Adductor Squeeze Test: Don’t Miss the Point

Club Leon midfielder Juan Dominguez (8) kicks the ball in the second half against the Real Salt Lake during Leagues Cup Quarterfinals at Dick’s Sporting Goods Park. Mandatory Credit: Ron Chenoy-Imagn Image

Groin pain is one of the most stubborn problems in field and court sport⁽¹⁾. Over a single season, close to half of male footballers report hip or groin pain, and around one in three carry symptoms into the following season⁽²⁾. Small wonder that the adductor squeeze test has become a fixture of screening and monitoring across football, rugby, ice hockey, Gaelic and Australian Rules football^(3-7).

The typical decision process runs like this: test, find a low score, prescribe adductor strengthening. That logic rests on two assumptions: that a low squeeze means weak adductors, and that stronger adductors will fix the problem. However, both deserve challenging. A recent framework paper from performance and clinical specialists working in elite football and at a high-volume orthopedic and sports medicine hospital in Doha argues that this reflex reflects a poor understanding of what actually drives a squeeze score⁽¹⁾. When clinicians target a single contributor to a multifactorial outcome, the results are unpredictable.

“Match the exercise to the deficit...”

What the Squeeze Actually Measures

The squeeze test measures the total force an athlete can produce in the frontal plane by pressing both legs together against a resistance in a set position (see figure 1). Crucially, that force is not the adductors alone. The adductor group includes pectineus, adductor longus, gracilis, adductor brevis, and adductor magnus, with secondary contributions from the long head of biceps femoris, the posterior fibers of gluteus maximus, quadratus femoris, and obturator externus⁽⁸⁾. Worth noting is that there is also a likely contribution from the ankle and hamstrings during long-lever testing. Beyond the muscles themselves, the force registered depends on trunk control, pelvic position and the athlete’s ability to coordinate force production across segments^(1,9). A low score can originate anywhere along that chain, which is exactly why it cannot, on its own, tell you where the problem sits.