Effects of Whole-Season Training and Match-Play on Hip Adductor and Abductor Muscle Strength in Soccer Players: A Pilot Study

Background: Previous investigations have associated weakness of hip muscles with a higher likelihood of developing hip groin injury. However, no previous investigation has examined the influence of soccer training and match-play during the season on maximal isometric hip adductor and abductor muscle strength. Hypothesis: Maximal hip adductor and abductor muscle strength would increase after the preseason, maintaining relatively constant levels across the soccer season. Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 26 semiprofessional male soccer players underwent measurements of maximal isometric hip adductor and abductor muscle strength at 3 time points of the soccer season: preseason, midseason, and end-season to investigate the longitudinal effect of soccer training and competition during a complete season on maximal isometric hip adductor and abductor muscle strength in the semiprofessional Spanish soccer player. Results: Compared with preseason, hip abductor muscle strength increased in the midseason (14.2% and 17.1%, for dominant and nondominant limb, respectively; P < 0.001) and in the end-season (13.1%; P = 0.005, and 14.1%; P < 0.005). In contrast, hip adductor muscle strength remained unchanged across the season in both limbs. As a result, the adductor/abductor strength ratio in the nondominant limb was reduced at midseason and end-season time points (−14.6% and −18.4%, respectively; P < 0.001) with a corresponding tendency in the dominant limb (−9.3% and −15.0%, respectively; P > 0.05). Conclusion: While maximal hip abductor muscle strength increased throughout the season, hip adductor muscle strength remained stable across the season. This produced a substantial deficit in hip adductor/abductor strength ratio at midseason and end-season. Clinical Relevance: The progressive imbalance in adductor/abductor strength across the soccer season may be an indicator of increased risk of groin injury and may reinforce the need for preventive rehabilitation activities focused on enhancing adductor muscle strength.

Muscle activity of cutting manoeuvres and soccer inside passing suggests an increased groin injury risk during these movements

Cutting manoeuvres and inside passing are thought to increase the risk of sustaining groin injuries. But both movements have received little research attention in this regard. The purpose of this study was to investigate the muscle activity of adductor longus and gracilis as well as hip and knee joint kinematics during $$90^{\circ }$$ 90 ∘ -cutting and inside passing. Thirteen male soccer players were investigated with 3D-motion capturing and surface electromyography of adductor longus and gracilis while performing the two movements. Hip and knee joint kinematics were calculated with AnyBody Modelling System. Muscle activity of both muscles was significantly higher during the cutting manoeuvre compared to inside passing. Kinematics showed that the highest activity occurred during phases of fast muscle lengthening and eccentric contraction of the adductors which is known to increase the groin injury risk. Of both movements, cutting showed the higher activity and is therefore more likely to cause groin injuries. However, passing might also increase the risk for groin injuries as it is one of the most performed actions in soccer, and therefore most likely causes groin injuries through overuse. Practitioners need to be aware of these risks and should prepare players accordingly through strength and flexibility training.

Efficacy of Hemostatic Gauzes in a Swine Model of Prolonged Field Care with Limb Movement

ABSTRACT Introduction Prolonged field care for junctional wounds is challenging and involves limb movement to facilitate transport. No studies to date have explored the efficacy of gauze products to limit rebleeding in these scenarios. Materials and Methods We randomly assigned 48 swine to QuikClot Combat Gauze, ChitoGauze, NuStat Tactical, or Kerlix treatment groups (12 each) and then inflicted a severe groin injury by utilizing a modified Kheirabadi model of a 6-mm femoral artery punch followed by unrestricted bleeding for 60 seconds. We reassessed rebleed following limb movement at 30 minutes of stabilization and 4 hours after stabilization. Results Swine treated with Combat Gauze proved to have the lowest incidence of rebleeding, and conversely, NuStat Tactical had the highest incidence of rebleeding at wounds after limb movement. Importantly, rebleeds occurred at a rate of 25%-58% across all swine treatment groups at 30 minutes postinjury and 0%-42% at 270 minutes postinjury demonstrating that limb movements universally challenge hemostatic junctional wounds. Conclusions Our findings highlight the difficulty of controlling hemorrhage from junctional wounds with hemostatic gauze in the context of prolonged field care and casualty transport. Our research can guide selection of hemorrhage control gauze when patients have prolonged field extraction or difficult transport. Our data demonstrates the frequency of junctional wound rebleeding after movement and thus the importance of frequent patient reassessment.

Muscle activity of cutting manoeuvres and soccer inside passing suggests an increased groin injury risk during these movements

Cutting manoeuvres and inside passing are thought to increase the risk for sustaining groin injuries. But both movements and cutting manoeuvres in particular have received little research attention in this regard. The purpose of this study was to investigate the muscle activity of adductor longus and gracilis as well as hip and knee joint kinematics during 90° -cutting and inside passing. Thirteen male soccer players were investigated with 3D-motion capturing and surface electromyography of adductor longus and gracilis while performing the two movements. Hip and knee joint kinematics were calculated with AnyBody Modelling System. Muscle activity of both muscles was significantly higher during the cutting manoeuvre compared to inside passing. Kinematics showed that the highest activity occurred during phases of fast muscle lengthening and eccentric contraction of the adductors which is known to increase the groin injury risk. Of both movements, cutting showed the higher activity and is therefore more likely to cause groin injuries. However, passing might also increase the risk for groin injuries as it is one of the most performed actions in soccer, and therefore most likely causes groin injuries through overuse. Practitioners need to be aware of these risks and should prepare players accordingly through strength and flexibility training.

Adductor Muscles Strength and Strength Asymmetry as Risk Factors for Groin Injuries among Professional Soccer Players: A Prospective Study

The aim of this study was to prospectively examine the association between isometric hip adductor strength and between-limb strength asymmetry to groin injuries in male professional soccer players. Isometric hip adductor strength and between-limb strength asymmetry of 45 professional outfield soccer players from three First Division teams were tested during the 2017/2018 preseason. Players were then monitored throughout the 2017/2018 season for groin injuries. Ten groin injuries were recorded. When compared with uninjured players, players who sustained groin injury had significantly lower strength of respective muscle groups and significantly higher between-limb strength asymmetries (all p < 0.05; ES = 1.16 and 0.88; mean % difference = 26% and 51%). Isometric hip adductor strength had a significant inverse relationship with the incidence of occurring groin injuries (p = 0.016). No significant relationship between hip adductor strength asymmetry and the incidence of future groin injury was observed (p = 0.09). Finally, players’ age and previous groin injury were not significantly associated with the incidence of future groin injuries (all p > 0.05). These results generally suggest that isometric adductor strength is a significant predictor of future groin injuries in men’s professional football; however, due to the relatively low sample size, further studies are required.