Table 2

Summary of significant and non-significant groin injury risk factors by quantity, quality and level of evidence

Level of evidence*12345Total studies
ab: High-quality RCTcab: True or quasi experimentalb: Prospective cohortb: Retrospective cohortcab: Case–controlPilot cohort cross-sectional
Risk factorRisk factorSIGNOTSIGNOTSIGNOTSIGNOTSIGNOTSIGNOT
ModifiableWeight1 (11)4 (13–19)1 (9)1 (12)7
BMI5 (13–18)1 (9)6
Body fat3 (11–18)3
Hip ROM1 (10)5 (9–18)1 (7)1 (11)1 (12)9
Hip Add strength1 (12)3 (9–18)2 (11–15)2 (7–11)1 (9)9
Hip Abd strength1 (12)1 (11)1 (9)1 (11)4
GMd activation1 (7)1
TrA thickness/activation2 (9–11)2
Knee muscle strength1 (11)1
Knee ROM1 (9)1
Calf flexibility1 (9)1
Clinical tests†1 (18)1 (11)1 (11)3
Fitness tests‡1 (18)4 (11–18)5
GrOS/function2 (16–18)1 (11)3
Exposure§3 (16–18)1 (10)4
Stretching and cross-training1 (10)1
Sport specific training1 (15)1
Non-modifiableAge1 (20)2 (10–13)6 (13–18)1 (9)2 (10–12)12
Sex1 (18)1 (16)1 (9)1 (10)4
Height6 (11–18)1 (9)1 (12)8
Previous injury1 (20)4 (15–18)5
Game play1 (13)1 (18)2
Level of play1 (20)2 (11–18)3
Player position1 (20)1 (11)2 (11–18)1 (9)5
Years of sport experience1 (15)2 (11–16)1 (9)4
Occupational demands1 (20)1
Skeletal maturation1 (10)1
Leg morphology1 (11)1
  • Cell values represent number of studies (range of Downs and Black quality assessment tool scores/23 for cohort studies and/32 for RCT's). As per exclusion criteria, systematic reviews (1a, 2a and 3a), case series (4) and opinion-based papers (5) were not included (shown in dark grey).

  • *Level of evidence is based on the modified Oxford Centre for Evidence-Based Medicine Model.

  • †Including tenderness on palpation, pain, joint stability (knee and ankle) and positive active straight leg raise test.

  • ‡Includes jump height, leg power (squat), 40 m sprint, sidestepping, kicking and VO2max estimated from a shuttle run.

  • §Includes measures of training and match exposure as well as weekly sports participation.

  • Abd, abduction; Add, adduction; ASLR, active straight leg raise test; BMI, body mass index; GMd, glutaeus medius; GrOS, groin outcome score; IO, internal oblique; LE, lower extremity (knee and ankle); NOT, not significant finding; RA, rectus abdominins; RCT, randomised control trial; ROM, range of motion; SIG, significant finding; TrA, transversus abdominis.