Treatment of Thigh Adductor Tendinitis

Initial Conservative Treatment

The American Academy of Family Physicians recommends relative rest, cryotherapy, eccentric strengthening exercises, and non-steroidal anti-inflammatory drugs (NSAIDs) for 3 to 6 months before considering more invasive interventions 1, 2
Relative rest is essential to reduce repetitive strain on the damaged tendon while maintaining some activity to prevent muscle atrophy 1, 3
Cryotherapy provides acute pain relief and is widely accepted 2
Eccentric strengthening exercises are effective and can reverse degenerative changes in the tendon 2
Oral or topical NSAIDs are recommended for short-term pain relief, but have no effect on long-term outcomes 2
Topical NSAIDs may be preferable due to fewer systemic side effects 2

Local corticosteroid injections may be more effective than oral NSAIDs for pain relief in the acute phase, but do not improve long-term outcomes 2
Ultrasonotherapy may decrease pain and increase collagen synthesis, although evidence of its effectiveness is limited 2
Extracorporeal shock wave therapy (ESWT) appears to be a safe and effective option, but is costly 2

Surgical evaluation is justified if pain persists despite 3 to 6 months of well-managed conservative treatment 2
Surgical techniques generally involve excision of abnormal tendinous tissue and longitudinal tenotomies to release areas of scarring and fibrosis 2

Most patients with overuse tendinopathies (approximately 80%) recover completely within 3 to 6 months with appropriate conservative treatment 3
Technique modification for athletes and manual workers aims to minimize repetitive strains on the tendons 4

Physical examination typically reveals well-localized tenderness that reproduces the pain experienced during activity 3
Standard radiography may show bony abnormalities, but generally does not visualize the soft tissue changes characteristic of tendinopathy 2

Direct injection into the tendon substance should be avoided as it can inhibit healing and reduce tensile strength 5
Complete immobilization for prolonged periods should be avoided as it can lead to muscle atrophy and deconditioning 5