Consensus of Return-to-Play Criteria After Adductor Longus Injury in Professional Soccer

Return to play (RTP) decision making in professional soccer is crucial for minimising re-injury risk, reducing financial burdens on clubs, and optimising player performance. Despite its significance, there is a lack of objective criteria and consensus on RTP for adductor longus injuries, one of the most common muscle injuries in soccer. The aim of the present consensus was to validate an RTP protocol based on clinical, functional, and performance criteria through expert evaluation. This study hypothesises that a validated RTP protocol for adductor longus injuries will enhance decision making, reduce re-injury rates, and improve player performance upon return. An observational survey was designed to validate an RTP protocol through an expert panel. A total of 63 injury-management professionals (strength and conditioning coaches, physiotherapists, doctors, and rehabilitation fitness coaches) with an average experience of 12.02 ± 6.87 years participated in validating a 20-criteria RTP protocol. The protocol, divided into clinical, functional, and performance criteria, was assessed using a 5-point Likert scale. Aiken's V coefficient was calculated for content validity, with criteria validated if Aiken's V ≥ 0.75. Out of 20 initial RTP criteria, 14 were validated by the expert panel, with Aiken's V ranging from 0.77 to 0.94 (overall range: 0.61-0.98). Key validated criteria included pain on palpation, flexibility, imaging, athlete feedback, strength assessments, movement quality, pre-injury GPS data, and performance under simulated match conditions. Criteria such as the Copenhagen adduction exercise and specific agility tests were not validated. The expert-validated RTP protocol for adductor longus injuries provides a structured approach to decision making, potentially reducing re-injury risk, improving rehabilitation strategies, and enhancing player performance. These findings could be integrated into clinical sports-medicine practices to enhance rehabilitation effectiveness and RTP decisions in professional soccer.