Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers

Abstract Background Adductor-related groin pain syndrome is the most common problem for athletes in many sports which often significantly reduces athletic performance and activity. Objective This study aimed to investigate the effectiveness of the Modified Holmich protocol on hip adductor strength,...

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Main Authors: Riya Gupta, Aditi Singh, Anu Bansal
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:Bulletin of Faculty of Physical Therapy
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Online Access:https://doi.org/10.1186/s43161-025-00298-8
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author Riya Gupta
Aditi Singh
Anu Bansal
author_facet Riya Gupta
Aditi Singh
Anu Bansal
author_sort Riya Gupta
collection DOAJ
description Abstract Background Adductor-related groin pain syndrome is the most common problem for athletes in many sports which often significantly reduces athletic performance and activity. Objective This study aimed to investigate the effectiveness of the Modified Holmich protocol on hip adductor strength, functional performance, and injury prevention in U-19 female footballers with groin discomfort. Methods An experimental study was conducted with a total of 34 U-19 female footballers from Olympus Sports Club in Noida. Participants were randomly assigned to either the experimental group (n = 17) or the conventional group (n = 17). The experimental group followed the Modified Holmich protocol, while the conventional group followed a general strengthening protocol. Baseline measurements of hip adductor strength, functional performance (measured using the Edgreen Side Hop Test), and groin-related issues (assessed using the HAGOS questionnaire) were obtained. Results The Modified Holmich Protocol group showed significant strength gains (Left: 18.3 ± 2.3 to 20.4 ± 2.2; Right: 19.6 ± 2.4 to 21.1 ± 2.4; p < 0.001) and functional improvement (ESST: 10.7 ± 1.9 to 12.1 ± 1.6, p < 0.001), outperforming conventional training (ESST post: 12.1 ± 1.6 vs 10.6 ± 1.5, p = 0.01). HAGOS subscales demonstrated clinically meaningful improvements (Pain: 63.4 ± 4.2 to 69.7 ± 4.1; Symptoms: 63.8 ± 4.7 to 68.9 ± 4.0; ADL: 62.7 ± 5.6 to 70.0 ± 4.0; Sports: 67.8 ± 4.5 to 72.6 ± 3.1; all p < 0.001), confirming the protocol's effectiveness for enhancing both physical capacity and patient-reported outcomes in female footballers. Conclusion The findings suggest that the Modified Holmich protocol is effective in improving hip adductor strength, functional performance, and reducing groin-related issues in U-19 female footballers with groin discomfort. Trial registration Clinical Trials Registry-India (ICMR-NIMS) registry no. CTRI/2023/02/049371.
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spelling doaj-art-4607f4cd57474636b0fe92637f4f2f202025-08-20T02:37:58ZengSpringerOpenBulletin of Faculty of Physical Therapy2536-96602025-06-013011710.1186/s43161-025-00298-8Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballersRiya Gupta0Aditi Singh1Anu Bansal2Department of Physiotherapy, School of Healthcare, Suresh Gyan Vihar UniversityDepartment of Physiotherapy, Jagannath UniversityAmity Institute of Health Allied Sciences, Amity UniversityAbstract Background Adductor-related groin pain syndrome is the most common problem for athletes in many sports which often significantly reduces athletic performance and activity. Objective This study aimed to investigate the effectiveness of the Modified Holmich protocol on hip adductor strength, functional performance, and injury prevention in U-19 female footballers with groin discomfort. Methods An experimental study was conducted with a total of 34 U-19 female footballers from Olympus Sports Club in Noida. Participants were randomly assigned to either the experimental group (n = 17) or the conventional group (n = 17). The experimental group followed the Modified Holmich protocol, while the conventional group followed a general strengthening protocol. Baseline measurements of hip adductor strength, functional performance (measured using the Edgreen Side Hop Test), and groin-related issues (assessed using the HAGOS questionnaire) were obtained. Results The Modified Holmich Protocol group showed significant strength gains (Left: 18.3 ± 2.3 to 20.4 ± 2.2; Right: 19.6 ± 2.4 to 21.1 ± 2.4; p < 0.001) and functional improvement (ESST: 10.7 ± 1.9 to 12.1 ± 1.6, p < 0.001), outperforming conventional training (ESST post: 12.1 ± 1.6 vs 10.6 ± 1.5, p = 0.01). HAGOS subscales demonstrated clinically meaningful improvements (Pain: 63.4 ± 4.2 to 69.7 ± 4.1; Symptoms: 63.8 ± 4.7 to 68.9 ± 4.0; ADL: 62.7 ± 5.6 to 70.0 ± 4.0; Sports: 67.8 ± 4.5 to 72.6 ± 3.1; all p < 0.001), confirming the protocol's effectiveness for enhancing both physical capacity and patient-reported outcomes in female footballers. Conclusion The findings suggest that the Modified Holmich protocol is effective in improving hip adductor strength, functional performance, and reducing groin-related issues in U-19 female footballers with groin discomfort. Trial registration Clinical Trials Registry-India (ICMR-NIMS) registry no. CTRI/2023/02/049371.https://doi.org/10.1186/s43161-025-00298-8Modified Holmich protocolGroin injury preventionMuscle strengtheningFunctional performanceU-19 female footballers
spellingShingle Riya Gupta
Aditi Singh
Anu Bansal
Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
Bulletin of Faculty of Physical Therapy
Modified Holmich protocol
Groin injury prevention
Muscle strengthening
Functional performance
U-19 female footballers
title Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
title_full Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
title_fullStr Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
title_full_unstemmed Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
title_short Effectiveness of Modified Holmich Protocol on strength, functional performance and injury prevention of groin injuries among U‑19 female footballers
title_sort effectiveness of modified holmich protocol on strength functional performance and injury prevention of groin injuries among u 19 female footballers
topic Modified Holmich protocol
Groin injury prevention
Muscle strengthening
Functional performance
U-19 female footballers
url https://doi.org/10.1186/s43161-025-00298-8
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AT anubansal effectivenessofmodifiedholmichprotocolonstrengthfunctionalperformanceandinjurypreventionofgroininjuriesamongu19femalefootballers