Adductor Magnus Static Manual Release

Differentiation

1. The adductor magnus comprises the posterior aspect of the adductor mass, just medial to the semimembranosus and semitendinous (semi's) .
2. This muscle may be easiest to palpate with the hip at 90° of horizontal abduction, knee at 90° of flexion, and foot resting on your outer anterior superior iliac spine (ASIS) (as pictured above).
3. In this position, the adductor magnus can be palpated by pressing into the posterior aspect of the adductor mass from caudal to cranial, just medial the semi's .
4. Functional anatomy can be used to aid in differentiation. The adductor magnus does not cross the knee, and the semis do not generally contribute to adduction. Start with a broad palpation, using the whole hand on the medial and posterior aspect of the thigh. Ask your patient to flex their knee against manual resistance, and perhaps abduct to inhibit the adductor magnus , contracting the semi's under your broad palpation.
5. "Fall-off" the semi's medially to find the adductor magnus . You can confirm your finger/hand position by asking your patient to adduct against resistance, and perhaps extend the knee to inhibit the semi's .

Potentially Sensitive Tissues

• The femoral artery and vein, femoral and saphenous nerve, and additional distributions of these vessels and nerves in the adductor canal may be palpated in this position, and possibly by accident during this technique. If a pulse is felt, or the patient complains of numbness, tingling, burning or searing pain, adjust hand placement. Remember, nerves, veins, and arteries are fairly narrow, a small adjustment in finger placement should be sufficient to continue performing the release technique without further insult to delicate structures.

Trigger Points

• Common trigger points for the adductor magnus are close to mid-length of the thigh and close to the origin of the muscle near the ischial tuberosity.

Release Technique

1. This technique is likely easiest to perform with the client in supine, the hip at 90° of horizontal abduction, the knee at 90° of flexion, and the foot resting on your outer anterior superior iliac spine (ASIS) (as pictured above).
2. The practitioner should be facing the client's face, with the pelvis slightly turned away from the patient.
3. Start with broad palpation using your whole hand on the medial and posterior aspect of the thigh. Ask your patient to flex their knee against manual resistance (and perhaps abduct to inhibit the adductor magnus ) contracting the semi's underneath your hand.
4. Once the semi's have been located, fall off" them medially to find the adductor magnus . You can confirm your finger/hand position by asking your patient to adduct against resistance (and perhaps extend the knee to inhibit the semi's ).
5. Use a thumb over thumb hand position to press into the posterior aspect of the medial thigh.
6. Use caudal to cranial strokes to identify taut bands in this tissue. The adductor magnus is a thick muscle, that may require several strokes at varying depths.
7. Once a taut band is located, the length of the band is explored for a dense nodule and consistent pressure is applied.
8. The practitioner may lean into the patient's foot to increase hip flexion, or press down with the hands to increase abduction; controlling the amount of tension to aid in pinning dense nodules.
9. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).