the inner thigh, running from the pubic bone and sitting bone to the femur and tibia, that pull the legs together.

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LatinMusculi adductores
Origin
  • Body of the pubis, below the pubic crest (adductor longus)
  • Body and inferior ramus of the pubis (adductor brevis, gracilis)
  • Pectineal line of the pubis (pectineus)
  • Inferior pubic ramus, ischial ramus and ischial tuberosity (adductor magnus)
Insertion
  • Linea aspera on the back of the femur (adductor longus, adductor brevis, adductor magnus)
  • Pectineal line of the femur, below the lesser trochanter (pectineus)
  • Adductor tubercle of the femur (adductor magnus, hamstring part)
  • Upper medial tibia, at the pes anserinus (gracilis)
Action
  • All members: adduct the hip (bring the thigh towards the midline)
  • Pectineus, adductor longus, adductor brevis and gracilis: help flex the hip
  • Adductor magnus, hamstring part: extends the hip
  • Gracilis: also helps flex the knee
NerveObturator nerve, except pectineus (femoral nerve) and the hamstring part of adductor magnus (tibial part of the sciatic nerve) (L2–L4)
MembersAdductor longus, Adductor brevis, Adductor magnus, Gracilis, Pectineus
NameLatin adducere, 'to lead towards' — they bring the thigh towards the midline.

Palpation

  1. Client supine with the hip slightly bent and turned out and the knee supported on a bolster; secure the drape firmly around the upper thigh before you start.
  2. Explain what you are going to do and get consent. Place your palm flat on the inner thigh at mid-thigh level, well below the groin.
  3. Feel the soft, rounded mass of the adductors between the quadriceps in front and the hamstrings behind.
  4. Ask the client to squeeze the knee inwards against your hand; the whole group firms. Stay at mid-thigh and below.

Landmarks: Ischial tuberosity

The adductors fill the inner thigh between the Quadriceps and the Hamstrings. From front to back and surface to depth they are Pectineus, Adductor longus, Adductor brevis and the large Adductor magnus, with the long, thin Gracilis running down the inner edge. Riders, footballers and swimmers use them heavily, and clients who play kicking sports often report tightness here.

Draping and client comfort. The inner thigh is a sensitive area close to the groin. Always explain what you plan to do and get clear verbal consent before working here, and check in again during the stroke. Tuck the drape securely around the upper inner thigh so the groin and genitals stay fully covered, and never work under the drape towards the groin. Keep your hands at mid-thigh and below in a relaxation routine; the upper attachments near the pubic bone are not massaged at Cert IV level. If the client seems uncomfortable, stop and move on. See Draping and room set-up.

The adductors work against the hip abductors on the outer hip, mainly Gluteus medius and Gluteus minimus. Most of the group is supplied by the obturator nerve, but pectineus gets the femoral nerve and the hamstring part of adductor magnus gets the sciatic nerve, which explains why these two are sometimes grouped with other compartments.

Techniques

  • Effleurage — Long, gliding strokes with the whole palm that spread the medium, warm the tissue and link the other strokes together.
  • Petrissage — Kneading strokes that compress, lift and squeeze the muscle away from the bone, working the tissue between the hands.
  • Compression — Pressing straight down into a muscle with the palm, fist or forearm, holding briefly, then releasing and moving on.
  • Passive stretching — The therapist gently moves a relaxed limb to lengthen a muscle to a point of mild stretch and holds it there, with no effort from the client.

Works with

  • Iliopsoas — Deep hip flexor made of psoas major and iliacus, running from the lumbar spine and inside of the pelvis to the lesser trochanter of the femur, and the strongest flexor of the hip.
  • Gluteus maximus — The largest and most superficial buttock muscle, and the main extensor of the hip.

Opposes

  • Gluteus medius — Thick, fan-shaped muscle on the outer side of the pelvis that abducts the hip and keeps the pelvis level when you stand on one leg.
  • Gluteus minimus — The smallest and deepest of the three gluteal muscles, lying under gluteus medius, that abducts and medially rotates the hip.
  • Tensor fasciae latae — Small muscle at the front of the outer hip, just below the ASIS, that tightens the iliotibial band and helps flex, abduct and medially rotate the hip.
  • Sartorius — Long, thin strap muscle, the longest in the body, running diagonally across the front of the thigh from the ASIS to the inner knee, which helps flex, abduct and laterally rotate the hip and bend the knee.

Sources

  1. Wikipedia: Adductor muscles of the hip
  2. Wikipedia: Obturator nerve