A Scoping Review of Exercises for Preventing Athletic Groin Pain

TL;DR

This review summarizes exercise interventions for preventing groin pain in athletes, finding that the Copenhagen Adduction Exercise is most common but new approaches are needed.

Contribution

The study provides a comprehensive overview of exercise-based prevention strategies for athletic groin pain, highlighting gaps and potential new directions.

Findings

The Copenhagen Adduction Exercise (CAE) was the most commonly studied intervention for preventing groin pain.

The Nordic hamstring exercise and multi-joint coordination programs showed emerging evidence of effectiveness.

Most studies had moderate methodological quality, and limited progress has been made in prevention strategies beyond CAE.

Abstract

Groin pain is a frequent injury in multidirectional sports such as soccer, ice hockey, and Australian football. It commonly occurs during kicking, sprinting, and directional changes, yet preventive strategies remain poorly established. Although the Copenhagen Adduction Exercise (CAE) is widely adopted for groin pain prevention, evidence for other exercise options is limited. This scoping review aimed to identify and summarize exercise-based interventions used to prevent groin pain in athletes. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Searches were conducted in PubMed, Web of Science, and PEDro (1983-April 2025) using the key concepts “groin pain,” “exercise,” and “prevention.” Only randomized and clinical trials published in English were included. After duplicate removal, 502 records were screened, and 19 studies met the eligibility criteria. Data were charted using Microsoft Excel, including study design, participant characteristics, intervention type, and outcomes. Two blinded reviewers assessed study quality using the PEDro scale. Descriptive and frequency-based analyses were performed to determine the most commonly implemented preventive exercises. In total, 19 randomized controlled trials were included, with an average PEDro score of 6.9 ± 1.2 (range = 5-9), indicating moderate methodological quality. The CAE was reported in 13 of 19 studies, showing improvements in adductor strength and, in some cases, reduced injury incidence. The Nordic hamstring exercise appeared in three studies, demonstrating benefits for strength and injury reduction. Additional programs such as the extended knee control program, abdominal and gluteus medius training, and trunk-hip coordination exercises were also identified. Counting the frequency of reported interventions revealed that CAE remains the most prevalent approach, while newer coordination-based or multi-joint programs show emerging evidence of benefit. Most studies focused on the CAE, indicating limited progress in groin pain prevention strategies. As CAE alone shows limited preventive effects, developing new, multifaceted exercise approaches is essential. This review was retrospectively registered in the Open Science Framework, relied solely on English-language publications, and included only published trials, which may introduce selection and publication bias.

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