You ask your post-stroke patient to squeeze a ball between their knees, but the left leg drifts outward instead of holding steady. This inability to pull a limb toward the midline is a deficit in adduction—a key finding that impacts everything from stability to mobility.
What is Adduction?
Adduction (ad-DUCK-shun) is a movement of a limb or other body part toward the midline of the body or, in the case of the fingers and toes, toward the central axis of the limb. It is the opposite of abduction. This anatomical term falls under the category of body mechanics and musculoskeletal assessment. You will assess this when checking Range of Motion (ROM) or performing a neurologic exam to evaluate motor strength.
Why Adduction Matters in Nursing Practice
Strength in adduction is essential for patient stability and mobility. Without it, patients struggle with balance, walking, and transferring from bed to chair. In neurologic assessments, weakness in adduction can indicate a stroke or nerve damage. It is also critical in post-operative care, particularly for patients recovering from total hip arthroplasty; preventing specific adduction movements is often a primary safety protocol to prevent dislocation.
What You’ll See at the Bedside
You will test this by asking the patient to move an arm or leg toward the center of their body against resistance. For example, asking them to bring their arm down to their side or squeeze your hand between their knees. You are looking for smooth movement and equal strength bilaterally.
“During Mr. Rivero’s neuro check, he was unable to adduct his right leg against resistance. He rated the effort 3/5 and demonstrated noticeable drift when trying to squeeze the ball between his knees, indicating persistent hemiparesis.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Confusing adduction with abduction. It is an easy mix-up when documenting quickly, but reversing these terms changes the clinical picture entirely.
💡 Pro Tip: Think of the word “Add.” You are trying to add the limb back to the body. For hip replacement patients, remember “no crossing legs”—crossing the legs forces the hip into adduction, which is exactly what you want to avoid to prevent dislocation.
Memory Aid for Adduction
Remember the phrase: “ADD to the body.”
You are adding the limb back to the center of the body. Conversely, to abduct is to take away.
NCLEX Connection
This term frequently appears in NCLEX questions related to musculoskeletal and neurological assessments. You may need to identify that a patient cannot adduct or select the correct intervention for a patient with hip precautions (e.g., keeping an abduction pillow in place).
Related Nursing Concepts
Adduction is directly connected to Range of Motion (ROM) exercises, which help maintain joint integrity. It is also a component of a complete Neurological Assessment, specifically the motor exam. Furthermore, understanding this movement is vital for Fall Prevention, as weak adductor muscles contribute to instability and a wide-based gait. Finally, it relates to Gait Training, as adduction stabilizes the hips during walking.
Quick Reference
✓ Normal movement: Smooth movement toward midline
✓ Priority level: Moderate (Routine assessment) to High (Post-Op hip/Neuro)
✓ Nursing considerations:
- Assess adductor strength during neuro checks
- Monitor hip replacement patients for accidental adduction
- Use abduction pillows as ordered to prevent hip dislocation
- Incorporate adduction exercises into ROM regimens
- Educate patients on safe body mechanics to avoid strain
Understanding adduction helps you assess weakness faster and protect vulnerable joints during recovery. Keep your eyes on the midline