Preseason hip/groin strength and HAGOS scores are associated with subsequent injury in professional male soccer players

Design
Prospective cohort.

Objective
To explore the association between preseason assessments of (1) isometric hip adductor and abductor strength using a novel field test and (2) the Copenhagen Hip and Groin Outcome Score (HAGOS) and subsequent hip/groin injury in male professional soccer players.

Methods
In total, 204 male elite soccer players from 10 professional A-League and English Football League Championship clubs underwent assessments of hip adductor and abductor strength and completed the HAGOS in the 2017–2018 preseason. All subsequent hip/groin injuries were reported by team medical staff. Data reduction was conducted using principal-component analysis. The principal component for the HAGOS and 3 principal components for strength and imbalance measures were entered, with age and prior hip/groin injury, into a multivariable logistic regression model to determine their association with prospectively occurring hip/groin injury.

Results
Twenty-four players suffered at least 1 hip/groin injury throughout the 2017–2018 season. The principal component for between-limb abduction imbalance (peak strength in the preferred kicking limb – nonpreferred limb) (odds ratio [OR] = 0.58; 95% confidence interval [CI]: 0.38, 0.90; P = .011), the principal component for peak adduction and abduction strength (OR = 0.71; 95% CI: 0.51, 1.00; P = .045), and the principal component for the HAGOS (OR = 0.77; 95% CI: 0.62, 0.96; P = .022) were independently associated with a reduced risk of future hip/groin injury. Receiver operating characteristic curve analysis of the whole model revealed an area under the curve of 0.76, which indicates a fair combined sensitivity and specificity of the included variables but an inability to correctly identify all subsequently injured players.

Conclusion
Hip abduction imbalance favoring the preferred kicking limb, higher levels of hip adductor and abductor strength, and superior HAGOS values were associated with a reduced likelihood of future hip/groin injury in male professional soccer players.