Objective: To investigate the relationship between repeated clinical measures and the progression of rehabilitation of male athletes with acute adductor injuries. Design: Prospective observational cohort study. Methods: Male athletes with acute adductor injuries received a standardized criteria-based rehabilitation program with four repeated clinical measures during rehabilitation; extent of palpation pain (length and width, cm), the bent knee fall out test (BKFO, cm), hip abduction range of motion (ABD ROM, degrees), and eccentric hip adduction strength (ECC ADD, Nm/kg). We analysed the association between each clinical measure and the percent progression of rehabilitation until return to sport (RTS), divided into two RTS milestones; RTS1: clinically pain free, and RTS2: completion of controlled sports training. Results: We included 61 male athletes for RTS1, and 50 athletes for RTS2 analyses. 381- 675 tests were performed for each clinical measure. The median time until RTS1 and RTS2 were 15 [IQR, 12-29] and 24 days [IQR 16-34], respectively. Each repeated clinical measure individually explained 13-36% of the variation in rehabilitation progression until either RTS milestone. The extent of palpation pain explained the highest variance of the progression of rehabilitation (r2 = 0.26-0.27 and 0.36, p<0.001). Eccentric adduction strength (r2 = 0.19-0.27, p<0.001) improved throughout the rehabilitation, whereas the flexibility tests (BKFO, r2 = 0.13-0.15, p<0.001 and hip ABD ROM, r2 = 0.19-0.20, p<0.001) returned to normal values early in rehabilitation. Conclusion: Repeated measures of adductor strength, flexibility, and palpation pain provided only a rough impression of rehabilitation progress following acute adductor injuries in male athletes. These clinical measures cannot define a precise recovery point during rehabilitation.
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