Diagnosis and Rehabilitation of a Proximal Adductor Longus Injury in a Professional Tennis Player: A Case Report.

Abstract

BACKGROUND: Groin injuries are common in multidirectional sports, but proximal adductor longus (pyramidalis-anterior pubic ligament-adductor longus complex [PLAC]) type 6 tears are rare in tennis. These injuries affect the fibrocartilaginous enthesis and pose diagnostic and management challenges. This case report details the conservative rehabilitation of a professional tennis player with a PLAC type 6 injury, highlighting clinical decision-making and return-to-sport progression. CASE PRESENTATION: A 25-year-old male professional tennis player experienced acute groin pain during the 2024 Wimbledon Championships. Magnetic resonance imaging showed a partial thickness tear of the left adductor longus fibrocartilage origin with pyramidalis edema—consistent with a PLAC type 6 injury. A multidisciplinary team opted for conservative management over surgery. A 24-week rehabilitation program began 5 days postinjury, progressing from pain management and protected loading to sport-specific drills. Load advancement was guided by pain ≤2/10 and functional testing. OUTCOME AND FOLLOW-UP: Pain, strength, range of motion, and Hip and Groin Outcome Score improved significantly by weeks 12 to 16. The athlete returned to competitive play at 16 weeks and was symptom-free at 6-month follow-up. Magnetic resonance imaging at 24 weeks showed healing to PLAC type 3. DISCUSSION: Structured, criteria-based rehabilitation enabled full recovery without surgery. Conservative treatment may be effective for selected PLAC injuries. JOSPT Cases 2026;6(1):56-63. Epub 16 December 2025. doi:10.2519/josptcases.2025.0191