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 Sciences, Oslo Sports Trauma Research Center, Oslo, 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
- Groin injuries are a major contributor to pain and lost time in male soccer
- Doing a prevention protocol using a simple Copenhagen Adduction Exercise can reduce the prevalence and risk of groin problems in male soccer players
- The Copenhagen Adduction Exercise protocol can easily be integrated into prevention programs, such as the FIFA 11+
- 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
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