Article Text

Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials
  1. E Esteve1,
  2. M S Rathleff2,3,
  3. C Bagur-Calafat1,
  4. G Urrútia4,
  5. K Thorborg5,6
  1. 1Department of Physical Therapy, Universitat Internacional de Catalunya, Barcelona, Spain
  2. 2Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
  3. 3Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
  4. 4Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute, Barcelona, Spain
  5. 5Faculty of Health Sciences, Sports Orthopedic Research Center, Arthroscopic Centre Amager, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
  6. 6Physical Medicine and Rehabilitation—Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark
  1. Correspondence to E Esteve, Department of Physical Therapy, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, Barcelona 08195, Spain; ernest.esteve{at}


Background/aim Groin injuries are common in football and ice hockey, and previous groin injury is a strong risk factor for future groin injuries, which calls for primary prevention. The aim of this systematic review was to evaluate the effect of specific groin-injury prevention programmes in sports.

Methods A comprehensive search was performed in May 2014 yielding 1747 potentially relevant references. Two independent assessors evaluated randomised controlled trials for inclusion, extracted data and performed quality assessments using Cochrane's risk of bias tool. Quantitative analyses were performed in Review Manager 5.3.

Results Seven trials were included: six on football players (four male and two female populations) and one on male handball players. In total there were 4191 participants with a total of 157 injuries. The primary analysis, including all participants, did not show a significant reduction in the number of groin injuries after completing a groin injury prevention programme (relative risk (RR) 0.81; 95% CI 0.60 to 1.09). Subgroup analysis based on type of sports, gender and type of prevention programme showed similar non-significant estimates with RR ranging from 0.48 to 0.81.

Conclusion Meta-analysis revealed a potential clinically meaningful groin injury reduction of 19%, even though no statistical significant reduction in sport-related groin injuries could be documented.

Trial registration PROSPERO registration ID CRD42014009614.

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