The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial

Harøy, Joar; Clarsen, Benjamin; Wiger, Espen Guldahl; Øyen, Mari Glomnes; Serner, Andreas; Thorborg, Kristian; Hölmich, Per; Andersen, Thor Einar; Bahr, Roald

doi:10.1136/bjsports-2017-098937

Cited by 122 publications

(163 citation statements)

References 37 publications

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“…Despite these results, suggesting that reach of the program was successful, the players reported to deviate from the recommended protocol. In the present study, about 45% of the players reported to have performed the program at least as often as prescribed, while data from the RCT documented an average weekly completion of the program of 70% . However, the discrepancy may not be contradictory.…”

Section: Discussioncontrasting

confidence: 57%

“…The groin‐specific interventions have had a combined focus on hip adductors, flexors, and abdominals . However, recently, the Adductor Strengthening Programme, a simple, single‐exercise program based on the Copenhagen Adduction exercise, was shown to reduce the risk of groin problems among male football players with 41% …”

Section: Introductioncontrasting

confidence: 57%

“…Players in the present study were positive to the preventive effect from the Adductor Strengthening Programme, in contrast to reports from elite players, which have shown skepticism toward the effect from preventive programs . Although players in the present study were positive, in future dissemination of the program, the documented preventive effect of the Adductor Strengthening Programme should be highlighted as a positive effect on performance. Increased participation of players without groin problems may increase the individual and team performance positively by increasing player availability .…”

Section: Discussionmentioning

confidence: 99%

“…All responses were exported into SPSS Statistics for Windows, version 24.0 (SPSS Inc), and analyzed using descriptive statistics. Player characteristics were obtained from the RCT (at the time of inclusion in February and March 2016) . All data are presented as mean and standard deviation (SD).…”

Section: Methodsmentioning

confidence: 99%

“…In this study, the compliance with the Adductor Strengthening Programme was higher than what has previously been reported in groin‐specific injury prevention trials . On average, the players completed approximately 70% of the prescribed training sessions both during the pre‐season and the regular season …”

Section: Introductionmentioning

confidence: 99%

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Implementation of the Adductor Strengthening Programme: Players primed for adoption but reluctant to maintain — A cross‐sectional study

Harøy

Wiger

Bahr

et al. 2019

Scandinavian Med Sci Sports

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Groin injuries represent a considerable problem in male football, accounting for 4%‐19% of all time‐loss injuries. The Adductor Strengthening Programme is the first groin‐specific prevention program shown to reduce the risk of groin problems. We aimed to use the RE‐AIM framework to examine the players’ experiences with the implementation of the program and player attitude toward groin injury prevention in football. Of the 632 players involved in the trial examining the effect of the Adductor Strengthening Programme, 501 agreed to participate in a survey at the end of the season. Most players thought that footballers are at moderate to high risk for groin injuries (87%) and that there is a need for preventive measures (96%). They also believed that a preventive program with strengthening exercises would reduce the risk of groin injuries (91%). Majority of the players reported using <5 minutes to complete the program (73%), and only 11% wanted additional exercises. However, only 46% reported to have performed the program as recommended, and an even smaller proportion (31%) planned to continue using it as recommended the next season. Our results suggest that footballers believe that prevention of groin injuries is needed. Attitude toward implementation of the Adductor Strengthening Programme was positive, and the single‐exercise approach was considered an important facilitator. However, in future dissemination of the program, the players’ reluctance to maintain the exercise protocol may be a potential barrier to implementation that should be addressed.

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Section: Discussioncontrasting

confidence: 57%

Section: Introductioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implementation of the Adductor Strengthening Programme: Players primed for adoption but reluctant to maintain — A cross‐sectional study

Harøy

Wiger

Bahr

et al. 2019

Scandinavian Med Sci Sports

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Gender‐specific hip strength disparities correlate with injury patterns in NCAA men's and women's soccer players

Bakal,

Hussain,

Dzierzawski

et al. 2024

PM&R

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BackgroundIn National Collegiate Athletic Association (NCAA) soccer athletes, men have higher rates of hip and groin strains, whereas women have higher rates of knee ligament injuries. Strength imbalances of the hip and thigh, specifically in agonist–antagonist muscles, are known risk factors for these injuries.ObjectiveTo perform hip and thigh strength assessments in NCAA soccer players to evaluate for differences between genders and correlations with gender‐specific injury patterns.DesignWith a handheld dynamometer, weight‐normalized isometric strength of six muscle groups (hip abductors, hip adductors, hip flexors, hip extensors, knee flexors, knee extensors) was calculated in NCAA soccer players. The strength ratio of each agonist–antagonist muscle was also calculated (hip abductors/adductors, hip flexors/extensors, knee extensors/flexors).ParticipantsThirty‐six NCAA soccer players (18 men, 18 women) from a single NCAA Division III institution.InterventionsNot applicable.Main Outcome MeasuresWeight‐normalized strength of six muscle groups and their agonist–antagonist strength ratios were compared between genders using linear mixed‐effects models.ResultsCompared with male players, female players had decreased weight‐normalized strength for hip abduction (0.170 vs. 0.204, p = .012) and hip extension (0.172 vs. 0.211, p = .021). Otherwise, weight‐normalized strength was similar between genders. When comparing agonist–antagonist strength ratios, there was a significant difference between female and male players for hip flexion:extension (1.70 vs. 1.35, p = .008), whereas the hip abduction: adduction ratio did not reach statistical significance (1.45 vs. 1.62, p = .080).ConclusionsNCAA male and female soccer players had different hip strength profiles that fit their injury patterns. Male NCAA soccer players have higher rates of hip and groin strains, and men in the cohort had strength ratios that were deficient in the hip flexors and adductors compared with women. Female NCAA soccer players have higher rates of knee sprains and anterior cruciate ligament tears, and women in the cohort had strength ratios that were deficient in the hip abductors and extensors, which function to stabilize the knee. These strength disparities could be the focus of future gender‐specific soccer injury prevention programs.

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Effects of a low‐dose Copenhagen adduction exercise intervention on adduction strength in sub‐elite male footballers: A randomised controlled trial

et al. 2021

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Footballers with weak hip adductors are at increased risk of groin injury, and adductor strengthening has been shown to reduce this risk. However, the minimal effective dose of strength training to improve hip adductor strength and mitigate the risk of adductor problems remains unknown. The aim of this randomised controlled trial was to investigate the training and detraining effects of a low‐dose Copenhagen adduction exercise (CA) intervention in sub‐elite male footballers on eccentric hip adduction strength (primary outcome) and peak adductor squeeze strength (secondary outcome). Thirty‐nine male footballers were randomised into two groups: The intervention group completed the CA twice weekly during six in‐season weeks in addition to normal football training, while the control group continued normal football training. Strength testing was performed at weeks 0, 3, 6 (training period), and weeks 7‐9 (detraining period). There was no between‐group difference in eccentric strength at week 6 and 9. There was a significant group by time interaction at 6 weeks (0.52 Nm/kg, 95% CI 0.17‐0.86) and 9 weeks (0.59 Nm/kg, 95% CI 0.25‐0.93) at which the intervention group displayed greater adductor squeeze strength. These results suggest the low‐dose CA intervention is insufficient to modify eccentric hip adduction strength but improves peak adductor squeeze strength.

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The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial

Abstract: ISRCTN98514933.

Cited by 122 publications

References 37 publications

Implementation of the Adductor Strengthening Programme: Players primed for adoption but reluctant to maintain — A cross‐sectional study

Implementation of the Adductor Strengthening Programme: Players primed for adoption but reluctant to maintain — A cross‐sectional study

Gender‐specific hip strength disparities correlate with injury patterns in NCAA men's and women's soccer players

Effects of a low‐dose Copenhagen adduction exercise intervention on adduction strength in sub‐elite male footballers: A randomised controlled trial

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