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Mechanisms of acute adductor longus injuries in male football players: a systematic visual video analysis
  1. Andreas Serner1,2,
  2. Andrea Britt Mosler1,3,
  3. Johannes L Tol1,4,
  4. Roald Bahr1,5,
  5. Adam Weir1,6
  1. 1 Aspetar Sports Groin Pain Centre/Research dept./Rehabilitation dept./Sports Medicine dept./Aspetar Sports Injury and Illness Prevention Programme (ASPREV), Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2 Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center Amager, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Denmark
  3. 3 La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
  4. 4 Academic Center for Evidence Based Medicine, Academic Medical Center, Amsterdam, The Netherlands
  5. 5 Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Oslo, Norway
  6. 6 Erasmus MC Center for Groin Injuries, Department of Orthopaedics, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
  1. Correspondence to Andreas Serner, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha 29222, Qatar; Andreas.Serner{at}


Background Change of direction and kicking have been described as the main actions resulting in adductor longus injury. Video descriptions of inciting events are lacking.

Objective Perform a standardised visual video analysis of a series of acute adductor longus injuries in football.

Study design Cross-sectional.

Methods Video footage was reviewed by players, and assessed independently by five sports medicine professionals. Inciting events were described and categorised using standardised scoring, including playing situation, player/opponent behaviour, movement and body positions.

Results Videos of acute adductor longus injuries in 17 professional male football players were analysed. Most injuries occurred in non-contact situations (71%), following a quick reaction to a change in play (53%). Injury actions were: change of direction (35%), kicking (29%), reaching (24%) and jumping (12%). Change of direction and reaching injuries were categorised as closed chain movements (59%), characterised by hip extension and abduction with external rotation. Kicking and jumping injuries were categorised as open chain (41%), characterised by a change from hip extension to hip flexion, and hip abduction to adduction, with external rotation.

Conclusion Acute adductor longus injuries in football occur in a variety of situations. Player actions can be categorised into closed (change of direction and reaching) and open (kicking and jumping) chain movements involving triplanar hip motion. A rapid muscle activation during a rapid muscle lengthening appears to be the fundamental injury mechanism for acute adductor longus injuries.

  • groin
  • soccer
  • muscle injury
  • strain
  • thigh

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  • Contributors AS conceived the study. All authors contributed to the design, analysis and interpretation of the data. AS drafted the article, and all authors revised it critically and approved the final article.

  • Funding The study was funded by Aspetar Orthopaedic and Sports Medicine Hospital.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Shafallah Medical Genetics Center (IRB Project No 2013-008/2012-013) and the Anti-Doping Lab Qatar Institutional Review Board (EXT2014000006/EXT2014000004).

  • Provenance and peer review Not commissioned; externally peer reviewed.