Adductor Squeeze Test

Groin injuries are among the most frequent complaints in sports involving sprinting, kicking, cutting, and sudden changes of direction – such as soccer, ice hockey, and handball. Weakness in the adductor group is a well-established risk factor for both acute and long-term groin problems. The Adductor Squeeze Test is therefore a valuable tool for diagnosis, screening, and prevention.

The test evaluates adductor muscle strength at different hip angles and identifies pain or functional deficits. It is simple, requires minimal equipment, and provides both subjective and objective information about adductor function.

Purpose – What the test reveals

• Assess strength of the hip adductors and identify weakness

• Detect pain in adductor muscles or tendon insertions

• Monitor function and recovery after groin injury

• Screen athletes pre-season to identify risk of future groin pain

Adductor weakness is one of the strongest risk factors for groin injuries in sports¹².

Test Procedure

Patient position: Supine on examination table.

Positions tested:

• 0° hip flexion (legs straight)

• 45° hip flexion (half-bent hips)

• 90° hip flexion (hip and knees at 90°)

Execution:

1. Examiner places a fist, dynamometer, or inflated sphygmomanometer cuff between the patient’s knees.

2. Patient squeezes knees together maximally for 5–10 seconds.

3. Test is repeated 2–3 times and average recorded.

Key point: 45° hip flexion produces the highest pressure and greatest EMG activity of the adductors, and is considered the most informative position¹.

https://www.youtube.com/watch?v=WgMdG7Y3-Ps

Interpretation

Positive test:

• Pain in the adductor region during squeezing

• Groin or pelvic pain at muscle/tendon insertion

• Noticeably reduced strength (compared to contralateral side, normative data, or prior testing)

Objective values:

• Sphygmomanometer: Normal >250 mmHg at 45° flexion²

• Dynamometer: Provides Newton values for research/elite settings

Low strength on the squeeze test is strongly associated with future groin injuries in football³.

Evidence and Clinical Value

• Delahunt et al. (2011): 45° hip flexion elicited highest muscle activation¹

• Moreno-Pérez et al. (2019): Low preseason scores increased injury risk during the season³

• Test–retest reliability: ICC >0.85 (excellent)⁴

Clinical Application

Used for:

• Pre-season screening

• Clinical diagnosis of groin pain

• Monitoring rehab progress

• Pre/post intervention comparisons

If positive or weak:

• Differential diagnosis: Iliopsoas tendinopathy, pubic symphysis irritation, hip OA

• Additional tests: Palpation, passive stretch, functional strength (Copenhagen Adduction Test, Thomas Test)

• Rehab strategies:

  • Copenhagen Adduction Exercise – reduces groin injuries by 41% in soccer⁵

  • Eccentric strengthening with bands/cables/bodyweight

  • Lumbopelvic stability training (planks, Pallof press, diagonal control drills)

  • Sports-specific progression (cutting, kicking, acceleration drills)

Goal: At least 80% adductor strength relative to abductor strength before return to play⁵.

Kilder:

1. Delahunt E, Kennelly C, McEntee BL, Coughlan GF, Green BS. The thigh adductor squeeze test: 45 of hip flexion as the optimal test position for eliciting adductor muscle activity and maximum pressure values. Manual therapy. 2011 Oct 1;16(5):476-80.

2. Hodgson L, Hignett T, Edwards K. Normative adductor squeeze tests scores in rugby. Physical Therapy in Sport. 2015 May 1;16(2):93-7.

3. 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 May 1;37:54-9.

4. Delahunt E, McEntee BL, Kennelly C, Green BS, Coughlan GF. Intrarater reliability of the adductor squeeze test in gaelic games athletes. Journal of Athletic Training. 2011;46(3):241-5.