Hip Adduction and Abduction Strength Profiles in Elite Soccer Players Implications for Clinical Evaluation of Hip Adductor Muscle Recovery After Injury

Background: An ipsilateral hip adduction/abduction strength ratio of more than 90%, and hip adduction strength equal to that of the contralateral side have been suggested to clinically represent adequate strength recovery of hip adduction strength in athletes after groin injury. However, to what extent side-to-side symmetry in isometric hip adduction and abduction strength can be assumed in soccer players remains uncertain. Purpose: To compare isometric hip adduction and abduction strength on the dominant and nondominant side in injury-free soccer players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: One hundred elite soccer players were included. Maximal unilateral isometric hip adduction and abduction strength on the dominant and nondominant side were measured with a handheld dynamometer, using a reliable test procedure. Results: The dominant side was stronger than the nondominant side for both isometric hip adduction (2.45 +/- 0.54 vs 2.37 +/- 0.48 Nm/kg, P = .02) and hip abduction (2.35 +/- 0.33 vs 2.25 +/- 0.31 Nm/kg, P < .001), corresponding to a 3% and 4% difference, respectively. Isometric hip adduction was greater than isometric hip abduction for both the dominant (2.44 +/- 0.53 vs 2.35 +/- 0.33 Nm/kg, P = .04) and nondominant (2.37 +/- 0.48 vs 2.26 +/- 0.33 Nm/kg, P = .03) side. Isometric hip adduction/abduction ratio was not different between the dominant (1.04 +/- 0.18) and nondominant (1.06 +/- 0.17, P = .40) side. A post hoc analysis showed that isometric hip adduction/abduction ratio was significantly lower in players with groin pain during hip adduction testing compared with players with a pain-free test (0.80 +/- 0.14, P < .001) Conclusion: The marginal difference between the dominant and the nondominant side is within the measurement variation of the test procedure, and contralateral isometric hip adduction strength can therefore be used as a simple clinical reference point of full recovery of hip adduction muscle strength in soccer players. Furthermore, it is suggested that the ipsilateral hip adduction/abduction strength ratio is used as a guideline for evaluating hip adduction strength recovery in soccer players with bilateral groin problems.