Groin and adductor strains are among the most persistent injuries in football codes, and one of the biggest reasons is that they’re often cleared to return based on pain settling during light activity, well before the adductor can produce the forceful, high-speed contraction needed to kick, cut, or change direction at pace. The adductor squeeze test gives us a way to measure that gap directly, rather than guess at it.
WHAT THE TEST ACTUALLY MEASURES
The test is performed lying on your back with the hips and knees bent, squeezing a pressure cuff, dynamometer, or the assessor’s hands between the knees as hard as possible for a few seconds. It’s a simple, quick measure of maximal isometric hip adductor strength, and it can be performed in both a short-lever position (knees bent) and a long-lever position (legs straighter), which stress the adductors slightly differently.
A 2019 prospective study by Moreno-Pérez and colleagues, published in Physical Therapy in Sport, followed 71 elite football players across a season and found that low adductor squeeze strength was directly associated with a higher probability of sustaining a groin injury. Players with maximal isometric adductor force below a specific threshold had a substantially higher chance of injury, and the association held even after accounting for body mass. That’s a genuinely useful, actionable number, not just a general impression of “tightness” or discomfort.
WHY TESTING BEATS GUESSING
Groin pain is notoriously slow and non-linear to resolve, and athletes and clinicians alike can be tempted to return to sport once pain-free walking, jogging, and even straight-line running have been achieved. The trouble is that a forceful cut, a kick, or a change of direction loads the adductors in a completely different way, at much higher speed and force, and that’s exactly where an undertested adductor tends to fail.
This mirrors return-to-sport research from other joints: a 2016 Delaware-Oslo cohort study by Grindem and colleagues found an 84% lower reinjury rate in athletes cleared using objective discharge criteria rather than time alone, and a related study by Kyritsis and colleagues found a fourfold higher reinjury risk in athletes who didn’t meet full discharge criteria before returning. The adductor squeeze test is the groin’s equivalent of those objective markers: a number that has to be met, not a feeling that has to pass.
THE KINETIC CHAIN COST OF CUTTING CORNERS
Weak adductors don’t just risk a repeat groin strain. The adductors work closely with the hamstrings and the deep hip stabilisers to control the leg during sprinting and cutting, and a deficit in one muscle group often shows up as compensatory overload in a neighbouring one, which is part of why hamstring and groin injuries so often cluster together in the same athletes and the same seasons. The broader principle, that an undertested muscle group pushes load onto whatever is next in the chain, is well documented in ACL research: a 2016 systematic review by Wiggins and colleagues found that athletes returning to sport after ACL reconstruction re-injured the same knee and the opposite knee at almost identical rates, illustrating how an underprepared joint or muscle group redistributes risk rather than eliminating it.
Chronic or recurrent groin pain, sometimes progressing to what’s described as athletic pubalgia, also becomes harder to fully resolve the more times it recurs, with more secondary compensation patterns to untangle each time. Confirming adequate adductor strength before full return to sport is one of the more effective ways to keep a single strain from becoming a recurring, season-defining problem.
WHAT WE DO AT PRAXIS
We use the adductor squeeze test alongside Copenhagen plank progressions and sport-specific cutting and kicking drills to confirm the groin is genuinely ready for full training, not just comfortable at jogging pace. If you’re managing groin or adductor pain, book a return-to-sport assessment with our team.
Until next time, Praxis What You Preach…
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Related Articles
Chronic Groin Pain (Athletic Pubalgia)
Nordic Curls and the Copenhagen Plank: Two Exercises That Could Save Your Season
Return to Sport Testing: The Complete Guide
References
Moreno-Pérez V, Travassos B, Calado A, Gonzalo-Skok O, Del Coso J, Mendez-Villanueva A. Adductor squeeze test and groin injuries in elite football players: a prospective study. Physical Therapy in Sport. 2019;37:54-59.
Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. British Journal of Sports Medicine. 2016;50(13):804-808.
Kyritsis P, Bahr R, Landreau P, Miladi R, Witvrouw E. Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. British Journal of Sports Medicine. 2016;50(15):946-951.
Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. American Journal of Sports Medicine. 2016;44(7):1861-1876.