The association between hip/groin pain and hip strength in football players: An exploratory analysis of the FORCe cohort

Objectives: Explore associations between peak hip strength in football players with hip/groin pain and healthy controls. Design: Cross-sectional study. Methods: Male and female sub-elite football players (soccer and Australian football) with hip/groin pain > 6-month duration and players without hip/groin pain were recruited across Melbourne and Brisbane, Australia. Demographic information and two questionnaires; the Copenhagen Hip and Groin Outcome Score and the International Hip Outcome Tool 33 were collected. Hand-held dynamometry was used to measure isometric hip strength for flexion, extension, abduction, adduction, internal rotation, and external rotation. Linear mixed effects models were used to compare strength measures between groups. Results: 190 football players with hip/groin pain (mean ± standard deviation age, 27.8 ± 6.3 years) and 64 controls (age, 27.3 ± 5.6 years) were included in this study. Of these, 291 symptomatic limbs and 128 control limbs were used for analyses. Symptomatic players had lower peak hip adduction (adjusted mean difference = − 0.18: 95 % confidence interval − 0.27 to − 0.08, P : 0.001), external rotation (− 0.06: 95 % confidence interval − 0.09 to − 0.02, P : 0.003), and internal rotation strength (− 0.06: 95 % confidence interval − 0.10 to − 0.03, P : 0.001) compared to controls. A sport-specific interaction was observed for hip abduction strength. When separated by football code, abduction strength was lower in symptomatic Australian football players compared to their same sport peers (− 0.20: 95 % confidence interval − 0.33 to − 0.06, P : 0.004), but not in symptomatic soccer players (− 0.05: 95 % confidence interval − 0.15 to 0.06, P : 0.382). Conclusions: Hip adduction, internal rotation, and external rotation strength appears lower in football players with hip/groin pain independent of sex and football code. Hip abduction strength was lower in symptomatic Australian football players but not in soccer players.