Adductor-related groin pain is a common problem in sports. Evidence-based management of athletes with adductor strains, adductor ruptures, and long-standing adductor-related groin pain can be approached in a simple yet effective and individualized manner. In most cases, managing adductor-related pain in athletes should be based on specific exercises and loading strategies. In this article, I provide an overview of the different types of adductor injuries, from acute to overuse, including their underlying pathology, functional anatomy, diagnosis, prognosis, mechanisms, and risk factors. This information leads to optimal assessment and management of acute to long-standing adductor-related problems and includes primary, secondary, and tertiary prevention strategies that focus on exercise and load-based strategies. In addition, information on different options and contexts for exercise selection and execution for athletes, athletic trainers, and sports physical therapists in adductor injury rehabilitation is provided. Key Points - Injuries to the hip-adductor muscles and tendon complexes are the most common problems in athletes presenting with acute and long-standing groin pain. - These injuries can present either in isolation or with associated groin injuries, and the differential diagnosis is important to understand the prognosis and management. - Measuring symptoms, strength, and performance can assist with early detection and monitoring, exercise progression, and return-to-sport decisions in athletes with adductor problems. - Addressing hip-adductor, gluteal, and trunk strength, as well as balance, coordination, and plyometrics, using specific exercises and loading strategies is mandatory in primary, secondary, and tertiary prevention of adductor-related injury and groin pain. - Progressive strength training and sport-specific loading is the treatment with the highest level of evidence for both acute and long-standing adductor-related problems.
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