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ORIGINAL ARTICLE
Year : 2017  |  Volume : 17  |  Issue : 1  |  Page : 32-35

Normative adductor squeeze test values in Indian women cricketers and its correlation with body mass index


Department of Physiotherapy, Ayushman College, Bhopal, Madhya Pradesh, India

Date of Web Publication3-Jan-2017

Correspondence Address:
Dr. Divya Khare
Department of Physiotherapy, Ayushman College, Bhopal, Madhya Pradesh
India
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DOI: 10.4103/1319-6308.197467

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  Abstract 

Aim: The aim of this study was to establish the normative adductor squeeze test score in state-level cricketers and to determine the effect of body mass index on the test values of adductor squeeze test. Participants and Methods: A total of forty healthy women cricketers aged 20-28 years were selected. Results: The mean adductor strength and normative adductor squeeze test values for the state-level cricketers were established. Conclusion: With the increasing demands of cricket as a professional game, prevention of injuries and rehabilitation for player performance and to maximize player training are important.

  Abstract in Arabic 

قيم اختبار الضغط المعياري المقرب لدى لاعبات الكريكت الهنديات وارتباطه بمؤشر كتلة الجسم
هدف الدراسة: الهدف من هذه الدراسة هو إنشاءاختبار ضغط معياري على مستوى لاعبات الكريكيت بالدولة ولتحديد أثر مؤشر كتلة الجسم على قيم اختبار مقرب الضغط.
المواد والوسائل: تم اختيار أربعين لاعبة كريكت صحيحات أعمارهن 20-28 عاماً.
النتائج: تم إنشاء متوسط قوة المقرب و قيم اختبار الضغط المعياري على مستوى الولاية للاعبات الكريكت.
الخلاصة: مع زيادة الطلب على الكركيت كلعبة احترافية من المهم الوقاية من الإصابات , وتأهيل اللاعبين للأداء وزيادة تمارين اللاعبين.

Keywords: Adductor muscles, groin, hip injuries, squeeze test, women cricketers


How to cite this article:
Khare D, Datey L, Sathe A. Normative adductor squeeze test values in Indian women cricketers and its correlation with body mass index. Saudi J Sports Med 2017;17:32-5

How to cite this URL:
Khare D, Datey L, Sathe A. Normative adductor squeeze test values in Indian women cricketers and its correlation with body mass index. Saudi J Sports Med [serial online] 2017 [cited 2019 Jun 19];17:32-5. Available from: http://www.sjosm.org/text.asp?2017/17/1/32/197467


  Introduction Top


The groin injuries are particularly true in sports that require lateral movements, change in direction, sudden high stretch, stepping, and sprinting. The evaluation and treatment of groin pain in the athletes are challenging,[1] and these injuries are prone to recurrence that can lead to chronic disability and prolonged recovery if not managed accordingly.[2] The adductor tendons attach onto a small area of the bone on the pelvis. This area has a poor blood supply and a rich nerve supply, making it slow to heal and very sensitive to any intervention.[3] The adductor group of muscles is most commonly injured when it is subjected to forceful contractions or excessive stretching which overloads the muscle to the point of failure. The site of injury is most commonly the musculotendinous junction. This is a section of the muscle close to the bone where the muscle becomes elastic and therefore more vulnerable to the injury.

The groin injuries in cricket can occur as a result of not warming up enough before playing cricket match and insufficient rests during and between cricket matches. The groin injuries particularly in bowling are following a sudden acceleration or deceleration movement while running at a high speed such as during fast bowling run-up or during delivery stride. Moreover, in batting, when playing a ball in defense with front foot action, it places a very high stretch on groin and adductor muscles.

Previous studies and researches have shown that the major risk factor and the prominent cause for groin injury is a "previous groin injury."[4] Any groin injuries during the matches or in season can be debilitating for the cricketers. Any adductor strain that is treated improperly can become chronic and further barrier to the career and play. Any of the adductor muscle from the adductor muscle group if injured can lead to groin pain or groin strain. The degree of groin injury can range from a minor strain to a very severe strain. The very common test used to assess groin injuries is adductor squeeze test; pain provocation during this test indicates long-standing groin pain. The adductor squeeze test is widely used in clinical practice as a technique to evaluate the strength of adductor muscles, by the use of bilateral isometric contraction of the adductor muscles on to the pressure cuff of a sphygmomanometer that is preinflated to 10 mm Hg. Delahunt et al.[5] evaluated the adductor squeeze test and compared three test positions at 0°, 45°, and 90° of hip flexion and found that 45° of hip flexion elicited the greatest EMG activity of the adductor mass, followed by 0° and finally 90°. This suggests 45° of hip flexion as the optimal adductor squeeze test position. The adductor squeeze test is an important objective outcome for both rehabilitation and prevention of groin injuries as it has been shown that decreased hip adductor strength precedes groin injuries in some populations.[6] Weak adductor muscles are an intrinsic risk factor for groin injuries.[7] Hip adductor strength is reduced by groin injuries.[6] Adductor strength can be utilized as an outcome to show improvements and may be helpful to gauge return to play readiness.


  Participants and Methods Top


A total of forty healthy female cricketers aged 20-28 years were selected practicing in a state-level run academy. Goniometer was used for setting up the squeeze test at three different angles, and pressure sphygmomanometer was used to quantify the adductor squeeze test score and adductor strength.

Procedure

A total number of forty female state-level cricket players were purposefully selected and assessed on the performance of adductor squeeze test to establish the normative adductor squeeze test score for cricketers. All the selected players were described the procedure beforehand, and informed consent from each participant was taken prior to the testing. The players were explained the protocol of testing. All the players underwent a height and weight check-up, and the readings were recorded after they performed a warm-up session of 30 min which included running and self-stretching. The players wore comfortable sports clothing as for fitness testing, all the players were barefoot, and they lied supine with the head flat on the assessment table and hands across over the chest. Each participant was explained the protocol prior to testing. Then, on their turn, they were asked to perform maximal squeeze in 0°, 45°, and 90° of hip flexion position. The hip flexion position was measured using a goniometer for all the three test positions. And, the adductor squeeze test values were assessed using a pressure cuff of a sphygmomanometer. The sphygmomanometer was preinflated to 10 mm Hg before each maximal effort. The cuff of the sphygmomanometer was placed between the prominent parts of the femoral condyles. The participants were asked to squeeze as hard as possible. They performed three trials for each test position. The participants were given 15 s rest between each trial and 1 min rest for each hip flexion test position; the best out of three readings was selected. The maximum pressure value obtained was recorded for 0°, 45°, and 90° of hip flexion.


  Discussion Top


This study has established the normative values of aspartate aminotransferase (AST) in this player population and showed that there was no significant effect of body mass index (BMI) on the test score values, which furthermore signifies that adductor strength is an independent variable in itself and is not dependent on any other factors such as height and weight. Hence, the study also suggests that for groin injury prevention and rehabilitation after injury, the groin has to be evaluated and assessed properly and functionally keeping all the aspects of groin injury including the other causative factors and associated injuries such as iliopsoas-related groin injury and pain, osteitis pubis, and especially more focused adductor muscles for any group of athletes. The multiplanar function of the hip adductor muscles plays an important role in the stability of lower kinetic chain during the gait cycle. Regardless of the hip position, the posterior fibers of the adductor magnus are powerful extensors of the hip, similar to the hamstring muscles. The remaining adductor muscles are, however, flexor and extensors, depending on the hip position. From a hip position <60° of hip flexion, the line of force of adductor longus shifts anteriorly to the medial lateral axis of rotation. The adductor longus now has a flexor moment arm and generates a flexor torque. In the transverse plane, they eccentrically control femoral internal rotation during the loading response as well as producing external rotation during terminal stance and preswing phase. In this study, we observed peak squeeze values in the 45° hip flexion position compared with values obtained in 0° and 90°.

Lovell et al.[8] suggest that the clinician should assess the strength of the gracilis adductor longus and adductor magnus muscle in 45° of hip flexion. We observed the lower squeeze test values in both the 0° and 90° of hip flexion position. In this study, the lower values in this range may result from the reduced ability of the adductors to produce force in the frontal plane because they change their orientation to work in sagittal plane as secondary hip flexors and extensors. In addition, with varying physical capacity and strength, no statistically significant difference (P) was observed in players with different BMI and AST values. However, further data with a larger sample size may lead to significant findings. The highest squeeze test values were observed in batsmen at 45° of hip flexion. The results in the study present normative adductor test values in cricket population and these cannot be considered for other athletic population.


  Results Top


Analysis was done to find the mean values and standard deviation for age, BMI, Adductor squeeze test values for 0°, 45° and 90° of hip flexion position was calculated. As shown in [Table 1] the mean age calculated was 26.20 ± 1.159. The mean value of adductor squeeze test score at 0° of hip flexion position came as 149.98 ± 19.770, for 45° of hip flexion position = 171.75 ± 17.609 and for 90° of hip flexion position = 133.35 ± 17.968. 45 degrees of hip flexion has the highest value of Adductor squeeze test.
Table 1: Descriptive Analysis

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As shown in [Table 2] Pearson's correlation indicated that effect of BMI of the player did not reach statistical significance for the AST values, P = .417 for 0° of hip flexion position, P = .633 for 45° of hip flexion and, P = .646 for 90° of hip flexion.
Table 2: Correlations

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The mean adductor strength and normative adductor squeeze test values for state level cricketers were established.




  Conclusion Top


With the increasing demands of cricket as a professional game, prevention of injuries and rehabilitation for player performance and to maximize player training are important. The design of a rehabilitation program that safely and effectively changes an injured player to recover and return to play is essential. It can be useful for groin injury prevention and further assessment of injured player and his/her rehabilitation. The adductor squeeze test values can be helpful in the reduction of injuries by early detection and management of injuries, giving attention to the techniques and monitoring the effects of intervention over time.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Tyler TF, Silvers HJ, Gerhardt MB, Nicholas SJ. Groin injuries in sports medicine. Sports Health 2010;2:231-6.  Back to cited text no. 1
    
2.
Werner J, Hägglund M, Waldén M, Ekstrand J. UEFA injury study: A prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med 2009;43:1036-40.  Back to cited text no. 2
    
3.
Brukner P, Khan K. Clinical Sports Medicine. Third Revised Edition. McGraw-Hill Education; 2010.  Back to cited text no. 3
    
4.
Ryan J, DeBurca N, Mc Creesh K. Risk factors for groin/hip injuries in field-based sports: A systematic review. Br J Sports Med 2014;48:1089-96.  Back to cited text no. 4
    
5.
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. Man Ther 2011;16:476-80.  Back to cited text no. 5
    
6.
Crow JF, Pearce AJ, Veale JP, VanderWesthuizen D, Coburn PT, Pizzari T. Hip adductor muscle strength is reduced preceding and during the onset of groin pain in elite junior Australian football players. J Sci Med Sport 2010;13:202-4.  Back to cited text no. 6
    
7.
Engebretsen AH, Myklebust G, Holme I, Engebretsen L, Bahr R. Intrinsic risk factors for groin injuries among male soccer players: A prospective cohort study. Am J Sports Med 2010;38:2051-7.  Back to cited text no. 7
    
8.
Lovell GA, Blanch PD, Barnes CJ. EMG of the hip adductor muscles in six clinical examination tests. Phys Ther Sport 2012;13:134-40.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2]



 

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Abstract
Introduction
Participants and...
Discussion
Results
Conclusion
References
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