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

• Published in: British journal of sports medicine Vol. 49; no. 12; pp. 803 - 809
• Main Authors: Whittaker, Jackie L, Small, Claire, Maffey, Lorrie, Emery, Carolyn A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group 01.06.2015; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Age Factors; Athletes; Athletic Injuries - etiology; Athletic Injuries - physiopathology; Citation management software; Epidemiologic Methods; Female; Groin - injuries; Humans; Injuries; Male; Medical Subject Headings-MeSH; Muscle Strength - physiology; Professional soccer; Quality; Range of Motion, Articular - physiology; Risk factors; Soccer; Sports injuries; Sports medicine; Studies; Young Adult; Athlete; Hip; Injuries; Groin; Risk factor
• ISSN: 0306-3674; 1473-0480; 1473-0480
• DOI: 10.1136/bjsports-2014-094287

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.