Effectiveness of Abdominal and Gluteus Medius Training in Lumbo-Pelvic Stability and Adductor Strength in Female Soccer Players. A Randomized Controlled Study

Héctor Guerrero-Tapia, Rodrigo Martín-Baeza, Rubén Cuesta-Barriuso, Héctor Guerrero-Tapia, Rodrigo Martín-Baeza, Rubén Cuesta-Barriuso

Abstract

Background: Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors.

Methods: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength.

Results: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: -2.48; p < 0.001 in the left adductor; MD: -1.48; p < 0.01 in right adductor) and control group (MD: -1.68; p < 0.001 in the left adductor; MD: -2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength.

Conclusions: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.

Trial registration: ClinicalTrials.gov NCT03617887.

Keywords: core; gluteus medius; isometric abdominal training; lumbo-pelvic stability; physiotherapy.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Show the three exercises.
Figure 3
Figure 3
Show both exercises.

References

    1. Read P.J., Oliver J.L., De Ste Croix M.B.A., Myer G.D., Lloyd R.S. An audit of injuries in six English professional soccer academies. J. Sports Sci. 2017;10:1–7. doi: 10.1080/02640414.2017.1402535.
    1. Kerbel Y.E., Smith C.M., Prodromo J.P., Nzeogu M.I., Mulcahey M.K. Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States. Orthop. J. Sports Med. 2018;6:2325967118771676. doi: 10.1177/2325967118771676.
    1. Mosler A.B., Weir A., Eirale C., Farooq A., Thorborg K., Whiteley R.J., Hölmich P., Crossley K.M. Epidemiology of time loss groin injuries in a men’s professional football league: A 2-year prospective study of 17 clubs and 606 players. Br. J. Sports Med. 2018;52:292–297. doi: 10.1136/bjsports-2016-097277.
    1. Elattar O., Choi H.R., Dills V.D., Busconi B. Groin Injuries (Athletic Pubalgia) and Return to Play. Sports Health. 2016;8:313–323. doi: 10.1177/1941738116653711.
    1. Leetun D.T., Ireland M.L., Willson J.D., Ballantyne B.T., Davis I.M. Core stability measures as risk factors for lower extremity injury in athletes. Med. Sci. Sports Exerc. 2004;36:926–934. doi: 10.1249/01.MSS.0000128145.75199.C3.
    1. Abdelraouf O.R., Abdel-Aziem A.A. The Relationship between Core Endurance and Back Dysfunction in Collegiate Male Athletes with and without Nonspecific Low Back Pain. Int. J. Sports Phys. Ther. 2016;11:337–344.
    1. Dello Iacono A., Maffulli N., Laver L., Padulo J. Successful treatment of groin pain syndrome in a pole-vault athlete with core stability exercise. J. Sports Med. Phys. Fit. 2017;57:1650–1659.
    1. Holmich P., Larsen K., Krogsgaard K., Gluud C. Exercise program for prevention of groin pain in football players: A cluster-randomized trial. Scand. J. Med. Sci. Sports. 2010;20:814–821. doi: 10.1111/j.1600-0838.2009.00998.x.
    1. Krommes K., Bandholm T., Jakobsen M.D., Andersen L.L., Serner A., Hölmich P., Thorborg K. Dynamic Hip Adduction, Abduction and Abdominal Exercises from the Holmich Groin-Injury Prevention Program are Intense enough to be Considered Strengthening Exercises—A Cross-Sectional Study. Int. J. Sports Phys. Ther. 2017;12:371–380.
    1. Serner A., Jakobsen M.D., Andersen L.L., Holmich P., Sundstrup E., Thorborg K. EMG evaluation of hip adduction exercises for soccer players: Implications for exercise selection in prevention and treatment of groin injuries. Br. J. Sports Med. 2014;48:1108–1114. doi: 10.1136/bjsports-2012-091746.
    1. Chandran A., Barron M.J., Westerman B.J., DiPietro L. Multifactorial examination of sex-differences in head injuries and concussions among collegiate soccer players: NCAA ISS, 2004–2009. Inj. Epidemiol. 2017;4:1–8. doi: 10.1186/s40621-017-0127-6.
    1. Thorborg K., Serner A., Petersen J., Madsen T.M., Magnusson P., Holmich P. Hip adduction and abduction strength profiles in elite soccer players: Implications for clinical evaluation of hip adductor muscle recovery after injury. Am. J. Sports Med. 2011;39:121–126. doi: 10.1177/0363546510378081.
    1. Drew M.K., Palsson T.S., Hirata R.P., Izumi M., Lovell G., Welvaert M., Chiarelli P., Osmotherly P.G., Graven-Nielsen T. Experimental pain in the groin may refer into the lower abdomen: Implications to clinical assessments. J. Sci. Med. Sport. 2017;20:904–909. doi: 10.1016/j.jsams.2017.04.007.
    1. Kak H.B., Park S.J., Park B.J. The effect of hip abductor exercise on muscle strength and trunk stability after an injury of the lower extremities. J. Phys. Ther. Sci. 2016;28:932–935. doi: 10.1589/jpts.28.932.
    1. Mendis M.D., Hides J.A. Effect of motor control training on hip muscles in elite football players with and without low back pain. J. Sci. Med. Sport. 2016;19:866–871. doi: 10.1016/j.jsams.2016.02.008.
    1. Ishøi L., Sørensen C.N., Kaae N.M., Jørgensen L.B., Hölmich P., Serner A. Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial. Scand. J. Med. Sci. Sports. 2016;26:1334–1342. doi: 10.1111/sms.12585.
    1. Akuthota V., Nadler S.F. Core strengthening. Arch. Phys. Med. Rehabil. 2004;85:S86–S92. doi: 10.1053/j.apmr.2003.12.005.
    1. Chan M.K., Chow K.W., Lai A.Y., Mak N.K., Sze J.C., Tsang S.M. The effects of therapeutic hip exercise with abdominal core activation on recruitment of the hip muscles. BMC Musculoskelet. Disord. 2017;18:1–11. doi: 10.1186/s12891-017-1674-2.
    1. Calatayud J., Casana J., Martin F., Jakobsen M.D., Colado J.C., Andersen L.L. Progression of Core Stability Exercises Based on the Extent of Muscle Activity. Am. J. Phys. Med. Rehabil. 2017;96:694–699. doi: 10.1097/PHM.0000000000000713.
    1. Mueller J., Hadzic M., Mugele H., Stoll J., Mueller S., Mayer F. Effect of high-intensity perturbations during core-specific sensorimotor exercises on trunk muscle activation. J. Biomech. 2018;70:212–218. doi: 10.1016/j.jbiomech.2017.12.013.
    1. Monteiro R.L., Facchini J.H., de Freitas D.G., Callegari B., Joao S.M. Hip Rotations’ Influence of Electromyographic Activity of Gluteus Medius Muscle During Pelvic-Drop Exercise. J. Sport Rehabil. 2017;26:65–71. doi: 10.1123/jsr.2015-0097.
    1. Krause D.A., Jacobs R.S., Pilger K.E., Sather B.R., Sibunka S.P., Hollman J.H. Electromyographic analysis of the gluteus medius in five weight-bearing exercises. J. Strength Cond. Res. 2009;23:2689–2694. doi: 10.1519/JSC.0b013e3181bbe861.
    1. Stastny P., Tufano J.J., Golas A., Petr M. Strengthening the Gluteus Medius Using Various Bodyweight and Resistance Exercises. Strength Cond. J. 2016;38:91–101. doi: 10.1519/SSC.0000000000000221.
    1. O’Sullivan K., Herbert E., Sainsbury D., McCreesh K., Clifford A. No difference in gluteus medius activation in women with mild patellofemoral pain. J. Sport Rehabil. 2012;21:110–118. doi: 10.1123/jsr.21.2.110.
    1. Struminger A.H., Lewek M.D., Goto S., Hibberd E., Blackburn J.T. Comparison of gluteal and hamstring activation during five commonly used plyometric exercises. Clin. Biomech. 2013;28:783–789. doi: 10.1016/j.clinbiomech.2013.06.010.
    1. Cha Y.J., Lee J.J., Kim D.H., You J.S.H. The validity and reliability of a dynamic neuromuscular stabilization-heel sliding test for core stability. Technol. Health Care. 2017;25:981–988. doi: 10.3233/THC-170929.
    1. Hrysomallis C. Hip adductors’ strength, flexibility, and injury risk. J. Strength Cond. Res. 2009;23:1514–1517. doi: 10.1519/JSC.0b013e3181a3c6c4.
    1. Gafner S., Bastiaenen C.H.G., Terrier P., Punt I., Ferrari S., Gold G., de Bie R., Allet L. Evaluation of hip abductor and adductor strength in the elderly: A reliability study. Eur. Rev. Aging Phys. Act. 2017;14:1–9. doi: 10.1186/s11556-017-0174-6.
    1. Pallant J. SPSS Survival Manual. McGraw-Hill Education; New York, NY, USA: 2013.
    1. Rosas F., Ramirez-Campillo R., Martinez C., Caniuqueo A., Cañas-Jamet R., McCrudden E., Meylan C., Moran J., Nakamura F.Y., Pereira L.A., et al. Effects of Plyometric Training and Beta-Alanine Supplementation on Maximal-Intensity Exercise and Endurance in Female Soccer Players. J. Hum. Kinet. 2017;58:99–109. doi: 10.1515/hukin-2017-0072.
    1. Pardos-Mainer E., Casajus J., Gonzalo-Skok O. Effects of Combined Strength and Power Training on Physical Performance and Interlimb Asymmetries in Adolescent. Int. J. Sports Physiol. Perform. 2020;20:1–9.
    1. Pardos-Mainer E., Casajus J.A., Gonzalo-Skok O. Adolescent female soccer players’ soccer-specific warm-up effects on performance and inter-limb asymmetries. Biol. Sport. 2019;36:199–207. doi: 10.5114/biolsport.2019.85453.
    1. Shalfawi S.A., Haugen T., Jakobsen T.A., Enoksen E., Tonnessen E. The effect of combined resisted agility and repeated sprint training vs. strength training on female elite soccer players. J. Strength Cond. Res. 2013;27:2966–2972. doi: 10.1519/JSC.0b013e31828c2889.
    1. Pardos-Mainer E., Lozano D., Torrontegui-Duarte M., Cartón-Llorente A., Roso-Moliner A. Effects of Strength vs. Plyometric Training Programs on Vertical Jumping, Linear Sprint and Change of Direction Speed Performance in Female Soccer Players: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health. 2021;18:401. doi: 10.3390/ijerph18020401.
    1. Grygorowicz M., Piontek T., Dudzinski W. Evaluation of functional limitations in female soccer players and their relationship with sports level—A cross sectional study. PLoS ONE. 2013;8:e66871. doi: 10.1371/journal.pone.0066871.
    1. Moffroid M.T. Endurance of trunk muscles in persons with chronic low back pain: Assessment, performance, training. J. Rehabil. Res. Dev. 1997;34:440–447.
    1. Sabiston C.M., McDonough M.H., Sedgwick W.A., Crocker P.R.E. Muscle gains and emotional strains: Conflicting experiences of change among overweight women participating in an exercise intervention program. Qual. Health Res. 2009;19:466–480. doi: 10.1177/1049732309332782.
    1. Jones M.T., Matthews T.D., Murray M., Raalte J.V., Jensen B.E. Psychological correlates of performance in female athletes during a 12-week off-season strength and conditioning program. J. Strength Cond. Res. 2010;24:619–628. doi: 10.1519/JSC.0b013e3181cc23c3.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir