Abstract
ObjectivesGroin injuries are common in professional male football and result in significant complaints, time-loss and cost. We aimed to study: 1. Normal values of hip muscle strength and self-reported hip and groin function (Hip And Groin Outcome Score (HAGOS)). 2. Changes in these values throughout the season. 3. If previous (groin) injuries, leg dominance or league were associated with these outcome measures. DesignProspective cohort study. Methods313 professional male football players (11 clubs) participated. Player characteristics and previous injuries were registered. Hip muscle strength (hand-held dynamometer) and HAGOS measurements were done at the start, middle and end of the season. ResultsData from 217 players were analysed. Adduction strength (mean±standard deviation, Nm/Kg) was 3.40±0.72 (start), 3.30±0.65 (mid) and 3.39±0.74 (end) (p=0.186). Abduction strength was 3.45±0.67, 3.14±0.57 and 3.28±0.61 (p<0.001). Adduction/abduction ratio was 1.00±0.21, 1.07±0.22 and 1.05±0.23 (p<0.001). Statistically, the HAGOS-subscale ‘Pain’ (median [interquartile range]) deteriorated slightly during the season (p=0.005), especially from mid-season (97.5 [90.6−100.0]) to end-of-season (95.0 [87.5−100.0]) (p=0.003). Other subscale scores remained unchanged between time points; 85.7 (symptoms), 100.0 (daily living), 96.9 (sports and recreation) 100.0, (physical activities) and 90.0 (quality of life). Previous injuries were associated with lower HAGOS-scores. Dominant legs had higher abduction strength (p<0.001) and lower adduction/abduction ratio (p<0.001). No differences between leagues were found for hip muscle strength and HAGOS-scores. ConclusionsIn Dutch male professional football players, hip muscle strength and HAGOS-scores remained relatively stable throughout the season. Pain increased slightly, which while statistically significant, was not clinically relevant.
Highlights
Groin injuries are common in athletes,[1,2] especially in professional male football, where they account for around 10% of all injuries.[2]
We found that previous injury other than the groin (47%) and groin injury (37%: one injury = 22%, more than one injury = 15%) were not associated with hip muscle strength but were related to lower Hip And Groin Outcome Score (HAGOS)-scores
Hip muscle strength and HAGOS normal values in professional male football players were obtained in a repeated fashion throughout one full season
Summary
Groin injuries are common in athletes,[1,2] especially in professional male football, where they account for around 10% of all injuries.[2] Groin injury incidence ranges from 0.2 to 2.1 per 1000 h of football and groin injuries affect 20% of all players each season.[2,3,4] Groin injuries result in significant time-loss from training and/or match play, typically between 15 and 20 days[2,5,6] and 28 days for recurrent injuries.[7]. Groin pain forces some players to stop playing, many continue to play with pain.[8] This is referred to as non-time-loss groin injury, which is relevant as the pain may interfere with performance levels.[9] Preventing the progression of non-timeloss injuries to time-loss injury and the accompanying reduction of athlete performance levels is important from both individual and clubs’ perspective. Monitoring of hip and groin functioning with patient-reported outcome measures and strength and pain provocation testing throughout the football season may assist in detecting early signs of groin pain.[10,11]
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