Dooley Noted: 1/8/2016
The Adductor Minimis head of Adductor Magnus muscle is a seldom-discussed head that needs more clinical attention.
This week, my business partner, master trainer Joe Boffi, was noticing a limitation in his right hip external rotation. He felt it lock up as he tried to squeeze the glutes and press a kettlebell overhead.
He pointed to a round sore spot that had created a palpable swelling, inferior to the greater trochanter of the femur.
This ball of tissue was inserting on the gluteal tuberosity, where 25% of the Gluteus Maximus attaches.
This ball of tissue was a concentrically loaded (locked short) Adductor Minimus.
The Adductor Minimus is a powerful internal rotator of the femur, due to its perfect positioning between the ischial tuberosity (sit bone) and the gluteal tuberosity (posterolateral hip).
This third head of the Adductor Magnus muscle can be recruited easily, as Adductor Magnus is dominating hip extension in an internally rotated position.
For Joe, the dysfunction was being driven by the labored ability to supinate his right foot, due to a fibular fracture in his history.
Without the cue from the foot to supinate, the Gluteus Maximus recruitment was down-regulated.
Adductor Magnus then acts like a hero, trying to step in as a hip extensor in the pronated foot.
This can’t go well, since Adductor Magnus is already loaded in the sagittal plane. The Adductor Minimus can become very painful, as an attempt to stretch into external rotation goes uncued by the foot.
The Gluteus Maximus needs foot supination and hip external rotation to shorten, and Adductor Minimus needs both of those movements to fully stretch.
We broke the vicious cycle by first mobilizing and encouraging supination in his right foot. After that was complete, Adductor Minimus had permission to relax, allowing Gluteus Maximus to externally rotate the hip.
After treatment, we got creative and gave Joe a corrective that supplies all those treatment features.
His press immediately improved, as did his comfort level at the hip. We could see and feel an absolute improvement in his foot supination and hip external rotation.
If your client is having trouble accessing supination and/or hip external rotation, assessing Adductor Minimus is a must.
Remember that it is an adductor and internal rotator, a direct opposer to Gluteus Maximus on those planes.
The other two heads to Adductor Magnus are powerful hip extensors, so Adductor Minimus can act as a compensator in an already loaded Adductor Magnus.
Check the pictures to learn the location for palpation of Adductor Minimus.
As always, it’s your call.
– Dr. Kathy Dooley