Soccer Injury Prevention: A Simple Adduction Exercise May Reduce The Risk of Groin Problems

The Adductor Strengthening Programme Prevents Groin Problems Among Male Football Players: A Cluster-Randomised Controlled Trial

The British Journal of Sports Medicine, June 10th, 2018

Harøy, Et. Al    

Department of Sports Medicine, Norwegian School of Sport SciencesOslo Sports Trauma Research CenterOslo, Norway

“An ounce of prevention is worth a pound of cure.” – Benjamin Franklin

As sports medicine physical therapists and athletic trainers we know that rehabbing injuries during the season can be a messy business, one that we want to stay away from as much as possible. There are many prevention programs circulating the online-world, but which ones are effective and have good adherence? The FIFA 11+  is a great prevention program for youth soccer; however, can we do any additional work to prevent groin pain in soccer player?

Groin injuries are a major issue in male soccer, contributing 4-19% of all time lost in male soccer. At the highest level, it can account for up to 1 in 5 injuries. The Copenhagen Adduction (CA) Exercise is proposed to be a simple and effective exercise to aid in groin injury prevention and hip strengthening.

Harøy, Et. Al looked to see if teams that implemented a simple protocol, based on the Copenhagen Adduction Exercise, could decrease groin issues in male soccer players. A total of 34 teams participated. 339 players performed the CA progression to be performed during the preseason and regular season. 313 other players served as the control.

The Copenhagen Adduction Exercise Protocol Used:

All players in the intervention group performed the CA exercise per the video in the post. However, if a player had pain with this, they were asked to perform modified versions until they could achieve the standard exercise. Videos of the modified versions can be seen in the supplementary material provided by the authors.

Level of CA Description Indication
3 (Standard / Hardest) See video above All players, if possible
2 (Moderate) Assistant holds the player at the knee instead of the ankle If groin pain >3/10 during level 3, perform level 2 instead
1 (Easiest) Side-lying hip adduction If groin pain >3/10 during level 2, perform level 1 instead

Throughout the season, the players in the intervention group performed the following progression below:

Week Weekly Sessions Sets Per Side Reps Per Side
Preseason
1 2 1 3-5
2 3 1 3-5
3-4 3 1 7-10
5-6 3 1 12-15
7-8 2 1 12-15
In Season
1 1 12-15

How Did the Numbers Play Out?

Below is the prevalence of average groin problems presented each week during the study/season:

  • Average weekly percentage of players presenting with any groin problem:
    • Intervention group: 13.5%
    • Control group: 21.3%
  • Average weekly percentage of players presenting with a substantial groin problem:
    • Intervention group: 5.7%
    • Control group: 8.0%

Very impressively, the players in the intervention group had a 41% less chance of reporting any groin problem compared to the control group!

Interesting Tidbits

  • Players in the study reported being approx. 70% compliant with performing the protocol regularly. One could imagine how good of an impact this protocol could make with 100% compliance. Then again, we’re not robots and there’s a 100% chance that our patients and athletes won’t be 100% compliant doing their home exercises.
  • We still don’t know the optimal dose of this exercise to maximize the risk reduction of groin injuries. Hopefully, more research to come!

Takeaways

  1. Groin injuries are a major contributor to pain and lost time in male soccer
  2. Doing a prevention protocol using a simple Copenhagen Adduction Exercise can reduce the prevalence and risk of groin problems in male soccer players
  3. The Copenhagen Adduction Exercise protocol can easily be integrated into prevention programs, such as the FIFA 11+
  4. If you’re not already doing a prevention program for the sports teams you’re covering then what are you waiting for? Get started!

Tyler Cope

Forever Disclaimers:

1): Readers –  If any of these articles peak your interest, please click the link to the original source to read the full text! It’s important to interpret research for yourself and as it pertains to you and your practice. Not to mention, we should support our journals and authors that provide this content.
2): Journals and authors – I do my best job to help promote the message from the research you provide to help clinicians improve. This is not a platform to try and promote my own individual views. I can promise you that I will not always have everything right, so please, if you have any feedback for me or if I misinterpreted anything then let me know!

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