One of the most overlooked and probably despised areas on the human body is the inner thigh, also known as the adductor muscles. Women hate them, recoil in terror at the thought of getting them bigger in any way possible, and tend to stick to using the inner-outer thigh machine with 15 pounds for 600 reps while reading a romance novel. Men ignore them in favour of the more “showy” muscles, like calves and quads. Screw you, adductors!! You do nothing for no one!!! Sure, they may be the redheaded stepchild of the leg, but they have feelings too you know, and just like that little ging no one cares about, they can mess you up if they feel slighted and don’t get the attention they deserve.
The adductors are a group of muscles that attach to the inner portion of the thigh and also at the pelvis in different locations. The longus, magnus and brevis attach more on the anterior side of the leg, whereas the gracilis and pectineus attach more on the posterior aspect of the thigh. This is important because not only does the adductor cause adduction (duh) but also assists in hip flexion, extension, and to a degree with rotation. Another biggie is that they are the direct antagonists to muscles like the glute major, tensor fascia latea, and glute medius, which means working one without the other is like working bi’s without tri’s: you just look silly. It also has direct attachments to the medial patellofemoral ligament, which means if it’s stiff and tight or not working properly, your kneecap may not track properly, and may result in some more than unnecessary amounts of “shit this knee is hurting like crazy” to ruin your day. If you think patellofemoral pain is caused by a weak VMO on the inner quad, think again, seeing as how the fibers line up to pull in a direction that can pretty much have no impact on patellar tracking whatsoever.
Here’s a funny bit of info for you. A study performed at St. John’s hospital HERE tested the differences between selectively training the VMO versus just doing general leg strengthening on reduction of patellofemoral pain, and found there was no difference in pain reduction or functional improvements between the groups. Sounds like we need something new to focus on with anterior knee pain, right?
Let’s look at the knee in another way. We know the IT band connects to the fascial network that also wraps around the front of the knee, seeing as how anyone with a tight IT band will say the have pain that radiates across the patellar tendon, not up and down. We know that the common adductor tendon has direct attachments into the patellofemoral ligament, which helps hold the knee cap alligned, and if stretched or weak can result in the knee cap tracking laterally.
The IT band and the adductors are pretty analogous to the tibialis posterior and the peroneals role in stabilizing the ankle against frontal plane forces, so how come no one ever really addresses this when it comes to anterior knee pain? We always have to focus on the quad, getting preferential activation out of one component of the quad (sort of like “targeting” some part of the bicep, right??), even though the quad pulls up and patellofemoral syndrome is more of a lateral-medial issue, but what the hell, let’s follow the crowd.
Now I know many of you are already saying “How come I need to work my adductors when I already know tight? Shouldn’t I just squat and get my diesel on?”
I’ll give you four responses to this question. First, no. Second, not working a muscle doesn’t make it function better. Tres, that’s three in spanish. Fourth, glute work and adductor work should be considered in the same vein as pull work and push work: there should be a ratio of 2 or 3 glute exercises to every one adductor exercise so that the balance between sides of the hip is maintained, and more specifically so that optimal range of motion is maintained.If we look at someone with piss-poor hip stability doing a landing test and their legs go everywhere but where they need them to, we can assume the quad isn’t the real issue here.Sure, they may need some glute strengthening, just like your lower traps need strengthening with a kyphotic posture. But if you don’t think about the rest of the equation, you’re missing the forest for the trees. If the adductors are dysfunctionally tight (think upper traps in kyphosis), they will always win the battle over the glutes, and never allow the pelvis to get out of anterior tilt with internal rotation.
Now before everyone gets into a queue near the inner thigh machine or starts doing all sorts of cable leg swings all over the place, let me clear something up. Working the adductors does not necessarily mean concentric based movements through adduction. It can mean creating stability at or near the terminal end range of motion, as well as eccentrically decelerating a movement.
Here’s a few examples of these two concepts.
Now on top of getting the adductor to contract and relax, stretching plays just as big of a role, and should be focused on by anyone not involved in gymnastics for at least 50% of their lives (Seriously, those people are freaks).
Spending some concerted time working on adductor function may sound like as much fun as getting your bikini zone shaved with Gary Busey’s teeth, but the results pay off in the end when you’re back-squatting a dump truck and running PR’s without pain.