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Risk factors for groin injury in sport: an updated systematic review
  1. Jackie L Whittaker1,
  2. Claire Small2,
  3. Lorrie Maffey3,4,
  4. Carolyn A Emery5,6
  1. 1Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
  2. 2Pure Sports Medicine, London, UK
  3. 3Faculty of Medicine, Division of Sport Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4School of Rehabilitation Science, McMaster University, Canada
  5. 5Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada
  6. 6Department of Pediatrics and Department of Community Health Sciences, Alberta Children's Hospital Research Institute for Child and Maternal Health, Cummings School of Medicine, University of Calgary, Calgary, Canada
  1. Correspondence to Dr Jackie L Whittaker, Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, Canada T2N 1N4; jwhittak{at}


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.

  • Athlete
  • Injuries
  • Groin
  • Hip
  • Risk factor

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