Impact Of Tailored Preventive Exercise Program For Reducing Risk Of Hip Adductors Injury

Abstract

Background: Football players often have groin injuries due to weak adductor muscles. However, an important factor that is often underestimated is the asymmetry between the adductors and abductors muscle complex. Sports medicine and physiotherapy research has long ignored the mechanical complexity of the hip joint and the effects of preseason preventative protocols in favour of an emphasis on isolated adductor strength as a means to lessen the likelihood of adductor injuries in football players. Adductor injuries, which cause groin discomfort and a decline in game performance and longevity, are common among football players due to the sport's strong physical demands, which include kicking, high velocity, speed, and quick changes of direction.

Objective: The goal of this study is to determine if football players may reduce their risk of hip adductor injuries by participating in a specialized preventative exercise program.

Methods: Forty football players (ranging in age from 18 to 35) from Cairo's Stars of Egypt and Gezira Club participated in this randomized controlled experiment. Twenty participants made up each of the two groups: group A, which received the intervention, and group B, which served as a control. Injured or herniated players were not allowed to participate. As part of their usual team training, members of the intervention group exercised twice or three times weekly for eight weeks, while members of the control group continued to use the conventional FIFA 11+ regimen. Before and after the preventive protocol's intervention, players had their isometric strength tested for adductors and abductors on both the dominant and non-dominant limbs using a handheld dynamometer (HHD) in neutral and functional positions (15-30 degrees of abduction). Their groin health was documented using the Copenhagen HAGOS Questionnaire pre and post the intervention.

Results: Both the neutral position (p = 0.008) and the functional position (p = 0.004) of the dominant limb's ADD:ABD strength asymmetry ratio decreased significantly in group A compared to group B after treatment. Furthermore, after treatment, group A had a significantly lower ADD:ABD strength asymmetry ratio for the non-dominant limb in both the neutral position (p = 0.001) and the functional position (p = 0.009) when compared to group B. In the neutral position, there was no significant difference between groups A and B in terms of limb symmetry index (LSI) or inter limb symmetry of non-dominant to dominant adductors (p = 0.62). However, in the functional position, there was a significant increase in LSI for group A compared to group B (p = 0.002). Additionally, after therapy, group A's Copenhagen HAGOS questionnaire score was significantly higher than group B's (p = 0.001).

Conclusion: Potentially lowering the incidence of hip adductor injuries and GPS (groin pain syndrome), the preseason preventative exercise program helped football players improve stability across hip muscle groups and decrease asymmetry. In this study, we found that the ADD:ABD ratio is a better predictor of functional hip stability and potential adductor injuries than isolating adductor strengthening regimens. In order to safeguard athletes, it is recommended to keep the ADD:ABD ratio near to 1.0. One significant diagnostic technique for diagnosing asymmetries and directing preventative treatments for football players is measuring the LSI between the dominant and nondominant limbs.