Hip Strength Testing of Soccer Players With Long-Standing Hip and Groin Pain: What are the Clinical Implications of Pain During Testing?

Objective:To investigate whether self-reported pain during hip strength testing correlates to a large degree with hip muscle strength in soccer players with long-standing unilateral hip and groin pain. Design:Cross-sectional study. Setting:Clinical assessments at Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Centre Amager, Copenhagen University Hospital, Denmark. Participants:Twenty-four male soccer players with unilateral long-standing hip and groin pain. Interventions:The soccer players performed 5 reliable hip muscle strength tests (isometric hip flexion, adduction, abduction, isometric hip flexion–modified Thomas test, and eccentric hip adduction). Main Outcome Measures:Muscle strength was measured with a hand-held dynamometer, and the players rated the pain during testing on a numerical rating scale (0-10). Results:In 4 tests (isometric hip adduction, abduction, flexion, and eccentric adduction), no significant correlations were found between pain during testing and hip muscle strength (Spearman rho = −0.28 to 0.06, P = 0.09-0.39). Isometric hip flexion (modified Thomas test position) showed a moderate negative correlation between pain and hip muscle strength (Spearman rho = −0.44, P = 0.016). Conclusions:Self-reported pain during testing does not seem to correlate with the majority of hip muscle strength tests used in soccer players with long-standing hip and groin pain.

[1]  E. Delahunt,et al.  Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain. , 2014, Journal of science and medicine in sport.

[2]  P. Hölmich,et al.  Hip strength assessment using handheld dynamometry is subject to intertester bias when testers are of different sex and strength , 2013, Scandinavian journal of medicine & science in sports.

[3]  Raymond Y. W. Lee,et al.  Movement coordination and differential kinematics of the cervical and thoracic spines in people with chronic neck pain. , 2013, Clinical biomechanics.

[4]  M. Ulrich-Vinther,et al.  Eccentric hip abductor weakness in patients with symptomatic external snapping hip , 2012, Scandinavian journal of medicine & science in sports.

[5]  C. Wassinger,et al.  The role of experimentally-induced subacromial pain on shoulder strength and throwing accuracy. , 2012, Manual therapy.

[6]  P. Hölmich,et al.  Eccentric strengthening effect of hip-adductor training with elastic bands in soccer players: a randomised controlled trial , 2012, British Journal of Sports Medicine.

[7]  L. Bisset,et al.  Elbow flexor and extensor muscle weakness in lateral epicondylalgia , 2011, British Journal of Sports Medicine.

[8]  J. Petersen,et al.  The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist , 2011, British Journal of Sports Medicine.

[9]  M. Henriksen,et al.  Experimental knee pain reduces muscle strength. , 2011, The journal of pain : official journal of the American Pain Society.

[10]  J. Petersen,et al.  Hip Adduction and Abduction Strength Profiles in Elite Soccer Players , 2011, The American journal of sports medicine.

[11]  Lars Engebretsen,et al.  Intrinsic Risk Factors for Groin Injuries among Male Soccer Players , 2010, The American journal of sports medicine.

[12]  C. Elley,et al.  Normative values of hip strength in adult male association football players assessed by handheld dynamometry. , 2010, Journal of science and medicine in sport.

[13]  A. Pearce,et al.  Hip adductor muscle strength is reduced preceding and during the onset of groin pain in elite junior Australian football players. , 2010, Journal of science and medicine in sport.

[14]  J. Petersen,et al.  Eccentric hip adduction and abduction strength in elite soccer players and matched controls: a cross-sectional study , 2009, British Journal of Sports Medicine.

[15]  Stephan Riek,et al.  Motor Unit Recruitment Strategies Are Altered during Deep-Tissue Pain , 2009, The Journal of Neuroscience.

[16]  J. Petersen,et al.  Clinical assessment of hip strength using a hand‐held dynamometer is reliable , 2009, Scandinavian journal of medicine & science in sports.

[17]  A. Schache,et al.  Hip flexibility and strength measures: reliability and association with athletic groin pain , 2009, British Journal of Sports Medicine.

[18]  L. Arendt-Nielsen,et al.  Impact of clinical and experimental pain on muscle strength and activity , 2008, Current rheumatology reports.

[19]  F. Backx,et al.  Diagnostics in athletes with long‐standing groin pain , 2008, Scandinavian journal of medicine & science in sports.

[20]  M. Landers,et al.  The use of fear-avoidance beliefs and nonorganic signs in predicting prolonged disability in patients with neck pain. , 2008, Manual therapy.

[21]  RobRoy L Martin,et al.  The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. , 2008, The Journal of orthopaedic and sports physical therapy.

[22]  P. Hölmich Long-standing groin pain in sportspeople falls into three primary patterns, a “clinical entity” approach: a prospective study of 207 patients , 2007, British Journal of Sports Medicine.

[23]  P. Hodges,et al.  Delayed onset of transversus abdominus in long-standing groin pain. , 2004, Medicine and science in sports and exercise.

[24]  H. Kautiainen,et al.  Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non‐specific neck pain , 2004, European journal of pain.

[25]  P. Hölmich,et al.  Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study , 2004, British Journal of Sports Medicine.

[26]  L. Arendt-Nielsen,et al.  Inhibition of maximal voluntary contraction force by experimental muscle pain: A centrally mediated mechanism , 2002, Muscle & nerve.

[27]  Bénédicte Forthomme,et al.  Hamstring Muscle Strain Recurrence and Strength Performance Disorders , 2002, The American journal of sports medicine.

[28]  J. Zuckerman,et al.  Pain inhibition of shoulder strength in patients with impingement syndrome. , 1994, Orthopedics.

[29]  P. A. Huijing,et al.  Influence of muscle architecture on the length-force diagram of mammalian muscle , 1983, Pflügers Archiv.

[30]  M. Fulcher,et al.  Reliability of handheld dynamometry in assessment of hip strength in adult male football players. , 2010, Journal of science and medicine in sport.

[31]  B. Ang Impaired neck motor function and pronounced pain-related fear in helicopter pilots with neck pain - a clinical approach. , 2008, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[32]  Sue Ann Sisto,et al.  Dynamometry testing in spinal cord injury. , 2007, Journal of rehabilitation research and development.