Key Points
- Understanding groin pain: The Adductor Strengthening Programme effectively reduces groin pain in male football players.
- Study findings: The programme led to a 41% reduction in groin pain incidence.
- Management of groin pain: The study supports using the Adductor Strengthening Programme as a preventive measure.
- Clinical implication: Physiotherapists should consider incorporating the programme into regular training.
- Patient advice: Patients should follow structured strengthening exercises to manage and prevent groin pain.
What is traditionally understood about groin pain?
Groin pain is a common complaint, especially among athletes such as football players. It can significantly affect mobility and performance. Traditionally, groin pain is understood to be complex due to the intricate anatomy of the groin region, including muscles, tendons, and ligaments. Pain can originate from various structures within and around the groin, making diagnosis challenging.
How was the study conducted?
The study titled “The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial” was conducted as a cluster-randomised controlled trial involving 35 semi-professional football teams in Norway. Teams were divided into an intervention group and a control group. The intervention group performed the Adductor Strengthening Programme, while the control group continued their usual training without additional exercises. The study spanned the preseason and the competitive season, with weekly monitoring of groin problems using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire.
How were the participants grouped?
Participants were grouped into two main categories:
- Intervention group: 18 teams with 339 players who performed the Adductor Strengthening Programme.
- Control group: 17 teams with 313 players who followed their regular training without additional exercises.
How did they measure the success of the programme?
The success of the programme was measured using the prevalence of groin problems reported weekly during the competitive season. The primary outcome was the average weekly prevalence of all groin problems, while the secondary outcome was the prevalence of substantial groin problems. These measures were obtained through the Oslo Sports Trauma Research Center Overuse Injury Questionnaire.
How was each group treated?
Intervention group
The intervention group followed the Adductor Strengthening Programme, which included a single exercise with three progression levels:
- Level 1: Side-lying hip adduction (easiest).
- Level 2: Modified Copenhagen Adduction exercise with a shorter lever arm (moderate).
- Level 3: Full Copenhagen Adduction exercise (hardest).
Players were instructed to start at level 3 and adjust to lower levels if they experienced pain greater than 3 on a numeric rating scale of 0 to 10. The programme was performed 2-3 times per week during the preseason (6-8 weeks) and once a week during the competitive season (28 weeks).
Control group
The control group continued their usual training routines without any additional adductor strengthening exercises.
What were the results of the study between each group?
The study results showed significant differences between the intervention and control groups:
- Prevalence of all groin problems: The intervention group had a 13.5% average weekly prevalence, while the control group had a 21.3% prevalence.
- Prevalence of substantial groin problems: The intervention group had a 5.7% average weekly prevalence, compared to 8.0% in the control group.
The risk of reporting groin problems was 41% lower in the intervention group compared to the control group, demonstrating the programme’s effectiveness.
What did the study conclude?
The study concluded that the Adductor Strengthening Programme substantially reduces the prevalence and risk of groin problems among male football players. It recommends incorporating the programme into regular football training to prevent groin injuries.
If you have groin pain, consider the following steps:
- Engage in strengthening exercises: Follow a structured adductor strengthening programme to reduce the risk of groin pain.
- Monitor your symptoms: Keep track of your pain and functional limitations to assess the effectiveness of the exercises.
- Consult a Physiotherapist: Work with a Physiotherapist to ensure proper exercise technique and progression.
- Adhere to the programme: Consistency is key to seeing improvements and preventing future injuries.
As a Physiotherapist, you should:
- Incorporate evidence-based exercises: Use the Adductor Strengthening Programme as part of your treatment plan for patients with groin pain.
- Educate patients: Inform patients about the benefits of the programme and the importance of adherence.
- Monitor progress: Regularly assess patients’ symptoms and adjust the exercise regimen as needed.
- Prevent recurrence: Use the programme as a preventive measure for patients at risk of groin injuries.
Physiotherapists can manage groin pain in:
- Football players: Especially those at the semi-professional and professional levels.
- Athletes in similar sports: Such as hockey, rugby, and Australian rules football, where adductor injuries are common.
- Patients with recurrent groin pain: Who need a structured programme to prevent future injuries.
The Adductor Strengthening Programme would benefit:
- Athletes: Particularly male football players who are prone to groin injuries.
- Individuals with low hip adduction strength: Who are at higher risk of groin pain.
- Patients with a history of groin injuries: Who need targeted exercises to prevent recurrence.
Conclusion
The Adductor Strengthening Programme effectively reduces groin pain among male football players. The study demonstrates the programme’s significant impact on reducing the prevalence of groin problems, providing strong evidence for its incorporation into regular training routines. Both patients and Physiotherapists should consider this evidence-based approach to manage and prevent groin pain. Contact us today to find out more!
Ref:
Harøy, J., Clarsen, B., Wiger, E. G., Øyen, M. G., Serner, A., Thorborg, K., Hölmich, P., Andersen, T. E., & Bahr, R. (2019). The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. British Journal of Sports Medicine, 53(3), 145-152. https://doi.org/10.1136/bjsports-2017-098937
Frequently Asked Questions
What causes groin pain in athletes?
Groin pain in athletes is often caused by overuse, muscle strain, or injuries to the adductor muscles and tendons. It can also result from hip joint issues or sports-related movements that stress the groin area.
How can groin pain be prevented in football players?
Groin pain can be prevented through targeted strengthening exercises, such as the Adductor Strengthening Programme, which focuses on improving hip adduction strength and flexibility.
What are the benefits of the Adductor Strengthening Programme?
The Adductor Strengthening Programme reduces the prevalence of groin problems, lowers the risk of injury, and improves overall hip strength and stability in football players.
When should an athlete seek medical help for groin pain?
Athletes should seek medical help if they experience persistent or severe groin pain, especially if it affects their performance or daily activities. Early intervention can prevent further injury and aid in faster recovery.
How does Physiotherapy help with groin pain?
Physiotherapy helps by providing targeted exercises to strengthen the hip adductors, improving flexibility, and using manual therapy techniques to reduce pain and inflammation. It also includes educating patients on proper movement and prevention strategies.
