Copenhagen Adduction Exercise Research Articles

Voleybolcularda Addüktör Kas Grubuna Uygulanan Kinezyolojik Bantlamanın Endurans, Güç ve Çeviklik Üzerine Akut Etkisi

Objective: This study was conducted to investigate the acute effect of kinesiology taping (KT) to the hip adductor muscle group (AMG) on endurance, strength and agility in female volleyball players (VP). Materials and Methods: Thirty female VP, with an average age of 17.53±2.55 years, who played licensed volleyball for at least two years were included in our study. KT was applied longitudinally to the athletes between the pubis and lower border of the tuberositas tibia, including the AMG using the facilitation technique (25% stretching). Evaluations were repeated before taping and 20 minutes after taping. The athletes' Adductor muscle endurance was evaluated using the Copenhagen adduction exercise, vertical jump test for lower extremity strength, and Edgren side step test for agility. Results: When the results of the study were evaluated, it was found that there was a statistically significant increase in the endurance (p<0.001), strength (p<0.001) and agility (p<0.001) values of the athletes after KT application. Conclusions: KT applied to the adductor area can be used by physiotherapists during competitions or training due to its positive effects on the performance of VP.

The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial

ABSTRACT Introduction Groin injuries are common in soccer players and often involve adductor muscle strains. The Copenhagen Adduction Exercise (CAE) is a targeted intervention whose effectiveness in rehabilitation for these injuries warrants investigation. Objective To investigate the impact of a rehabilitation program, which includes the CAE, on eccentric hip adduction (EHAD) strength, hip joint range of motion (ROM), self-reported disability, and pain among soccer players with adductor-related groin pain. It was hypothesized that the addition of CAE to the rehabilitation program would yield greater improvements. Methods Employing a randomized controlled trial with a two-group parallel design, thirty male soccer players with a mean age of 26.4 ± 3.9 years were randomized into an intervention group (IG) including CAE (n = 15) and a control group (CG) without CAE (n = 15), based on a power analysis to ensure 80% power to detect significant differences. Both groups engaged in their respective rehabilitation programs twice a week for eight weeks. The primary outcome measured was EHAD strength, while secondary outcomes included hip joint ROM, self-reported disability measured by the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain levels. Results Significant improvements within groups were observed across all measures (p < 0.001). The IG demonstrated a greater increase in EHAD strength (Mean Difference [MD] = 0.49 Nm/kg, 95% Confidence Interval [CI] [0.31, 0.66]), a more pronounced reduction in pain (MD = -1.60, 95% CI [−2.18, −1.02]), and betterment in all HAGOS subscale scores compared to the CG. There were no significant between-group differences in hip joint ROM. Conclusion Incorporating the CAE into rehabilitation programs significantly improves EHAD strength, decreases pain scores, and reduces self-reported disability in soccer players with adductor-related groin pain. Registration ClinicalTrials.gov identifier: NCT05589623

Can the Copenhagen Adduction Exercise Prevent Groin Injuries in Soccer Players? A Critically Appraised Topic.

Injuries that affect the groin region are among the most common in football players. To prevent this condition, studies have focused on strengthening the adductors, hip flexors, or abdominal muscles. Recent investigations have used an eccentric-biased exercise (Copenhagen Adduction Exercise [CAE]) that promotes functional and architectural adaptations in the muscle tissue, though its effect on injury risk reduction is unknown. Can the Copenhagen Adduction Exercise prevent groin injuries in soccer players? The literature was searched for studies investigating the potential groin injury risk reduction effect of the CAE. (1)Three studies met the inclusion criteria and were used for this appraisal; (2)one study observed a significantly lower injury rate ratio favoring the group that used the CAE program; and (3) 2 studies found similar or higher injury rates in the intervention groups, not supporting the inclusion of the CAE as a preventative tool. There is conflicting evidence that usage of the CAE is superior to not performing adductor strengthening exercises in mitigating the risk of sustaining groin injuries. Given the evidence supporting these findings, it is advisable to exercise caution when contemplating the incorporation of the CAE into training regimens aimed at preventing groin injuries. There is Grade B evidence to suggest that inclusion of the CAE may not be associated with reduced injury rates.

Players’, Head Coaches', And Medical Personnels' Knowledge, Understandings and Perceptions of Injuries and Injury Prevention in Elite-Level Women’s Football in Ireland

BackgroundTo manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understanding the injury context, whereby specific personal, environmental, and societal factors can influence the implementation of injury prevention initiatives and injury management strategies is critical to player welfare. To date, no qualitative research investigating the context of injuries, has been undertaken in elite-level women’s football. The aim of our study was to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish Women’s National League (WNL) to injury prevention and injury management.MethodsWe used qualitative research methods to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish WNL to injury prevention and injury management. Semi-structured interviews were undertaken with 17 players, 8 medical personnel, and 7 head coaches in the Irish WNL. The data were analysed using thematic analysis. Our study is located within an interpretivist, constructivist research paradigm.ResultsThe participants had incomplete knowledge of common injuries in elite-level football, and many held beliefs about risk factors for injuries, such as menstrual cycle stage, which lacked evidence to support them. Jumping and landing exercises were commonly used to reduce the risk of injuries but evidence-based injury prevention exercises and programmes such as the Nordic hamstring curl, Copenhagen adduction exercise, and the FIFA 11+ were rarely mentioned. Overall, there was dissatisfaction amongst players with their medical care and strength and conditioning (S & C) support, with resultant inadequate communication between players, head coaches, and medical personnel.ConclusionPoor quality and availability of medical care and S & C support were considered to be a major obstacle in the effective implementation of injury risk reduction strategies and successful return-to-sport practices. More original research is required in elite-level women’s football to explore injury risk factors, injury prevention initiatives, and contextual return-to-sport strategies, so that players, head coaches, and medical personnel can use evidence that is both up-to-date and specific to their environment.

Effects of a Groin Pain Prevention Program in Male High School Soccer Players: A Cluster-Randomized Controlled Trial.

BackgroundGroin pain is frequently reported by soccer players. A prevention program incorporating the Copenhagen adduction exercise (CAE) has been shown effective in decreasing adductor muscle injury in semi-professional soccer players. However, the effect of such programs on groin pain in high school soccer players is unknown. No reports have examined the effects of combining the CAE with other targeted exercises such as the Nordic hamstrings exercise (NHE).PurposeTo evaluate the preventative effects of exercise on groin pain in high school soccer players in three groups comprising NHE alone, combined NHE and CAE, and a control group.DesignRandomized Controlled Clinical Trial.MethodsA cluster randomized controlled trial spanning 16 weeks was conducted on 202 high school soccer players from seven high schools in a Japanese under 18 Soccer League. Players were allocated to either group A (three schools, 66 players) receiving the CAE alone, or group B (two schools, 73 players) receiving the CAE and NHE, or control group C (two schools, 63 players) who performed their usual training. This study compared the number of injuries, injury rate, and severity of the injury of groin pain in these three groups.ResultsThe number of players injured was less in group B (4 players) compared to C (18 players), and time-lost to soccer was less in groups A (6 players) and B (3 players) compared to group C (16 players). Injury rates were significantly lower in groups A and B, with the relative risk of injury compared to group C of 0.42 (95% CI 0.19% to 0.90%) in group A and 0.19 (95% CI 0.07 to 0.54) in group B.ConclusionA 16-week program incorporating the CAE in training sessions in high school soccer players reduced the incidence of groin pain and which may be related to injury severity according to time -lost to soccer, however the combination of both the CAE and NHE may be more effective than the CAE alone.Level of Evidence2b

Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility.

Groin injuries are one of the most prevalent in sports, especially due to the hip adductor muscles’ weakness, which is considered as a risk factor. The Copenhagen adduction exercise (CAE) has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics and flexibility of the adductors has been little studied. The aim of the present study was to analyse the impact on the muscular architecture and flexibility of the adductor musculature after 8 weeks of CAE-based training and after 4 weeks of subsequent detraining. A sample of 45 active subjects (26.1 ± 2.8 years old) were randomly divided into a control group with no intervention and an experimental group with an intervention based on 8 weeks of CAE training and 4 weeks of subsequent detraining. The muscle thickness of adductors was measured before and after training and detraining using ultrasound imaging and hip abduction range with goniometry. A significant increase in muscle thickness (left leg: +17.83%, d = 1.77, p < 0.001//right leg: +18.38%, d = 1.82, p < 0.001) and adductor flexibility was found in the experimental group (left leg: +7.3%, d = 0.96, p < 0.05//right leg: +7.15%, d = 0.94, p < 0.05), and after detraining, both variables returned to their initial values. These results could indicate that CAE would be a suitable strategy to modify the architecture of the adductors and thus form part of training protocols designed for the prevention and rehabilitation of muscle injuries.

Risk Factors for Groin Pain in Male High School Soccer Players Undergoing an Injury Prevention Program: A Cluster Randomized Controlled Trial

Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.

The Copenhagen Adduction Exercise is not Applied by the Majority of Professional and Semi-Professional Soccer Players and Coaches

The Copenhagen Adduction Exercise is not Applied by the Majority of Professional and Semi-Professional Soccer Players and Coaches

Effects of Copenhagen Adduction Exercise on the Architectural Characteristics of Adductors in U-17 Male Soccer Players: A Randomized Controlled Trial.

Groin injuries are one of the most prevalent in male soccer players, especially due to the hip adductor muscles’ weakness which is considered as a risk factor in these injuries. The Copenhagen adduction (CA) exercise has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics of adductor muscles have not been studied yet. This study aimed to analyze the effects of the CA exercise on the muscle thickness of the adductors. Twelve male U-17 soccer players were randomized into two groups: the control group with no intervention and the experimental group with an intervention based on an eight-week training with CA exercise. The muscle thickness of adductors was measured before and after the intervention using ultrasound imaging. A significant increase in muscle thickness was found in both control (p = 0.002) and experimental group (p < 0.001), but the experimental group did not show additional effects in comparison with the control group. In conclusion, an 8-week CA exercise intervention does not increase the muscle thickness of adductors in U-17 soccer players more than their regular training.

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

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.

Combining the Copenhagen Adduction Exercise and Nordic Hamstring Exercise Improves Dynamic Balance Among Male Athletes: A Randomized Controlled Trial.

Copenhagen adduction exercise (CAE) and Nordic hamstring exercise (NHE) reduce the incidence of groin and hamstring injuries. Efficient dynamic balance can improve motor performance and reduce the risk of injuries in athletes. However, the effects of these exercises on dynamic balance have not been investigated. CAE and NHE, as well as a combination of both exercises, would improve dynamic balance among amateur male athletes. Randomized controlled trial. Level 1. A total of 200 male athletes aged 21.9 ± 2.4 years were included in the study and randomly assigned to 4 groups: CAE group (n = 50), NHE group (n = 50), CAE and NHE group (n = 50), and a control group (n = 50). A total of 177 male athletes completed the study. The primary outcome measure was the limit of stability (LoS), which was measured using the Biodex Stability System to assess the performance of the dynamic balance. The LoS of the athletes' performance was measured pre- and postintervention after 6 weeks. The LoS significantly improved in all treatment groups, including CAE (44.5% ± 5.3%), NHE (43.2% ± 5.3%), and CAE + NHE (48.4% ± 5.1%) groups when compared with the control group (28.3% ± 4.8%) after 6 weeks (all Ps < 0.01). The improvement of LoS was significantly greater in the CAE + NHE group compared with other groups (CAE, NHE, and control groups). There was a significant increase in dynamic balance performance postintervention among male athletes. CAE and NHE may improve injury prevention programs. The results of this study provide evidence for athlete trainers and coaches to consider including the CAE and NHE as components of injury prevention programs to improve balance capacity and performance in athletes. Such improvements in balance may prevent injury risk and decrease absenteeism and injury-related financial burdens.

THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE FOR INJURY PREVENTION IN ELITE SPORT: A CLINICAL COMMENTARY.

As clinicians strive to apply evidence-based principles, team-based practitioners have identified a large gap as it relates to published research, ideal applications of evidence-based practice, and actual clinical practice related to injury prevention in elite sport within the United States. For rehabilitation professionals, especially those intimately involved in the research of injury prevention, the solution often seems quite clear and defined. However, preventing injury by implementing the latest recommendation from the most recent prospective study on the using the FIFA 11 + warm-up, a Copenhagen Adduction exercise, or a plyometric drill with elite athletes may not be as effective as was seen among the cohort used in the study. In addition to extrapolating research, clinicians face additional challenges such as variance among professions, schedule density, and off-season contacts with athletes. There is an inherent difficulty in the application of research to practice in elite sport as it relies on the teamwork of not only the practitioner and athlete, but the entire sporting organizational structure and those involved in athlete participation. The purpose of this clinical commentary is to explore the difficulty with application of research in clinical practice and to discuss potential strategies for improving carry over from research to clinical practice.

Copenhagen Adduction Exercise to Increase Eccentric Strength: A Systematic Review and Meta-Analysis

Background: The purpose of this study was to systematically review the scientific literature about the benefits of using the Copenhagen Adductor (CA) exercise to improve eccentric hip adduction strength (EHAD), as well as to provide directions for training. Methods: A systematic search was conducted in three electronic databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The inclusion criteria were: (a) EHAD as outcome variable, with means and standard deviations before and after the intervention, (b) the study was a randomized controlled trial using the CA in the program intervention, (c) the article was written in English. The quality of evidence was evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines. A mini meta-analysis was performed to determine the overall effect. Results: Three studies were selected and included in this systematic review and mini meta-analysis. All articles reported significant enhancement in EHAD in football (soccer) players. The overall effect for the EHAD test was significant in favor to CA group (mean difference = 0.61; 95% CI from 0.20 to 1.01; p = 0.003) with large heterogeneity. Conclusions: CA exercise performed 2–3 times for 8 weeks is useful for improving EHAD in football players.

Impact of a modified progressive Copenhagen adduction exercise programme on hip adduction strength and postexercise muscle soreness in professional footballers

BackgroundReduced hip adduction strength has been identified as a key predisposing factor in developing hip and groin injuries. The Copenhagen adduction programme has been shown to increase hip adduction strength...

The Efficacy of Copenhagen Adduction Exercise and Nordic Hamstring Exercise on Dynamic Balance among Male Athletes: A Randomized Controlled Trial

The Efficacy of Copenhagen Adduction Exercise and Nordic Hamstring Exercise on Dynamic Balance among Male Athletes: A Randomized Controlled Trial

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

BackgroundGroin injuries represent a considerable problem in male football. Previous groin-specific prevention programmes have not shown a significant reduction in groin injury rates. An exercise programme using the Copenhagen Adduction...

Including the Copenhagen Adduction Exercise in the FIFA 11+ Provides Missing Eccentric Hip Adduction Strength Effect in Male Soccer Players: A Randomized Controlled Trial

Background: The FIFA 11+ was developed as a complete warm-up program to prevent injuries in soccer players. Although reduced hip adduction strength is associated with groin injuries, none of the exercises included in the FIFA 11+ seem to specifically target hip adduction strength. Purpose: To investigate the effect on eccentric hip adduction strength of the FIFA 11+ warm-up program with or without the Copenhagen adduction exercise. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: We recruited 45 eligible players from 2 U19 elite male soccer teams. Players were randomized into 2 groups; 1 group carried out the standard FIFA 11+ program, while the other carried out the FIFA 11+ but replaced the Nordic hamstring exercise with the Copenhagen adduction exercise. Both groups performed the intervention 3 times weekly for 8 weeks. Players completed eccentric strength and sprint testing before and after the intervention. Per-protocol analyses were performed, and 12 players were excluded due to low compliance (<67% of sessions completed). The main outcome was eccentric hip adduction strength (N·m/kg). Results: Between-group analyses revealed a significantly greater increase in eccentric hip adduction strength of 0.29 Nm/kg (8.9%; P = .01) in favor of the group performing the Copenhagen adduction exercise, whereas no within-group change was noted in the group that used the standard FIFA 11+ program (–0.02 N·m/kg [–0.7%]; P = .69). Conclusion: Including the Copenhagen adduction exercise in the FIFA 11+ program increases eccentric hip adduction strength, while the standard FIFA 11+ program does not. Registration: Registration: ISRCTN13731446 (International Standard Randomised Controlled Trial Number registry).

INCLUDING THE COPENHAGEN ADDUCTION EXERCISE IN THE FIFA 11+ PROVIDES MISSING ECCENTRIC HIP ADDUCTION STRENGTH EFFECT: A RANDOMISED CONTROLLED TRIAL

BackgroundThe FIFA 11+ was developed as a complete warm-up programme to prevent injuries in football players. Although reduced hip adduction strength is associated with groin injuries, none of the exercises...

ADDUCTOR LONGUS ACTIVATION DURING TWO COMMON HIP ADDUCTION EXERCISES

Various exercises are prescribed in the management of adductor-related groin pain. Isometric adductor ball squeeze exercises are commonly incorporated into both prevention and rehabilitation training, as is the Copenhagen Adduction...

Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial.

Hip adductor injuries are frequent in football, and players with low adductor strength appear to be at increased risk of injury. High adductor muscle activity has been shown in the Copenhagen Adduction exercise (CA); however, an associated strength gain has not been investigated. This study aims to examine the eccentric hip adduction strength (EHAD) gain using the CA in-season. Two U-19 sub-elite football teams, including 24 football players, were randomized to either an 8-week supervised progressive training program in addition to the usual training (intervention) or to continue training as usual (control). EHAD, eccentric hip abduction strength (EHAB), and side-bridge endurance were measured using reliable test procedures at baseline and follow-up by a blinded tester. There was a significant interaction between group and time on EHAD, EHAB, and EHAD/EHAB ratio (P < 0.025). The intervention group demonstrated a 35.7% increase in EHAD (P < 0.001); a 20.3% increase in EHAB (P = 0.003), and 12.3% increase in EHAD/EHAB ratio (P = 0.019). No significant within-group differences were found in the control group (P > 0.335). Compliance was 91.25%, and median muscle soreness ranged from 0 to 2. The CA implemented in-season with an 8-week progressive training program elicited a large significant increase in EHAD, EHAB, and EHAD/EHAB ratio.