Manual therapy and early return to sport in football players with adductor-related groin pain: A prospective case series

Physiother Theory Pract. 2020 Sep;36(9):1009-1018. doi: 10.1080/09593985.2018.1531096. Epub 2018 Oct 11.


Objectives: To study the clinical course including return to sport success rates of football players with adductor-related groin pain (ARGP) after manual therapy of the adductor muscles.

Design: Prospective case series.

Methods: Thirty-four football players with ARGP with median pre-injury Tegner scores of 9 (IQR 25-75: 9-9) were treated with manual therapy of the adductor muscles. Main outcome measures were numeric pain rating scale (NPRS), Hip and Groin Outcome Score (HAGOS) and global perceived effect (GPE) for treatment and patient satisfaction at 2, 6 and 12 weeks. Return to sport was documented.

Results: Pain during (NPRS 7 (6-8) and after (NPRS 8 (6-8) sports decreased to NPRS 1 (0.2-3) and 1 (0.8-3), respectively (p < 0.001). Within 2 weeks 82% of the players returned to pre-injury playing levels with improved (p < 0.001) HAGOS subscale scores. Eighty-five percent reported clinically relevant improvement, 82% reported to be satisfied. At 12 weeks, 88% had returned to pre-injury playing levels. HAGOS showed symptoms were still present.

Conclusion: Early return to sport seems possible and safe after manual therapy of the adductor muscles in football players with ARGP in the short term. While the majority of injured football players return to sport within two weeks, caution is advised regarding effectiveness as hip and groin symptoms were still present and no control groups were available.

Keywords: Football; Groin Pain; Manual Therapy; Return to Play.

MeSH terms

  • Adult
  • Athletic Injuries / therapy*
  • Groin / injuries*
  • Humans
  • Male
  • Muscle, Skeletal / injuries*
  • Musculoskeletal Manipulations / methods*
  • Pain Measurement
  • Prospective Studies
  • Return to Sport*
  • Soccer / injuries*
  • Surveys and Questionnaires
  • Young Adult