Original paper
Hip adductor muscle strength is reduced preceding and during the onset of groin pain in elite junior Australian football players

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Abstract

Groin pain is a condition with a high prevalence in young Australian football players. It is considered that early identification of this condition allows for optimal management. Eighty-six players from two elite under-age Australian football sides were screened weekly for hip adductor muscle strength, using a hand-held dynamometer and for the onset of groin pain. The maximum variation in the average hip adductor muscle strength values of the sample was a 2.6% decrease from baseline in week 7 of the study. Twelve players (14% of the sample studied) reported groin pain for two consecutive weeks and were considered to have an onset of groin injury. The mean hip adductor muscle strength of these players was decreased significantly from baseline by an average of 11.75 ± 2.50% at the week of pain onset (F = 264.76 (1,11), p < 0.001), and 5.82 ± 5.16% in the week preceding the onset of pain (F = 14.03 (1,10), p = 0.004). These results confirm that hip adductor muscle strength is decreased both preceding and during the onset of groin injury in elite under-age Australian footballers.

Introduction

Groin injury has a high incidence in all football codes. Elite junior Australian football players have an increased risk of developing groin injury compared with their senior counterparts with over 50 injuries per ten thousand player hours.1 Although this condition is poorly defined and lacks clear diagnostic criteria, it is one that is prone to chronicity and recurrence.2

It has been suggested that groin pain is part of a continuum of pathology and that early identification might be the key to optimal management.3, 4 Several clubs in the Australian Football League reportedly perform screening of hip adductor muscle strength in individual players as they believe a loss of strength may precede the onset of groin injury.4 The purpose of this study was to test the hypothesis that hip adductor muscle strength is decreased in the weeks preceding the onset of groin injury in a group of elite junior Australian footballers.

Section snippets

Methods

Participants were recruited from the pre-season training squads of two elite under-age Australian football clubs competing in the Transport Accident Commission (TAC) Cup. Players (n = 113, aged 16–18 years) gave informed written consent, which included consent from a parent or guardian, to participate in this study which had been approved by the University Human Research Ethics Committee. Players completed an initial survey of demographic information. A pain provocation test called the “squeeze”

Results

After the application of exclusion criteria 86 players remained in the study (Club 1 = 53; Club 2 = 33). Over the pre-season period nine players (Club 1 = 6; Club 2 = 3) were deselected by coaches from the training squads and consequently dropped out of the study. No other players chose to withdraw from the study. No significant differences in height (p = 0.25), weight (p = 0.36) or baseline hip adductor muscle strength (p = 0.24) were apparent between the two clubs.

The largest variation in the mean hip

Discussion

This study supports the role of regular screening by the use of a hand-held dynamometer to allow for early identification of groin injury. Further investigation is required to establish the real value of this protocol in terms of its impact on groin injury duration.

The finding of a high incidence of groin injury in this population of elite junior Australian footballers is consistent with results reporting an onset of groin injury in 4 out of a group of 18 elite junior soccer players (16–17

Acknowledgements

This study was supported by equipment grants from Sports Medicine Australia (Victoria branch).

References (7)

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  • Hip adduction strength and provoked groin pain: A comparison of long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test

    2022, Physical Therapy in Sport
    Citation Excerpt :

    Despite the observed strong correlation, the Bland-Altman plots showed a systematic bias and very wide 95% limits of agreement with only 39% (32/83) of players within the prespecified acceptable limits of agreement (±15% between-method difference). An effect size of 15% is considered to represent clinical meaningful change in long-lever squeeze strength (Wollin et al., 2018), which if negative could be a potential indicator of an upcoming groin problem (Crow et al., 2010). Consequently, the 5SST and the ForceFrame cannot be considered interchangeable methods and it remains unknown whether long-lever hip adduction strength assessed using a ForceFrame can be used as a single variable to monitor risk of groin problems in male senior soccer (Esteve et al., 2021).

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