Hip Adductor Strengthening Programmer Reduces Groin Problems in Football Players

Groin injuries are prevalent in male football, accounting for 4%–19% of all time-loss injuries.  In elite players, approximately one in five male players incur a groin injury causing time loss to play. Previous groin-specific prevention programmes have not shown a significant reduction in groin injury rates.

In football, two out of three cases of groin injuries are related to hip adductor. Low hip adduction strength has been identified as an important risk factor associated with an increased risk of groin injuries.

Thus, an exercise programme called the Copenhagen Adduction exercise was designed to strengthen hip adduction. And a study was conducted to evaluate the effectiveness of this on the prevalence of groin problems in male football players.

35 semi-professional Norwegian football teams were cluster-randomised into an intervention group (18 teams, 339 players) and a control group (17 teams, 313 players). The intervention group performed an Adductor Strengthening Programme using one exercise, with three progression levels, three times per week during the preseason (6–8 weeks), and once per week during the competitive season (28 weeks). The control group were instructed to train as normal.

The Copenhagen Adduction exercise is as follows:

A partner exercise where the player is lying on the side of the non-dominant leg with one forearm as support on the floor and the other arm placed along the body. The dominant leg is held in approximately the height of the hip of the partner, who is holding the leg with one hand supporting the ankle and the other supporting the knee. The player then raises the body from the floor and the non-dominant leg is adducted so that the feet touch each other and the body is in a straight line. The body is then lowered halfway to the ground while the foot of the non-dominant leg is lowered so that it just touches the floor without using it for support. New suggested high-intensity exercise.

Figure (A) Starting/ending position and (B) mid position for the different levels of the Adductor Strengthening Programme. From Harøy et al. (2019)

As the exercise might be painful or difficult to perform for symptomatic players, there are two easier levels that players could choose from:

level 1 (easiest): side-lying hip adduction;

level 2 (moderate): as described above, but with a shorter lever arm; and

level 3 (hardest): as described above

The results showed that the average prevalence of groin problems during the season was 13.5% in the intervention group and 21.3% in the control group. The risk of reporting groin problems was 41% lower in the intervention group.

The authors concluded that this simple Adductor Strengthening Programme substantially reduced the self-reported prevalence and risk of groin problems in male football players.

They further suggested that the adductor strengthening programme should be included in football training. However, the generalisation of the programme to female, youth-level, and professional players, is not known.

Nevertheless, the hip adduction strengthening exercise may also benefit other sport which has groin problems, such as ice hockey, rugby and Australian rule football.