Adductor Injuries in Major League Soccer: A 10-Year Analysis of Injury Rate and Return to Play, and Performance Metrics by Player Position.

BACKGROUND

Adductor injuries are common in professional soccer, leading to prolonged recovery, compromised player performance, high recurrence rates, and variable outcomes despite advancements in injury prevention and management.

PURPOSE/HYPOTHESIS: This study aims to assess trends in return-to-play (RTP), reinjury rates, and performance effects in Major League Soccer (MLS) players. It was hypothesized that RTP times and performance metrics after adductor injuries vary by time period (2010-2015 vs 2016-2021) and player position, with changes in injury management influencing outcomes.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Adductor injuries in MLS players (2010-2021) were analyzed November 8, 2024, using the MLS Injury Surveillance database. All recorded injuries were included and cross-referenced with publicly available data. Injuries were compared across 2 time periods (2010-2015 vs 2016-2021). Injured players were matched 1:2 with noninjured controls by position, age, and MLS experience. RTP duration, reinjury rates, and pre- and postinjury performance metrics were evaluated by time period and player position. Independent tests and chi-square tests were used to assess differences in RTP duration, reinjury rates, and injury rates. Multivariate regression was performed to identify predictors of RTP.

RESULTS

Between 2010 and 2021, a total of 1706 players with adductor injuries were identified. RTP times increased from 14.4 ± 10.1 days (2010-2015) to 19.7 ± 15.2 days (2016-2021; = .0475). Multivariate linear regression identified significant predictors of prolonged RTP, including injury type, onset, and field surface. Compared with acute contact injuries, acute noncontact injurieswere associated with a 12.5-day shorter RTP (β = -12.50; = .010) and chronic injuries with an 18.4-day shorter RTP (β = -18.44; = .001). Osteitis pubis was associated with a 37.2-day increase in RTP duration compared with nonrupture injuries(β = 37.24; = .007). Injuries occurring on grass were associated with a 9.6-day shorter RTP than those on artificial turf (β = -9.56; = .010). Reinjury rates remained stable between the 2 time periods (21.14% vs 23.18%; = .513). After injury, all player positions experienced declines in games played and minutes logged, with defenders exhibiting the most pronounced reductions.

CONCLUSION

Adductor injuries in MLS athletes were associated with increasing RTP durations over time, with notable position-specific performance effects. Acute contact injuries had the longest RTP duration. RTP durations were significantly longer in 2016-2021 compared with 2010-2015, suggesting evolving trends in injury management. These findings underscore the need for individualized rehabilitation strategies tailored to player position and injury characteristics.