Risk factors for groin injury in sport: an updated systematic review

Br J Sports Med. 2015 Jun;49(12):803-9. doi: 10.1136/bjsports-2014-094287. Epub 2015 Apr 1.


Background: The identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies.

Objective: To identify and evaluate the evidence examining risk factors for groin injury in sport.

Material and methods: Nine electronic databases were systematically searched to June 2014. Studies selected met the following criteria: original data; analytic design; investigated a risk factor(s); included outcomes for groin injury sustained during sport participation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed and two independent authors assessed the quality and level of evidence with the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine model, respectively.

Results: Of 2521 potentially relevant studies, 29 were included and scored. Heterogeneity in methodology and injury definition precluded meta-analyses. The most common risk factors investigated included age, hip range of motion, hip adductor strength and height. The median DB score across studies was 11/33 (range 6-20). The majority of studies represented level 2 evidence (cohort studies) however few considered the inter-relationships between risk factors. There is level 1 and 2 evidence that previous groin injury, higher-level of play, reduced hip adductor (absolute and relative to the hip abductors) strength and lower levels of sport-specific training are associated with increased risk of groin injury in sport.

Conclusions: We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury.

Keywords: Athlete; Groin; Hip; Injuries; Risk factor.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Athletic Injuries / etiology*
  • Athletic Injuries / physiopathology
  • Epidemiologic Methods
  • Female
  • Groin / injuries*
  • Humans
  • Male
  • Muscle Strength / physiology
  • Range of Motion, Articular / physiology
  • Young Adult