Prevention of groin injuries in sports

a systematic review with meta-analysis of randomised controlled trials

Esteve, E
Rathleff, M S
Bagur-Calafat, C
Urrútia, G
Thorborg, K

¹Department of Physical Therapy, Universitat Internacional de Catalunya, Barcelona, Spain
²Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
³Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
⁴Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute, Barcelona, Spain
⁵Faculty of Health Sciences, Sports Orthopedic Research Center, Arthroscopic Centre Amager, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
⁶Physical Medicine and Rehabilitation—Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark

E Esteve, Department of Physical Therapy, Universitat Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, Barcelona 08195, Spain; [email protected]

Accepted January 26, 2015

British Journal of Sports Medicine 49(12):p 785-791, June 2015. | DOI: 10.1136/bjsports-2014-094162

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.