Hip and groin issues are prevalent in sports, particularly those involving rapid changes in direction or kicking movements. Therefore, assessing and tracking hip and groin strength can serve as a valuable monitoring tool for athletes.
Several tools are available for assessing hip and groin strength, ranging from simple devices like sphygmomanometers for adductor squeeze measurements to sophisticated isokinetic dynamometry that measures force during eccentric, concentric, and isometric movements. Recent technological advancements have introduced load cell assessments, enabling the collection of force measurements during isometric contractions in various positions.
Today, we'll focus on measuring isometric adductor and abductor strength using VALD's ForceFrame, which offers a wide range of testing positions. In the video below, we'll demonstrate the most common approach: adductor and abductor testing in a supine position with a bent knee.
Testing Protocol
To begin testing, the athlete lies down, and the knee position for testing is selected (common angles include 45, 60, or 90 degrees). Consistency in knee positioning is crucial for accurate comparisons across tests. Initially, a goniometer may be used to ensure the correct knee angle, determining the bar height and foot position. Subsequently, the bar height can be logged for future tests to maintain consistency.
During the test, the athlete pushes against or squeezes the knee pads with their legs. It's essential to instruct athletes to keep their arms crossed over their chest to prevent leveraging and to ensure that their butt remain on the ground throughout the test! We need to keep it isometric.
A standardised warm-up, followed by low- and moderate-effort repetitions, prepares the athlete for maximum effort trials. Each trial consists of five-second repetitions of squeezing or pushing out with the abductors, with adequate rest between sets.
Data Analysis
Results from the test provide four key outcomes: abductor and adductor isometric strength on both the left and right sides (see figure right). This is in parallel to shoulder testing with the ForceFrame, in which we use a similar method and get four key force outcomes.
These results can be compared over time and to other athletes, but we need to consider individual playing positions and sport-specific demands when analysing these variables.
Analysing the data involves assessing between-limb (left vs right) and within-limb (adductor vs abductor on the same side) imbalances. While some asymmetry is expected, particularly in sports with asymmetrical demands like kicking, significant imbalances may indicate injury risk.
Specifically, the adductor-abductor (ADD:ABD) ratio is an evidence-based approach in which the force output on the same side for adduction is divided by abduction force output. However, we're not necessarily seeking a perfect ratio of 1. The capacity of many athletes is adapted to the demands of their sport so it is essential to establish norms and benchmarks within your specific athlete population. More on the research and application of the ADD: ABD ratio is provided in the above video.
Monitoring pain during the test can also provide valuable insights into hip and groin issues. Youth male footballers, for example, will often show a reduction in adductor squeeze strength prior to the onset of pain, with a further reduction at the onset of pain, possibly due to an inhibitory muscle response (DeLang et al., 2022). Tracking pain during the adductor squeeze, either using the 0-10 Numerical Pain Rating Scale or by asking the athlete if they experience pain as a Yes/No response, is therefore worthwhile.
While the test provides valuable data on isometric strength, it's important to recognise its limitations, particularly its static nature and limited position specificity. Nonetheless, it offers a simple, safe, and non-fatiguing method for assessing athletes' strength capacity.
FAQs on Hip and Groin Strength Testing
Why is it important to test and track hip and groin strength in athletes?
Testing and tracking hip and groin strength is crucial because issues in these areas are common in sports that involve rapid changes in direction or kicking. Monitoring strength can help identify potential weaknesses or imbalances that may lead to injury, allowing for preventive measures to be implemented.
What tools can be used to measure hip and groin strength?
Various tools can be used to measure hip and groin strength, including:
Sphygmomanometer: A pressure cuff used to measure adductor squeeze.
Dynamometry: This includes both isokinetic dynamometers and handheld dynos, which measure force during eccentric, concentric, and isometric movements.
Load Cell Assessments in Fixed Frame Dynamometers: These collect force measurements during isometric contractions in various positions, such as the VALD Performance ForceFrame.
What is the testing protocol for adductor and abductor strength using the ForceFrame?
The testing protocol includes:
Conducting a standardised warm-up.
Performing a 50% effort rep followed by a 75% effort rep before maximum trials.
Performing five-second long reps for both adductor (squeezing in) and abductor (pushing out) movements.
Alternating between adductor and abductor reps with about 30 seconds of rest in between.
Conducting three sets of these trials (ideally).
What are the key outcomes in hip and groin strength test results?
Peak force in each position, tracked by athlete over time.
The Adductor: Abductor ratio represents the within-limb (im)balance.
Asymmetries across the left and right side, although these are often expected due to limb dominance.
Tracking pain as it can be an important indicator of hip and groin issues.
Stay tuned for more insights on strength testing in our series sponsored by VALD Performance. Subscribe to our blog to stay updated!
Found my free content useful? Say thanks here 😊: https://www.buymeacoffee.com/joclubb
This article is support by VALD Performance. For more information, about their technology, visit their website.