Does Anterior Oblique Sling Training Reduce Groin Pain and Enhance Hip Mobility, Adductor Strength, and Performance in Soccer Players with Groin Strain?

Abstract

Background: Groin strains are common in soccer and often lead to prolonged recovery and high recurrence. Traditional rehabilitation may overlook the role of integrated trunk-limb coordination, which is essential in multidirectional sports. The anterior oblique sling (AOS) system, involving the obliques, adductors, and abdominal fascia, is key in dynamic stability and force transfer. Objectives: Evaluate the effects of AOS training on pain, hip mobility, adductor strength, and performance in soccer players with groin strain. Methods: In this quasi-experimental study, 30 male semi-professional footballers (18 - 30 years, with ≥ 5 years' experience and confirmed groin strain) were allocated to either an 8-week supervised AOS training program (3x/week, 40 - 60 min/session; n = 15) or a control group (n = 15). Outcomes assessed pre- and post-intervention included pain [Visual Analog Scale (VAS)], hip mobility, isometric adductor strength (dynamometer), and change-of-direction and acceleration test (CODAT). The data were analyzed via repeated-measures ANOVA and nonparametric tests. Results: The AOS group experienced a 35.6% reduction in pain (VAS: 4.66 ± 0.61 to 3.00 ± 0.92; P = 0.001), unlike the control group. Hip mobility significantly improved in the AOS group (abduction: +4.47°, flexion: +8.87°, extension: +2.54°, internal rotation: +5.73°, external rotation: +3.93°; all P ≤ 0.04, η2 = 0.14 - 0.36), with no similar gains in the control group. Adductor strength increased by 19.8% in the AOS group (P = 0.001, η2 = 0.32) compared to 4.6% in the control group (P = 0.17). Performance improved by 8.0% in the AOS group (CODAT time: 7.03 ± 0.46 to 6.47 ± 0.41 s; P = 0.001, η2 = 0.51), with no change in the control group. Conclusions: The AOS training effectively reduces groin pain and enhances functional outcomes in soccer players. It offers a promising, chain-based rehabilitation approach for dynamic sports.