Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Adductor Tendonitis / Tendinosis

SYMPTOMS

Gradual onset of diffuse or localised exercise-induced pain at the insertion of the adductor longus around the symphysis. It can be associated with a slip, strain or split on a slippery football pitch. It is common in footballers, who usually complain of an inability to strike the ball with full power.

AETIOLOGY

This is usually caused by excessive stress reaction or strain from jumping, twisting and plyometric or running exercises. Partial ruptures have also been discussed as a potential cause. The left and right leg anatomy can vary substantially in the same individual; therefore the symptoms may vary.

CLINICAL FINDINGS

There is distinct tenderness on palpation over the most proximal part of the adductor longus tendon and its insertion, aggravated by contraction against resistance.

INVESTIGATIONS

X-ray is normal. MRI may show intra-tendinous hyper-intensity and subchondral oedema. Ultrasound may show signs of tendinosis.

TREATMENT

If it is the primary cause for the symptoms, this injury will most often respond to conservative treatment, including modification of training and stretching exercises. There is seldom any indication for immobilisation or surgery. The main clue to success is to realise whether the symptoms from the tendon are secondary to impaired core stability caused by another injury or the primary root of the symptoms.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant orthopaedic surgeon for symptomatic treatment and planning of a three months’ return programme back to sport. Refer to Dr Kevin Yip (+65 9724 1219) orthopaedic surgeon if non-operative treatment fails.

EXERCISE PRESCRIPTION

Cycling and other low–impact activities are usually good alternatives to keep up general fitness.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs.

DIFFERENTIAL DIAGNOSES

It is important to be aware that myriad different conditions can cause these symptoms.

PROGNOSIS

Excellent-Poor, depending on the cause.

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