Brief Summary
Rebecca Davis, Alexander Poor, Charles Buz Swanik, Martha Hall, Benjamin Brewer and Jill Higginson
https://www.mdpi.com/2673-7078/5/1/17
Within elite soccer, adductor muscle strains represent a significant injury burden, accounting for up to 23% of all muscle injuries and resulting in substantial time loss. Median return-to-play durations range from 14 to 22 days but can potentially extend to a full season. Mechanisms of adductor strain injuries are frequently associated with eccentric muscle actions during movements such as kicking, changes of direction, jumping, and reaching. Specific kinematic patterns, including hip flexion and internal rotation combined with knee extension, have also been implicated. Positional variations in soccer impose differential workloads, potentially influencing injury susceptibility. Midfielders, for example, exhibit greater distances covered and higher intensities of activity, suggesting increased loading.
The authors' aims were to investigate the relationship between player characteristics, including position, age, and prior adductor injury, and the incidence of adductor strains within a controlled environment. By leveraging comprehensive injury and performance data, the authors looked to identify at-risk populations and clarify injury mechanisms, hypothesising that (1) adductor strains will be a prevalent injury, (2) midfielders will demonstrate the highest injury incidence due to increased workload, and (3) changes of direction, reaching, and kicking will be the predominant mechanisms of injury.
The seven-year retrospective analysis of a single professional soccer team revealed that 23% of playing staff suffered from non-contact adductor strains, consistent with established injury patterns. Of all soft tissue injuries, adductor strains were the second most common, with only hamstring muscle injuries exceeding. The authors hypothesised that midfielders, due to their elevated game-related distance coverage, would exhibit the highest incidence of adductor strains. The findings confirmed that midfielders experienced the greatest absolute number of adductor strains, representing the largest proportion of total injuries among all positional groups.
Figure 1. Soft-tissue, non-contact adductor injury mechanisms (n = 30).
Adductor strain mechanisms were predominantly overuse, change of direction, and running, accounting for approximately 70% of cases. Game exposure (26.5%) exhibited a higher injury rate than practice (10.5%), suggesting increased in-game risk. Overuse, defined broadly, requires further mechanistic clarification to inform training modifications. Individuals with an adductor injury exhibited a significantly increased chance of re-injury in the following half-season. This finding corroborates prior research identifying the previous injury as a robust predictor of future adductor strains. Limitations stated by the author include single-team cohort size, strain severity and specific muscle involvement were not characterised and pre-contract injury history was excluded. While inter-practitioner variability exists in injury logging, consistency within this study was maximised by using the same personnel across all seasons. The controlled single-team design provided a standardised environment, mitigating some external factors inherent in multi-team studies.
This study indicates that position, movement patterns, game environment and prior injury contribute to adductor strain risk. The author states that future research should address player workload and biomechanics to refine risk assessment and inform targeted prevention strategies. While incidence studies are valuable, translating findings into effective injury mitigation requires a focus on modifiable factors within the treatment room, gym, and training environment. Specifically, strength profiling and longitudinal monitoring of hip/groin musculature have demonstrated efficacy in reducing adductor injury risk. For further information on athlete profiling and monitoring, visit kangatech.com or contact info@kangatech.com.