Adductor Tendons Injection

Chronic tendinitis

Causes and findings:
• Overuse or trauma
• Pain in groin
• Painful: resisted adduction passive abduction

Equipment:
Syringe - 2ml
Needle - 23G 1.25 inches (30mm) blue
Kenalog 40 - 20 mg
Lidocaine - 1.5 ml 2%
Total volume - 2 ml

Anatomy:
The adductor tendons arise from the pubis and are approximately two fingers wide at their origin. The lesion can lie at the teno-osseous junction or in the body of the tendon. The technique described is for the more common site at the teno-osseous junction.

Technique:
• The patient lies supine with leg slightly abducted and laterally rotated
• Identify and mark the origin of the tendon
• Insert needle into tendon, angle towards pubis and touch bone
• Pepper solution into teno-osseous junction

Aftercare:
Rest for at least 1 week then start a graduated stretching and strengthening programme. Deep friction massage may be used as well to mobilize the scar.

Comments:
Sprain of these tendons is commonly thought to cause 'groin strain'. However, there are many alternative causes of pain in the groin (see psoas bursa technique) and these should be eliminated carefully.

Alternative approaches:
For the less common site at the body of the tendon, the solution is peppered into the tender area in the body, but deep friction massage and stretching may be more effective here.