Soccer: Groin Injury Hard to Predict

Groin injuries are common in soccer players and often lead to substantial time being sidelined from the game. Being able to identify clear risk factors could help sports medicine physicians develop preventative strategies for their patients. Unfortunately, predicting which players are most at-risk is not easy.

According to a new study, “Musculoskeletal Screening Tests and Bony Hip Morphology Cannot Identify Male Professional Soccer Players at Risk of Groin Injuries: A 2-Year Prospective Cohort Study,” published online on March 27, 2018 in The American Journal of Sports Medicine, hip/groin screening tests are not conclusive.

In their study, researchers investigated how effective musculoskeletal hip/groin screening tests and bony hip morphology were at identifying at-risk male professional soccer players.

They recruited 438 male professional soccer players aged 18 years or older, who had completed 609 player seasons with the Qatar Stars League. Each of these players underwent hip/groin screening which included pain provocation, range of motion and strength tests as well as hip radiographic examination, including an anteroposterior pelvic view and 45 degree Dunn view. They also determined bony hip morphology.

Any hip/groin injury that resulted in time-loss of a day or more was also recorded and the injuries were categorized as adductor-related, inguinal-related, iliopsoas-related, pubic-related, or hip-related or as “other”.

According to the data, there were 113 hip/groin injuries that met the inclusion criteria and 85 of those injuries were categorized as adductor-related. In addition, the following percentage of players had bony morphological variants: cam, 71%; pincer, 5%; and acetabular dysplasia, 13%.

Previous hip/groin injuries (HR, 1.8, 95% CI, 1.2-2.7) and eccentric adduction strength were associated with the risk of hip/groin injuries.

The researchers also found that higher than normal eccentric adduction strength was associated with an increased risk for all hip/groin injuries (HR, 1.6; 95% CI, 1.0-2.5), and that lower than normal eccentric adduction strength was associated with an increased risk for adductor-related injuries (HR, 1.7; 95% CI, 1.0-3.0). However, bony hip morphology was not associated with the risk of a groin injury.

The researchers wrote, “Previous groin injuries and eccentric adduction strength were associated with the risk of groin injuries. However, these associations were not strong enough to identify an ‘at-risk’ individual and therefor musculoskeletal screening tests were not useful to dictate individualized prevention strategies.”