How to prevent groin injuries?

Hip adductor injuries are frequent in football and other sports, and it seems like athletes with low adductor strength have an increased risk of injury.

You can prevent groin injuries by training one of the risk factors: Adductor weakness. One of the best ways to reduce adductor weakness is the Copenhagen adductor exercises. If you improve your adductor strength you are less likely to get a groin injury.

In this blog, we will discuss the risk factors of groin injuries and how you could work on these risk factors to have a less likely chance of a groin injury. Make sure to read our blog to know more about groin injuries and how to prevent them!

How can we prevent groin injuries?

By answering this question, we decided to dive into the literature. Our first goal was to find out which factors could increase the chance of groin injuries. We found a study that reviewed a total of 25 articles that investigated the risk factors for these types of injuries in sports such as soccer, ice hockey, and Australian football. ⁽¹⁾

Risk factors

The study found that several risk factors are associated with an increased risk of groin and hip injuries in field-based sports, including:

• Previous injury: Athletes who have previously sustained a groin or hip injury have an increased risk of re-injury.
• Adductor muscle weakness: Weakness in the muscles located in the inner thigh (adductors) increases the risk of groin and hip injuries.
• Imbalances in hip muscle strength: Imbalances between the hip muscles such as strength differences between the hip flexors and extensors, can increase the risk of groin and hip injuries.
• Poor flexibility: Limited flexibility in the hips and groin can increase the risk of injury.
• High training volume and intensity: Athletes who participate in high-volume and high-intensity training are at an increased risk of groin and hip injuries.
• Age: Older athletes are at a higher risk of groin and hip injuries.

The study also found that some risk factors are sport-specific, such as the use of artificial turf in soccer and the role of hip internal rotation in ice hockey players.

In conclusion, the study found that multiple risk factors are associated with an increased risk of groin and hip injuries in field-based sports, including a previous injury, muscle weakness, muscle imbalances, poor flexibility, high training volume and intensity, and age.

Which risk factors can we modify?

The study ⁽¹⁾ had modifiable and non-modifiable factors. Eventually, ‘previous injury’ was the highest reported risk factor for groin/hip injuries. Older age was the second most prevalent non-modifiable risk factor. Whereas weak hip adductor muscles (WHAM) are the third most common risk factor identified for groin/hip injuries together with body mass (BM)/weight.

This means that if you get a lower BM and improve your adductor strength you have less chance of getting a groin injury!

Weak adductors are one of the risk factors, but how do I train them?

We aren’t Physiobodyfactory if we didn’t dive into the literature for you to find out how to train these adductors in the best possible way!

We found a few articles that mentioned training the adductors to reduce the risk of groin injuries.

Firstly, we found a randomized controlled trial that aimed to investigate the effectiveness of the Copenhagen Adduction exercise in increasing the eccentric strength of the adductor muscles in football players. ⁽²⁾

The study included a total of 24 football players who were randomly assigned to either a training group or a control group. The training group performed the Copenhagen Adduction exercise, while the control group performed a different exercise that did not target the adductors.

The study found that the training group experienced large increases in the eccentric strength of the adductors compared to the control group.

Furthermore, we found a systematic review and meta-analysis that aimed to investigate the effectiveness of the Copenhagen Adduction exercise in increasing the eccentric strength of the adductor muscles. ⁽³⁾

The study included a total of 3 studies that investigated the effects of the Copenhagen adduction exercise on adductor muscle strength in various populations. Also, this study found that the Copenhagen adduction exercise is an effective method for increasing the eccentric strength of the adductors.

So how do I perform this Copenhagen adduction exercise?

To perform this exercise, lie on your side and support yourself on your forearm.

Place your upper leg with your foot on a firm surface and lift your upper hip so that it forms a straight line, then lower the leg in a controlled manner (if you are going to do the dynamic Copenhagen Adductor plank) so that your adductor stretches.

Try to keep your torso stable and tilt your pelvis forward. The upper leg (groin) is being trained.

You can perform the exercise both isometrically or dynamically. In addition, you can also do the exercise on your knee to make it a short lever plank. You can build it up as followed:

Small lever Copenhagen adductor plank (Isometric)

Small lever Copenhagen adductor plank (Dynamic)

Large lever Copenhagen adductor plank (Isometric)

Large lever Copenhagen adductor plank (Dynamic)

Luca performed the exercises above, he also made a video on youtube about how to perform these exercises. Click on this link to go to that video!

How many sets and reps should I do?     

• For the isometric exercise, you can do 1-3 sets of 10-60 seconds. Make sure to build up slowly!
• For the dynamic exercise, you can do 1-3 sets of 3-15 repetitions. Make sure to build up slowly!

Conclusion of us:

In conclusion, one of the risk factors for groin pain is adductor weakness. The Copenhagen adduction exercise is an effective method for increasing the eccentric strength of the adductors. This exercise may be beneficial in reducing the risk of groin and hip injuries in athletes who engage in sports that involve a lot of cutting and pivoting movements.

Want to learn more about other subjects? Make sure to read our other blogs, like “What is the ‘Five P’s model’?” and more.

Literature:

1. Ryan J, DeBurca N, Mc Creesh K. Risk factors for groin/hip injuries in field-based sports: a systematic review. Br J Sports Med. 2014 Jul;48(14):1089-96. doi: 10.1136/bjsports-2013-092263. Epub 2014 May 2. PMID: 24795341.
2. Ishøi L, Sørensen CN, Kaae NM, Jørgensen LB, Hölmich P, Serner A. Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial. Scand J Med Sci Sports. 2016 Nov;26(11):1334-1342. DOI: 10.1111/sms.12585. Epub 2015 Nov 21. PMID: 26589483.
3. Pérez-Gómez, J., Villafaina, S., Adsuar, J. C. Carlos-Vivas, J., Garcia-Gordillo, M. A., & Collado-Mateo, D. (2020). Copenhagen adduction exercise to increase eccentric strength: A systematic review and meta-analysis. Applied Sciences, 10(8), 2863.