Atlas · Thigh

Pectineus

Deep inguinal aching from pectineus trigger points near the pubic and femoral attachments

Body region

Thigh

Trigger points

documented in this muscle

Common symptoms

patterns cataloged

Common causes

contributory factors

Illustrated overview

Pectineus · Anatomy 1. Anatomical view of the illustrated muscle. — **Pectineus · Anatomy 1**
Anatomical view of the illustrated muscle.
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Trigger points

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1. Pectineus

Location. Upper inner thigh, deep

Pectineus — Trigger point map — Trigger point map

Pectineus — Referred pain map — Referred pain map

Pain referral. Groin, upper inner thigh

Pain Pattern

Groin
Upper inner thigh
Pubic area

What This Pain Feels Like

A deep, sharp groin pain just below the inguinal crease that worsens noticeably with hip flexion and adduction movements such as stepping sideways or climbing stairs. The pain can closely mimic hip joint pathology or a sports hernia, making it frequently misdiagnosed. Patients often describe it as a deep pinching or catching sensation in the groin fold that intensifies after running or prolonged walking. The aching tends to linger after activity and may be accompanied by stiffness when first standing up from a seated position.

What Patients Report

Deep groin pain
Pain when walking
Thigh discomfort

What Makes It Worse

Walking
Running
Hip flexion
Adduction

Browse related exercises (1)

Symptoms patients report

Groin pain Deep inguinal aching from pectineus trigger points near the pubic and femoral attachments

Deep thigh pain Upper medial thigh ache from pectineus trigger point referral to proximal femoral area

Pain with walking Groin discomfort during hip flexion phase of gait from pectineus trigger point activation

Common causes

Running Repetitive hip flexion and adduction during running overloads the pectineus muscle each stride

Soccer Inside-foot kicking demands combined hip flexion and adduction straining the pectineus

Hockey Skating stride requires repetitive hip adduction that overloads the pectineus chronically

Sudden movements Unexpected lateral leg displacement with flexion acutely strains pectineus muscle fibers

Hip flexion Sustained or repetitive hip flexion activities overload the pectineus beyond its recovery capacity

Treatment & self-care

Professional Treatment

Clinician-led manual care for assessed groin pain

A clinician can examine the hip and groin, identify whether muscle or tendon tenderness contributes, and select comfortable manual therapy when appropriate. Keep home pressure out of the groin crease, where major vessels and nerves pass. Between visits, use supported hip movement within a comfortable range and the gentle exercises agreed after assessment.

Duration: A short treatment trial with reassessment of a useful hip movement
Frequency: Individualized after hip and groin assessment
Expect: More comfortable hip movement when local manual care is appropriate to the findings

Caution Stop any contact that causes pulsing, tingling, numbness or spreading pain. Seek assessment for a groin bulge, swelling, catching or increasing weight-bearing pain.

Immediate Relief

Hip flexor stretch (half-kneeling)

Kneel on the affected side with the opposite foot forward in a lunge position. Tuck your pelvis under (flatten the lower back) and gently shift your weight forward until you feel a stretch deep in the front of the hip and groin on the kneeling side. Keep your trunk upright and avoid arching the low back. This lengthens the pectineus along with the iliopsoas.

Duration: 30-45 seconds per side, 3 repetitions
Frequency: 3-4 times per day
Expect: Work toward comfortable hip motion; compare the range used in walking or sitting.

Exercises

Adductor ball squeeze isometrics

Lie on your back with knees bent and feet flat on the floor. Place a soccer ball, pillow, or soft ball between your knees. Squeeze the ball gently with your inner thighs, holding for 5 seconds, then relax. Gradually increase squeeze intensity over sessions as pain allows. This strengthens the pectineus and adductors in a safe, controlled position.

Duration: 10-15 repetitions, 3 sets
Frequency: 2 times per day
Expect: Build hip strength and control; track walking, stairs or the relevant activity.

Exercises

Copenhagen adductor exercise (modified)

Lie on your side with the top leg resting on a bench or sturdy chair at knee height. Lift the bottom leg up to meet the bench, engaging the inner thigh muscles. Hold for 2-3 seconds, then lower slowly. For the modified version, keep the top knee bent on the bench rather than the foot. Progress to the full version as strength improves.

Duration: 8-10 repetitions per side, 2-3 sets
Frequency: Every other day
Expect: Build hip strength and control; track walking, stairs or the relevant activity.

Lifestyle Changes

Warm-up protocol before sport

Before any running, kicking, or lateral movement activity, perform a thorough warm-up including 5 minutes of light jogging, dynamic leg swings (forward-back and side-to-side), bodyweight sumo squats, and gentle groin stretches. A proper warm-up increases blood flow to the pectineus and prepares it for the demands of sport, significantly reducing the risk of flare-ups.

Duration: 10-15 minutes before activity
Frequency: Before every exercise session or sport
Expect: Reduce provoked symptoms while maintaining tolerable activity; progress with the response.

Professional Treatment

Professional hip assessment to rule out labral tear

See an orthopedic specialist or sports medicine physician if deep groin pain persists beyond 3-4 weeks despite self-care, especially if accompanied by clicking, catching, or a sensation of the hip giving way. A comprehensive hip examination and possibly imaging (MRI arthrogram) can rule out acetabular labral tears, femoroacetabular impingement, or sports hernias that present similarly to pectineus trigger points.

Duration: Initial evaluation: 45-60 minutes
Frequency: As needed based on symptom persistence
Expect: A working diagnosis and an individualized treatment plan, with progress judged by the relevant daily activity.

Caution Seek prompt evaluation if you experience groin swelling, a palpable bulge, or pain that worsens significantly with coughing or straining

Differential diagnosis

Groin strain
Hip pathology
Sports hernia

Associated Trigger Points

Key Takeaways

Deep inguinal aching from pectineus trigger points near the pubic and femoral attachments
Upper medial thigh ache from pectineus trigger point referral to proximal femoral area
Groin discomfort during hip flexion phase of gait from pectineus trigger point activation