What is adductor tendinopathy (pubalgia)?
Adductor and pubic anatomy
The adductor muscles connect the pelvis (at the pubic bone) to the inner thigh and bring the leg back toward the body’s midline. Their tendons attach to the pubic bone, a convergence zone for many muscular and abdominal structures. Pubalgia, a term covering chronic groin pain, most often corresponds to adductor tendinopathy at its pubic attachment.
Why does this area become painful?
Pain appears when the adductors are repeatedly loaded beyond their capacity, particularly during changes of direction, ball strikes, or intense running efforts. A strength imbalance between adductors and abdominals, too rapid an increase in training volume, or poor recovery between sessions are common contributing factors.
Which sports contribute to adductor tendinopathy?
Any sport with fast changes of direction and ball strikes carries a particular risk:
- Football/soccer, the most affected sport
- Ice hockey
- Rugby
- Racquet sports
- Athletics (sprinting, hurdles)
- Combat sports with changes of stance
Treating adductor tendinopathy in rehab with a sports physio
The goal of treatment is to progressively strengthen the adductors and rebalance the strength ratio with the abdominals, while temporarily reducing load on the painful area.
- 1Reducing pain and managing load
- 2Hip mobility
- 3Isometric strengthening
- 4Progressive concentric strengthening
- 5Eccentric strengthening
- 6Pelvic chain work
- 7Correcting sporting technique
- 8Strengthening under sport-specific load
- 9Progressive return to your sport
- 10Return to competition
Why the physio’s initial assessment matters
During the initial assessment, the physiotherapist aims to identify the movements that reproduce the pain (striking, changing direction), recent training volume, and the strength balance between adductors and abdominals.
“It’s not that the tendon is fragile, it’s that the load needs to be better dosed and distributed.”
Strengthening, the cornerstone of treatment
Progressive strengthening of the adductors, particularly eccentric work, combined with core abdominal work, rebalances the forces around the pubic bone and reduces repeated tension on this convergence zone.
In brief
- Progressive strengthening of the adductors
- Associated core abdominal work
- Eccentric strengthening
- Gradual return: mobility, then load, then sport
Ready to take your adductor tendinopathy (pubalgia) seriously?
Start the HOPP programme designed by sports physios.
Should you rest or keep playing sport?
Total rest is generally not necessary. It’s better to temporarily adapt the striking and change-of-direction movements that clearly reproduce the pain, while starting strengthening as soon as possible.
Think you might have a different hip injury?
Take your free test in 3 minutes flat.
When should you see a specialist for pubalgia?
If the pain persists for more than four to six weeks despite adapting your activities and following a well-run strengthening programme, a medical opinion is recommended to pinpoint the exact origin of the pain (tendon-related, abdominal or mixed).
The HOPP care programmes to treat your pubalgia and get back to sport
This pubalgia requires comprehensive, progressive strengthening. HOPP offers you a precise exercise programme, allowing you to get back to your activities as quickly as possible.
The programme runs from 3 to 9 weeks depending on the injury and ends with a reconditioning phase allowing a return to competition in the best possible conditions. Each programme is designed by the HOPP team, made up of two sports physiotherapists who are experts in assessing and treating athletes. You’ll also find theoretical content throughout your progression, so you master every aspect of your recovery and can adjust your treatment independently. If needed, our team of physiotherapists is on hand to support you.
Essential
FROM INJURY TO
BACK TO YOUR ACTIVITIES
59€
One-time payment
“AT YOUR OWN PACE WITH
DAILY ADAPTATION”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
Performance
TO GET BACK TO SPORT
IN THE BEST CONDITIONS
79€
One-time payment
“GET BACK TO YOUR LEVEL
WITHOUT RISK OF RELAPSE”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility
- Strengthening
- Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
Expert
PERSONALISED VIDEO-CALL
SUPPORT, ANY TIME
149€
One-time payment
“A PHYSIO
WHENEVER YOU NEED”
- 100% of the treatment programme
- Daily personalisation
- Flexibility / Mobility, Strengthening, Proprioception
- Progress tracking
- Return-to-running programme
- Theoretical content included
- + 4-week return-to-play plan with 6 difficulty levels
- + 2 video calls with an expert sports physio / return check-up
A programme that adapts to you every day
Every day, how you feel (RPE) is factored in to automatically adjust the rest of your programme: more load if all is well, a bit less if your groin is complaining. This daily personalisation is what makes the difference compared to a fixed, paper-based programme.
Ready to start your programme?
Join the HOPP support programme designed by sports physios.
F.A.Q
Does the HOPP programme replace a medical consultation?
No. HOPP is a support and rehab tool designed by sports physiotherapists, but it doesn’t replace a doctor’s opinion. If in doubt, or if the pain persists, see a health professional.
Is the programme suited to all sporting levels?
Yes. Every programme is personalised to your sport, your level and how you feel each day, whether you’re a recreational athlete or preparing for competition.
Can I keep playing sport with this pubalgia?
In most cases, yes, by temporarily adapting the movements that reproduce the pain, while starting strengthening in parallel.
How long does it take to recover?
Pubalgia can take longer to heal than other tendinopathies, with gradual improvement over several weeks to a few months depending on how long the symptoms have been present.
Why does pubalgia often come back?
Because it’s often linked to a broader strength imbalance (adductors/abdominals) that needs to be treated as a whole and maintained over time to prevent recurrence.
