Clinical examination findings were not associated with isometric strength or functional performance in adults with groin pain

OBJECTIVES: The aim of this study was to investigate whether positive clinical examination findings were associated with selected measures of lower-limb isometric strength or functional performance in physically active adults with groin pain. METHODS: This was a cross-sectional, observational and exploratory study with blinded outcome assessment. A total of 37 physically active adults (18-45 years) with clinically diagnosed groin pain (≥ 6 weeks) underwent standardised orthopaedic testing (flexion, abduction and external rotation [FABER]; flexion, adduction and internal rotation [FADIR]; scour; squeeze), targeted palpation (adductors, pubic symphysis), isometric hip and knee strength testing using a handheld dynamometer and functional performance tests (modified Star Excursion Balance Test [mSEBT], cross-over hop). Associations between clinical findings and strength/performance measures were analysed using adjusted binary logistic regression models controlling for age, body mass index and height, with false discovery rate correction. RESULTS: Participants demonstrated broadly similar right- and left-side performance in the mSEBT and cross-over hop tests, with strength ratios close to 1.0. Positive clinical examination findings were common, particularly for left adductor-region palpation (74.3% of valid observations) and the left FABER test (70.3%). After adjustment for multiple comparisons, no significant associations were found between positive clinical tests and functional or strength measures. CONCLUSIONS: In this exploratory sample of physically active adults with groin pain, positive orthopaedic and palpation tests were not significantly associated with deficits in dynamic balance or isometric strength. These findings are limited to the selected isometric and general functional measures and reinforce the importance of a multi-modal assessment that incorporates clinical classification, eccentric adductor strength testing and sport-specific functional evaluations to guide rehabilitation and return-to-sport decisions.