Pectineus Pain - Muscle Location, Diagnosis, Symptoms and Risk Factors

Introduction:

Treating groin pain in athletes is challenging. Understanding the cause and how to assess it is tricky. Hands-on assessments, including resistance tests, are used by doctors to examine hip muscles. Strong hips may mean fewer injuries. Five hip muscles may cause groin pain. They begin in the front of the pelvis. Electromyography (EMG) measures muscle activity during exercises. It helps to identify active muscles. Because pain tests need the patient to remain still, EMG may be useful. The hip muscles are evaluated during athletes with groin pain tests to check muscle strength and past injuries. The goal is to find the best tests for athletes with groin pain.

Where Is Pectineus Muscle Located?

The pectineus muscle is a flat muscle that is quadrangular and is located in the groin and upper thigh. It is part of the medial compartment of the thigh and functions as a thigh adductor, which means it helps move the thigh toward the body's midline. Additionally, it aids with medial (interior) and lateral (side) rotation of the thigh. The muscle starts from the pubic bone and inserts onto the back surface of the femur. A branch of the femoral nerve, a major nerve in the thigh, primarily supplies it. When present, the auxiliary obturator nerve also helps to supply the pectineus muscle. The muscle is regarded as a component of the ventral thigh muscles. It is situated where the ventral and dorsal thigh muscles meet, innervated by the femoral and obturator nerves.

What Is the Cause of Pectineus Pain?

A pectineus muscle injury is the most frequent reason for pectineus pain. The pectineus muscle may become damaged when the legs are stretched out too far to the side or in front of the body. Overstretching the muscle can also happen when you kick, sprint, change directions when running, or sit with your legs crossed for an extended time. There may also be soreness, edema, bruising, and stiffness in the inner thigh as signs of a pectineus injury. Various things can cause pain in the pectineus, including:

• Rapidly or swiftly changing directions.

• Playing sports like hockey, basketball, soccer, football, skiing

• Sitting for extended periods with the legs crossed.

• Making swift motions, such as sprinting or kicking.

• Performing ballet, gymnastics, and martial arts

• Lifting heavy objects

• Extending the leg or legs out too far from the body.

• Taking excessive strides when running or power walking.

• Strenuous exercise when the pectineus muscle is already worn out.

How to Diagnose One Have Pectineus Pain?

In diagnosing groin pulls one common risk factor is an imbalance in strength between the adductor muscles (inner thigh) and abductor muscles (outer thigh). Previous strains increase the risk due to strength imbalances and hip instability. Injury history affects muscles like adductor longus, pectineus, and gracilis. This can be easily identified by using X-rays and better-quality MRIs. Pectineus injuries result from forceful hip movements or stabilisation issues, which are common in ice hockey. Persistent groin pain after treating other muscles, accompanied by vague, poorly localized pain in the hip, groin, and genital area, indicates pectineus involvement. Consider athletic pubalgia if adductor strain is ruled out. Pectineus abnormalities account for 20% of pubalgia cases. The physician will evaluate the degree of damage in the groin strain. The three types of groin strains are as follows:

• Grade 1: This mildest strain affects up to 5% of the muscle fibers, which causes the muscle to be stretched or ripped. While stretching, jogging, jumping, and kicking may not be unpleasant, these exercises and walking can.

• Grade 2: A grade 2 strain is a larger rip that affects a more significant proportion of the muscle fibers. Bringing your thighs together when walking might be uncomfortable.

• Grade 3: The most severe strain, where the muscle or tendon is completely torn apart. When injured, it often results in immediate, severe pain. Utilizing the injured muscle is typically painful, and there is frequently swelling, bruising, and a palpable gap in the muscle when touched.

Sometimes, other medical disorders like a stress fracture, hip bursitis, or a hip strain (damage to the hip muscles or tendons) can be misinterpreted as groin strains.

What Are the Risk Factors Associated With Pectineus Pain?

• Decreased Range of Motion: Muscle strength and flexibility are linked to the risk of muscle strains in athletes. For example, football players with limited hip movement are likely to experience groin strains. However, this doesn't apply to professional ice hockey players.

• Weak Adductors: In another study, hockey players with weaker hip adduction strength before the season had a higher risk of groin strains. The strength ratio between adduction and abduction differed between injured and uninjured players, with injured players having weaker adduction strength. However, muscle strength didn't affect the risk of adductor strains in ice hockey players.

• Age: As ageing, muscles and connective tissues may lose some flexibility and become more prone to injury. As a result, pectineus injuries may become more likely.

• Improper Conditioning in Athletes: Hockey trainees and athletes who trained in the off-season had lower rates of groin injuries. Past adductor strains increase the risk of recurring injuries. In soccer players, previous groin strains and limited hip movement predicted future injuries.

• Previous Hip or Groin Injury: Groin strains and athletic pubalgia have increased in sports like American football, soccer, and hockey. Injuries in the past will make the muscle weak and tense and have a high risk of recurring injury. To prevent these injuries, it's essential to be aware of the risk factors, including past injuries and restricted hip movement.

What Are the Possible Symptoms Associated With Pectineus Pain?

Depending on how severe the damage is, the symptoms encountered from a groin strain can differ in intensity. These signs could consist of:

• Pain: A groin strain's main symptom is pain. Although it can occur anywhere between the hip and the knee, it is commonly felt in the inner thigh. Depending on the strain's severity, the pain level might range from slight discomfort to acute or intense ache.

• Lower Strength: An upper leg strain may result in groin weakness. When attempting tasks that require using the affected muscles, such as walking, jogging, or making leg motions, one could experience a loss of strength.

• Swelling: An indication of a groin strain is swelling in the region that was injured. The inflammatory reaction to the injury by the body causes it to happen. Depending on how severe the strain was, different edema levels may occur.

• Bruising: In some circumstances, a groin strain may cause bruising near the injured area. Due to the injury's damage to the blood vessels, the bruising may appear as discolouration that ranges in intensity from minor to obvious.

• Walking or Running With Pain: Groin strains can make it difficult to move freely while walking or jogging. It can be challenging to carry out these tasks usually because the pain may get worse with movements that use the strained muscles.

• Snapping Sound at the Time of Injury: Some people report hearing a snapping or cracking sound when they experience groin strain. This unnerving sound may signal a torn or severe strain in the muscle.

• Other symptoms include redness, can't poop or pass gas, nausea, vomiting, and fever.

Treatment:

• For the initial treatment of a groin strain, it is essential to act quickly within the first 24 to 48 hours following the injury. This helps reduce swelling, bleeding, and pain.

• Resting the leg and avoiding walking or exercise is advised to prevent further damage.

• Applying ice packs or a bag of frozen vegetables wrapped in a cloth to the affected area for 15 to 20 minutes every 2 hours can help reduce swelling.

• If another medical condition causes groin pain, that condition will be treated first.

• If it's a strain causing the pain, a physical therapist can help with stretching and strengthening exercises. They may also use compression clothing or athletic tape to reduce swelling.

• Over-the-counter pain relievers like acetaminophen or ibuprofen can be taken for relief, and more potent pain relievers can be prescribed if needed.

• Physical therapy focuses on muscle strength, range of motion, and stretching and may include additional treatments like ultrasound and massage.

• A training program targeting the muscles in the pelvic and adductor areas can be effective for long-standing groin pain.

• Most pectineus muscle injuries heal independently, but in rare cases, surgery may be required, followed by physical therapy for complete hip function restoration.

Conclusion:

Warm up before physical activity to prevent groin strain, maintain consistent exercise levels, and gradually increase intensity. Stretch and strengthen adductor muscles regularly, especially for sports prone to groin strain. Pectineus pain can result from sports injuries or overstretching the hip. Most pectineus injuries heal naturally but seek medical attention if severe pain or difficulty walking occurs.