I’m going to start an article off with the forbidden: In my opinion. Don’t judge me just yet though.
In my opinion, the adductor complex is the second most forgotten body region to train behind the feet. This LEARN will cover all things adduction as it relates to rotational power, groin rehab, hip extension, and ACL injuries.
Which two muscles are primary hip extensors?
We often hear people reference being either knee dominant squatter (quadriceps) or a hip dominant squatter (glutes). We squat for quadricep, hamstring, and glute development; but what if science tells us that there is another muscle group that may be equally or even more important than those muscle groups for squat development and hip extension torque.
Enter ADDUCTOR MAGNUS
The largest inner thigh muscles function as a primary adductor of the hip as well as extension of the hip. Secondary actions of pelvic stabilization (ill cover in another article how we can treat excessive adductor tension and tightness by addressing core stabilization and never directly addressing adductor stretching. It also has actions of eccentric control of internal rotation of the hip. This becomes all the more important in our efforts to reduce ACL risk and other lower extremity injuries in athletes.
Origin:
Origin: Inferior pubic ramus, ramus of ischium and ischial tuberosity.
Insertion: Gluteal tuberosity, linea aspera (medial lip), medial supracondylar line Ischiocondylar part: Adductor tubercle of femur
HIP EXTENSION AND ADDUCTOR HYPERTROPHY DURING A SQUAT
The study by Kubo (1) they looked at two groups of men training squats for 10 weeks. One group was going beyond parallel to maximal depth while the other went only to 90 degrees of knee flexion. Both groups squatted twice per week; totaling 20 squat sessions over the course of the study. It’s very critical to highlight that both groups were untrained. Keep in mind that untrained athletes have significantly higher strength gains in the first 4-6 weeks due to central nervous system adaptations. But the study was looking more so at muscle volume (size). In order for a muscle to grow in size (hypertrophy) we need direct load to that region causing both metabolic and mechanical changes within those tissues.
The results of the study are very significant:
“While quad muscle volume increased by a shade under 5%, adductor muscle volume increased by 6.2% on average, while glute muscle volume increased by an average of 6.7%.”
Adductor muscle volume increased by 6.2%. For that muscle growth to occur in a muscle it has to have some relatively significant tension and demand to stimulate the needed growth.
What this means is that the squat is more of an adductor exercise than a hamstring exercises.
Another study by Vigotsky and Bryanton (2) they found that half or more of your hip extension torque in the squat should come from your adductor magnus.
Takeaway: Want to develop your squat, specifically getting out of the bottom position: train your adductors.
GROIN INJURIES
Quad to Hamstring ratio (knee extension to knee flexion) is a term we often use in the rehab world to guide exercise selections and measures to ensure we have developed adequate strength and synergy with movement. But we never talk about abduction to adduction ratios. Groin rehab is all about making the adductor muscle group both LONG and STRONG to develop proper length/tension relationships.
A study by Tyler et al. (3) did find was that preseason hip adduction strength of the players who sustained groin injuries was 18% lower than that of the healthy players. They also found that adduction strength was 95% of abduction strength in the uninjured players, compared to only 78% in the injured players. This suggests that a muscular imbalance between the weak adductors and the relatively strong abductors plays a large role in groin issues. Reducing groin injuries or rehabbing groin injuries must consider adductor strength relative to abduction strength.
Since most groin injuries involve force being applied to the muscle in a lengthened position more than that muscles capacity to absorb or withstand applied force; training with a high emphasis on the ECCENTRIC phase is key.
ACL INJURIES
Adductors play an important role in internally rotating the hip and developing rotational power.
Excessive hip adduction and internal rotation during weight bearing has the potential to affect the kinematics of the entire lower extremity. More specifically, excessive hip adduction and internal rotation can cause the knee joint center to move medially relative to the foot. Because the foot is fixed to the ground, the inward movement of the knee joint causes the tibia to abduct and the foot to pronate, the end result being dynamic knee valgus; placing more stress on passive structures like the ACL.
Regardless if you’re a powerlifter looking to increase hip extension torque or a soccer athlete training to minimize injury risk; programming should incorporate submaximal and maximal isometrics, concentric muscle actions for both strength AND power development, and force absorption with controlled eccentric loading in the adductor muscle group.
Before we get into the many different ways we can target and strengthen the adductors for various roles; I have to preface it with this. None of this exercises matter if you can’t do them while maintaining a neutral spine with proper spinal stabilization strategies. If you feel like you’re adductors are overactive and have constant tension/tightness then start by addressing lumbopelvic stability with exercises like: deadbug variations, birddogs, pallof press, loaded carries, and other anti-extension/rotation movements.
Let’s start with isometrics.
COPENHAGEN PLANK
Copenhagen Plank is an all around win-win. Minimal equipment needed and easily one of the most efficient ways to train the adductors for hip stabilization, pelvic stabilization, and force absorption. This can be utilized as an isometric with longer holds at the top position.
Progression 1-Short lever position: Utilize a bent knee position (similar to a clamshell setup. Have your bottom arm positioned as if you are going to side a side plank. Pull your top leg into the bench to utilize your adductors to create upward movement or relative adduction of your trunk.
I love starting with submaximal isometric holds for 3-5 sets of 10-15 second. You can also focus on the eccentric or lowering portion to address the adductors ability to absorb force. This is really important for athletes moving in multidirectional planes or that have had previous groin strains.
Progression 2-Long lever position: With the top leg fully extended this places more demand on the adductors to produce force and tension.
Progression 3-Long lever with march: This progression places more demand on core, shoulder, and hip engagement
UNILATERAL ADDUCTOR RDL
Rememer this study (2) referencing the importance of the adductors in aiding hip extension. This is a must training for squatters and deadlifters looking to optimize their lifts. Use this singe led RDL variation to unlock hidden force with your hip extension movement pattern.
Place the foam roller just above the inner knee. Place the KB in the opposite hand of the stance limb for more internal rotation and adductor recruitment. Hinge in your hips as you begin with a neutral pelvis (not tipping forward and not tucked underneath).
HALF KNEELING ADDUCTOR MED BALL TOSS
By using our adductors to keep the foam roller pinned to the wall we can create more rotational stability and power. This is key for rotational athletes and getting the right hip to shoulder separation for power development. This would be more of an isometric based movement.
REACTIVE NEUROMUSCULAR TRAINING
Reactive Neuromuscular Training (RNT) is designed to restore the synchrony and synergy of muscle firing patterns in a particular region or muscle group; which is required for dynamic joint stability and fine motor control. RNT allows us to bridge the gap between the achievement of clinical based goal and a return to activity. RNT utilizes external resistance (I.E., resistance band) to facilitate an automatic, subconscious response at the neuromuscular level. This can translate into improved movement patterns with less compensation. I love using RNT with individuals that are appropriate for it because it avoids over-cueing, complicating things, and you can get quick results with it. Below we are using this with a rear foot elevated split squat and a single leg lateral step down. You often see people use this same method for correcting dynamic knee valgus positioning, BUT if someone has poor control of their adductor muscle groups and pelvic stabilization, test and retest without and with a band to see movement quality and range of motion.
QUADRUPED ADDUCTOR SLIDERS
You will only be able to go as low and wide as your adductor mobility will allow, but you will find as you improve both strength and control in the muscle group you will be able to progress further into range of motion.
One cue I love to give for this exercises is to PULL the ground together.
LATERAL SLIDER w/ CONCENTRIC FOCUS
By having band tension in the slide leg we have to use our adductors on the stance leg (left in video) to produce force and adduct our trunk and contralateral leg back to the starting position. Focus on a tempo of:
3 second slide-1 second pause-1 second return.
LATERAL SLIDER WITH ECCENTRIC FOCUS
Once you pull yourself back to the upright position on the stance limb (LEFT in video) you will feel some pattern assistance with the band. It’s key to use your adductors to CONTROL the return position.
SUMMARY
Yes we have covered ALOT. The next time you want to train your glutes and place a band around your knee for every single movement; try not to leave your adductors hanging. Show them love and they will show you love through pain-free PR’s and rotational power Sammy Sosa dreamed of (PED’s not included).
References
1) Kubo K, Ikebukuro T, Yata H. Effects of squat training with different depths on lower limb muscle volumes. Eur J Appl Physiol. 2019;119(9):1933-1942.
2) Vigotsky, Andrew & Bryanton, Megan. (2016). Relative Muscle Contributions to Net Joint Moments in the Barbell Back Squat.
3)Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility on the incidence of groin strains in professional ice hockey players. Am J Sports Med. 2001;29(2):124-128.
4)Neto JBDS, Fukuda TY. Letter to editor in chief: Do hip muscle weakness and dynamic knee valgus matter for the clinical evaluation and decision making process in patients with patellofemoral pain?. Braz J Phys Ther. 2018;22(5):431-432.
5)Haroy J, Clarsen B, Wiger EG, et al. The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med. 2019;53(3):150-157.
6)Ishoi L, Sørensen CN, Kaae NM, Jorgensen LB, Hölmich P, Serner A. Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial. Scand J Med Sci Sports. 2016;26(11):1334-1342.