Comparison of hip strength in football players with hip and/or groin-related pain and healthy controls

Abstract

Introduction: Muscle weakness and atrophy have been associated with longstanding joint pathology, and strength testing is often recommended during the physical examination of patients with hip/groin pain. The aim of this study was to compare peak strength in football players (soccer and Australian football) presenting with hip and/or groin-related pain with healthy controls. Methods: Male and female football players were recruited across Melbourne and Brisbane, Australia. Demographic information and two questionnaires; the Copenhagen Hip and Groin Outcome Score (HAGOS) and the International Hip Outcome Tool 33 (iHOT) were collected. Hand-held dynamometry was utilised to test isometric hip muscle strength across flexion, extension, abduction, adduction, internal and external rotation planes. Peak strength (N) and torque (Nm) were normalised to body mass and linear mixed effects models were used to investigate the relationship between strength and symptomatic hips. Results: 191 football players with hip and/or groin-related pain (mean [+/- SD] age, 27.8 ± 6.3 years) and 69 controls (mean [+/- SD] age, 27.3 ± 5.6 years) were include in this study. Of this, 293 symptomatic hips and 138 control hips were used for analyses. Results demonstrated peak adduction (-0.18 Nm/kg: 95% CI -0.27 to -0.08, P 0.001), external rotation (-0.06 Nm/kg: 95% CI -0.09 to -0.02, P 0.003) and internal rotation strength (-0.06 Nm/kg: 95% CI -0.10 to -0.03, P 0.001) were lower in symptomatic hips than control hips. Abduction strength was lower in symptomatic Australian football players hips than controls (-0.20 Nm/kg: 95% CI -0.33 to -0.06, P 0.004) but this was not observed in symptomatic soccer players hips (-0.05 Nm/kg: 95% CI -0.15 to 0.06, P 0.382). No difference was found between peak flexion strength (0.07 Nm/kg: 95% CI -0.15 to 0.01, P 0.103) or peak extension strength (-0.07 Nm/kg: 95% CI -0.18 to 0.05, P 0.249) in symptomatic hips and control hips. Discussion: The findings from this research suggest that hip adduction, internal and external rotation are lower in footballers with hip and/or groin related pain than controls irrespective of the sport played. Hip abduction strength was lower in symptomatic Australian Rules football players but not observed in soccer. Impact:•Findings from this research suggest common impairments are found in hip adduction, internal and external rotation in football players with hip and/or groin related pain than controls regardless of sport played.•Hip abduction strength was lower in symptomatic Australian Rules football players but not observed in soccer. My co-authors and I acknowledge this research was supported by an Australian National Health and Medical Research Council (NHMRC) project grant 1088683.