title: Risk factors for groin injury in sport: an updated systematic review.
abstract: BACKGROUND
  The identification of risk factors for groin injury in sport is important to develop and implement injury prevention strategies.
  
  
  OBJECTIVE
  To identify and evaluate the evidence examining risk factors for groin injury in sport.
  
  
  METHODS
  Nine electronic databases were systematically searched to June 2014. Studies selected met the following criteria: original data; analytic design; investigated a risk factor(s); included outcomes for groin injury sustained during sport participation. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed and two independent authors assessed the quality and level of evidence with the Downs and Black (DB) criteria and Oxford Centre of Evidence-Based Medicine model, respectively.
  
  
  RESULTS
  Of 2521 potentially relevant studies, 29 were included and scored. Heterogeneity in methodology and injury definition precluded meta-analyses. The most common risk factors investigated included age, hip range of motion, hip adductor strength and height. The median DB score across studies was 11/33 (range 6-20). The majority of studies represented level 2 evidence (cohort studies) however few considered the inter-relationships between risk factors. There is level 1 and 2 evidence that previous groin injury, higher-level of play, reduced hip adductor (absolute and relative to the hip abductors) strength and lower levels of sport-specific training are associated with increased risk of groin injury in sport.
  
  
  CONCLUSIONS
  We recommended that investigators focus on developing and evaluating preparticipation screening and groin injury prevention programmes through high-quality randomised controlled trials targeting athletes at greater risk of injury.
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Whittaker
authors.affiliation: Pure Sports Medicine, London, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Small
authors.affiliation: Faculty of Medicine, Division of Sport Medicine, University of British Columbia, Vancouver, British Columbia, Canada School of Rehabilitation Science, McMaster University, Canada.
authors.forename: Lorrie
authors.initials: L
authors.lastname: Maffey
authors.affiliation: Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Canada Department of Pediatrics and Department of Community Health Sciences, Alberta Children's Hospital Research Institute for Child and Maternal Health, Cummings School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001265:Athletic Injuries / Q000209:etiology* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006119:Groin / Q000293:injuries*; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D055815:Young Adult
keywords: Athlete; Groin; Hip; Injuries; Risk factor