Adductor tendonitis is one of many possible causes of groin pain in runners and athletes. Most groin pain comes from overload of the tendons and joints around the pubic symphysis, and the main treatment is a progressive exercise programme. But some people don’t settle for rehab alone. So what are the options for complex adductor tendonitis injection cases — and how effective is injecting in the groin?
Which injection suits which cause of groin pain?
The cause of the groin pain determines the best injection.
- Adductor tendonitis → An adductor tendonitis injection into the tendon makes sense where the adductor tendon is the source.
- Pubic symphysis/osteitis pubis → an ultrasound-guided pubic symphysis injection is more effective where the pain comes from that joint.
- Hip joint pathology → A hip joint or iliopsoas sheath injection is the better choice.
Whatever the target, injecting in the groin is an addition to a rehab programme — it doesn’t replace exercise therapy.
What injections are used for adductor tendonitis?
Cortisone injection
The most common injection for adductor tendonitis is cortisone into the adductor tendon. Cortisone is a potent anti-inflammatory that reduces tendon pain. Dr Masci has written a review paper on cortisone for tendonitis, which is covered on the tendon injection page. It’s a reasonable option, but cortisone can weaken a tendon and cause skin side effects, so we use it carefully.
PRP injection
PRP (platelet-rich plasma) — concentrated from your own blood — is also used for adductor tendonitis. It avoids cortisone’s tendon risks, though evidence for PRP specifically for groin pain remains limited.
Both cortisone and PRP injections in the groin are performed under ultrasound guidance, which improves accuracy and reduces side effects.
Nerve injections (nerve blocks)
More recently, groin nerve injections have been used to relieve persistent pain for weeks to months. For adductor tendonitis, an injection around the obturator nerve (which innervates the adductor muscles) can relieve pain without directly injecting the tendon. An ilioinguinal nerve injection can help relieve pain from the pubic symphysis and abdominal wall region. Because the tendon itself isn’t injected, we consider nerve blocks a safer option, and they’re sometimes combined with a tendon or joint injection for greater effect.
How does a nerve block relieve groin tendon pain?
Temporarily numbing the nerve with local anaesthetic reduces the pain signals reaching the brain and appears to “reset” the nerve pathways, producing relief that outlasts the anaesthetic itself. A small dose of cortisone is sometimes added to settle nerve inflammation. The result is pain relief without injecting cortisone directly into the tendon. The image below shows an obturator nerve injection, with the needle tip placed precisely at the nerve.
Frequently asked questions about adductor tendonitis injections
When should I consider an injection for adductor tendonitis?
Generally, only when a good rehab programme hasn’t settled the pain, or when severe pain is blocking meaningful rehab. The injection supports the rehab — it isn’t a first-line treatment or a shortcut back to sport.
Cortisone or PRP for adductor tendonitis — which is better?
Cortisone reliably reduces pain in the short term but can weaken a tendon, so we use it sparingly. PRP avoids that risk but has weaker evidence specifically for the groin. The choice depends on the tendon, your goals, and how the pain has behaved — an ultrasound assessment helps decide.
Is an adductor injection done under ultrasound?
Yes. The groin is anatomically complex, so we use ultrasound to place the injection accurately into the tendon, joint, or nerve sheath — improving both accuracy and safety.
Are nerve blocks safer than tendon injections?
In one sense, yes — a nerve block relieves pain without injecting cortisone into the tendon, avoiding the small risk of tendon weakening. That’s why we often consider a nerve block first, or combine it with a tendon injection.
Will an injection cure my adductor tendonitis?
No. An injection reduces pain for a period, creating a window to rehab — but the lasting recovery comes from the strengthening programme, not the injection.
Final word from Sport Doctor London about adductor tendonitis injection options
Injections for groin pain are about reducing pain so you can rehab. An adductor tendon or pubic symphysis injection — cortisone or PRP — helps in some cases, while nerve injections relieve pain without the risks of injecting a tendon directly. Whatever the approach, injecting in the groin works best alongside a rehabilitation programme.
To discuss the right injection for your groin pain, Dr Masci can assess you in London under ultrasound. Contact the team here or call +44 (0) 203 488 0350.
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