Anatomical and mechanical relationship between the proximal attachment of adductor longus and the distal rectus sheath

Abstract

The objectives of this study were to investigate the anatomical relationship between the proximal adductor longus (AL) and rectus abdominis muscles and to determine whether unilateral loading of AL results in strain transmission across the anterior pubic symphysis to the contralateral distal rectus sheath. Bilateral dissections were conducted on 10 embalmed cadavers. Strain transfer across the pubic symphysis was examined on seven of these cadavers. An AL contraction was simulated by applying a controlled load in the direction of its proximal tendinous fibers, and the resultant strain in the contralateral distal rectus sheath was measured using a foil-type surface mounted microstrain gage. Adductor longus attached to the antero-inferior aspect of the pubis. In 18 of the 20 limbs, the proximal attachment of AL was tendinous on its superficial surface and muscular on its deep surface. The proximal AL tendon was found in most instances to have secondary communications with structures such as the contralateral distal rectus sheath, pubic symphysis anterior capsule, ilio-inguinal ligament, and contralateral proximal AL tendon. Despite these consistent anatomical observations, strain measured in the contralateral distal rectus sheath upon unilateral loading of the proximal AL varied considerably between cadavers. Measured strain had an average ± 1SD of 0.23 ± 0.43%. The proximal attachment of AL contributes to an anatomical pathway across the anterior pubic symphysis that is likely required to withstand the transmission of large forces during multidirectional athletic activities. This anatomical relationship may be a relevant factor in explaining the apparent vulnerability of the AL and rectus abdominis attachments to injury.

Intermuscular force transmission along myofascial chains: a systematic review

“…) In contrast to this, force transfer between adductor longus and rectus abdominis was only marginal despite structural continuity (Norton‐Old et al. ). Though broad definitions of fascia (encompassing tendinous, aponeurotic and ligamentous tissue as well as the muscle fascia itself) emphasizing histological similarity have been proposed (Schleip et al.…”

“…; Norton‐Old et al. ) or fibre‐optic force measurements (Erdemir et al. ), others report tension transfer based on visual inspection (Vleeming et al.…”

Skin, fascias, and scars: symptoms and systemic connections

“…The distal rectus abdominis sheath has a direct connection with the gracilis and adductor longus muscles through fascial connections; this relationship is important to distribute the load of the step between the trunk and the lower limbs 103. Over time, an alteration of the loads may lead to pubalgy, and even to back pain.…”

Anatomical study of the ostrich (Struthio camelus) foot locomotor system

“…3B), restricting the tendon as well as limiting friction during tendon motion. Tendon sheath is composed of an outer fibrous sheath and an inner synovial sheath (Norton et al, 2013). Synovial fluid was found between these two layers in the ostrich foot and there were two tendon sheath trochlea of different sizes on the posterior aspect of the metatarsophalangeal joint.…”