The Adductor Squeeze Test is a hip and groin assessment used to provoke adductor-related groin symptoms and, when paired with a sphygmomanometer, dynamometer or force device, monitor hip adductor squeeze strength. A positive test may increase suspicion of adductor-related groin pain when it reproduces the client’s familiar adductor or groin symptoms, but it does not confirm a diagnosis on its own. The test is most useful when interpreted alongside history, tenderness, resisted adduction findings, hip range of motion, strength, function, training load and symptom behaviour.
Groin pain is common in sports that involve sprinting, kicking, cutting, twisting, acceleration and repeated change of direction. The adductor muscle group is often involved, but groin pain can also relate to iliopsoas-related, inguinal-related, pubic-related, hip-related or other causes.
The Adductor Squeeze Test is a practical assessment used to reproduce groin symptoms and assess hip adductor force production. It is commonly used in football, rugby, hockey, Gaelic games and other field or court sports.
This upgraded article follows the uploaded Measurz Evidence-First Orthopaedic Test Article Optimiser prompt, including the required focus on protocol clarity, positive and negative interpretation, diagnostic accuracy, reliability, validity and Measurz recording guidance.
The test can support assessment reasoning, but it should not be used to diagnose groin injury on its own. The Doha agreement on groin pain in athletes defines adductor-related groin pain using adductor tenderness and pain on resisted adduction, meaning the squeeze test may contribute to classification when it matches the full clinical picture rather than acting as a stand-alone diagnostic test.
Test name: Adductor Squeeze Test
Region: Hip and groin
Test type: Pain provocation and/or isometric adductor strength test
Common positions: Supine, hips flexed to 0°, 45° or 90°
Common tools: Examiner fist, ball, sphygmomanometer, handheld dynamometer or groin strength device
Positive finding: Familiar groin or adductor pain reproduced during squeeze
Strength finding: Reduced force, pressure or side-to-side confidence compared with baseline or expected values
Best use: Groin pain assessment, monitoring symptoms, tracking adductor squeeze strength and supporting return-to-training reasoning
Key caution: A positive test does not confirm adductor injury, and a negative test does not fully exclude groin-related pathology
The Adductor Squeeze Test is a clinical hip and groin assessment in which the client squeezes both legs inward against a fixed object or device.
It can be used in two main ways:
Pain provocation: Does squeezing reproduce the client’s familiar groin symptoms?
Force monitoring: How much adductor squeeze force or pressure can the client produce?
The test is often performed in supine with the hips flexed to:
0° hip flexion
45° hip flexion
90° hip flexion
Research comparing these positions found that the 45° hip flexion position produced the greatest adductor muscle activity and maximum pressure values in Gaelic games athletes without groin injury, making it a common position for screening and monitoring.
The Adductor Squeeze Test is used because adductor-related symptoms can be difficult to interpret from pain location alone.
The test may help professionals:
reproduce familiar adductor or groin pain
compare pain response across positions
monitor adductor squeeze force or pressure
compare the client with their own baseline
track symptom response during rehabilitation or training progression
support decisions about further assessment
communicate findings clearly in Measurz
monitor athletes across a season
It is especially useful when combined with:
history and mechanism
training load changes
palpation of adductor structures
resisted adduction testing
hip range of motion
hip and groin strength testing
running, kicking or change-of-direction exposure
client-reported outcome measures such as HAGOS
The Adductor Squeeze Test may assess:
adductor pain provocation
hip adductor squeeze force
symptom response to resisted adduction
groin irritability
confidence producing force
pain response at different hip angles
change in symptoms or force over time
It may be associated with:
adductor-related groin pain
adductor muscle or tendon irritation
athletic groin pain
pubic or adductor-region symptom presentations
reduced adductor strength or squeeze tolerance
It does not directly assess or confirm:
exact tissue injury
adductor tendon pathology
pubic aponeurosis injury
hip joint pathology
inguinal-related groin pain
femoral neck stress injury
hernia
readiness to return to sport
The Adductor Squeeze Test may be useful for:
exercise professionals
strength and conditioning coaches
allied health support teams
movement assessment professionals
sport and performance staff
students learning hip and groin assessment
professionals using Measurz or MAT for tracking
It may be relevant for clients with:
groin pain during running
groin pain during kicking
groin pain during change of direction
pain during acceleration or deceleration
adductor tenderness
reduced confidence with cutting or sprinting
history of groin strain or recurring groin symptoms
sport-related hip and groin complaints
The test has been studied in athletic populations including Gaelic games athletes, football players, basketball players and other sports cohorts.
Use the Adductor Squeeze Test when you want to assess or monitor:
familiar adductor or groin pain during resisted squeeze
adductor squeeze strength
groin symptom irritability
response to training or rehabilitation
pre-season baseline values
in-season symptom changes
readiness for progressive loading discussion
side-to-side or baseline changes over time
It may be used at:
initial assessment
post-injury baseline
reassessment
before return to running
before return to kicking
before change-of-direction progressions
during in-season monitoring
after a symptom flare-up
return-to-training reviews
Use caution when the client has:
severe or unexplained groin pain
suspected fracture or stress fracture
severe acute trauma
inability to lie supine comfortably
severe pain at rest
recent surgery without appropriate clearance
neurological symptoms
systemic symptoms
symptoms not consistent with a musculoskeletal presentation
pain that escalates sharply during testing
Stop or avoid the test if:
pain is severe
symptoms are unfamiliar or concerning
the client cannot produce a controlled squeeze
the client reports sharp, worsening or unsafe symptoms
testing would not change the assessment plan
further medical review is more appropriate
The test should not be used as a stand-alone decision tool for diagnosis, imaging, treatment selection or return-to-sport clearance.
The test can be performed with:
examiner fist
ball
rolled towel
sphygmomanometer
handheld dynamometer
fixed groin strength device
force plates or specialised squeeze device
plinth or floor mat
pain rating scale
Measurz recording workflow
For monitoring, a measurable device is preferred because it improves repeatability and allows force or pressure to be tracked over time.
Explain the purpose of the test.
Example wording:
“We are going to check whether squeezing the legs together reproduces your familiar groin symptoms and, if we use a device, how much squeeze force you can produce. This test does not diagnose the problem on its own, but it helps us understand and monitor your response.”
Position the client:
lying supine
pelvis level
spine relaxed
arms resting comfortably
hips in the chosen test angle
knees flexed if testing 45° or 90°
feet relaxed unless standardising a specific setup
Common test angles:
0° hip flexion: legs straighter, short-lever or long-lever variation depending on setup
45° hip flexion: common monitoring position with high adductor activation
90° hip flexion: hips and knees flexed, often easier to standardise with a ball or cuff
Stand or sit where you can:
observe pelvic movement
ensure the device remains centred
monitor knee and hip position
read the measurement device
stop the test if symptoms escalate
Depending on the variation:
place the fist, ball, cuff or device between the knees, distal thighs or ankles
ensure the device is centred
keep the position consistent across sessions
avoid allowing the device to slide or tilt
Stabilise by ensuring:
pelvis remains level
hips do not rotate excessively
knees remain aligned
trunk does not brace or twist excessively
the client does not use hands to assist
the same lever length and hip angle are repeated at retest
Ask the client to squeeze both legs inward toward the midline.
The force direction is:
bilateral hip adduction
controlled inward squeeze
maximal or submaximal depending on the purpose
usually held for a short duration if measuring force
For pain provocation, a controlled squeeze may be enough. For force monitoring, standardise the effort level, build-up time and hold duration.
Example instructions:
“Squeeze the device between your knees.”
“Build up gradually.”
“Squeeze as hard as you can without pushing through unsafe pain.”
“Hold for five seconds.”
“Tell me if you feel pain and where you feel it.”
“Tell me whether that pain is your familiar symptom.”
The Copenhagen five-second squeeze uses a five-second maximal hip adduction squeeze and has been studied as an indicator of sports-related hip and groin function, pain and severity in football players.
A positive finding is usually:
reproduction of the client’s familiar groin or adductor-region pain during the squeeze
Record:
pain location
pain score
hip angle
force or pressure value if measured
whether symptoms are familiar
whether the response is unilateral or bilateral
whether symptoms change across positions
A negative finding is usually:
no reproduction of familiar groin or adductor pain during the squeeze
If measuring strength, the test may still show:
reduced pressure or force
poor confidence
asymmetry
guarded effort
non-pain-related weakness
Stop the test if:
pain becomes sharp or severe
symptoms are unfamiliar
the client loses control of the movement
the client cannot maintain position
symptoms radiate or change unexpectedly
the client asks to stop
you suspect the test is not appropriate
The test is usually low risk when performed carefully, but it can provoke symptoms in irritable groin presentations.
Use lower intensity or defer maximal testing when:
symptoms are acute
pain is highly irritable
the client is early post-injury
a stress injury or other serious cause has not been excluded
maximal contraction is not needed for the assessment question
A positive Adductor Squeeze Test means the client’s familiar groin or adductor-region symptoms are reproduced during resisted hip adduction.
A positive test may increase suspicion of adductor-related groin pain when it is combined with:
adductor tenderness
pain on resisted adduction
groin pain during kicking, sprinting or cutting
reduced adductor force or pressure
symptom reproduction in a consistent location
relevant training-load history
The Doha agreement supports a clinical classification of adductor-related groin pain when there is adductor tenderness and pain on resisted adduction, but this classification depends on the broader clinical presentation rather than one squeeze result alone.
A positive test does not confirm:
adductor tear
tendon injury
pubic aponeurosis injury
hip joint pathology
hernia
specific tissue diagnosis
Other factors that may contribute to pain during the test include:
pubic-related pain
hip joint-related symptoms
iliopsoas-related pain
abdominal or inguinal-related symptoms
high irritability
fatigue
poor test tolerance
recent training load
A negative Adductor Squeeze Test means the squeeze does not reproduce the client’s familiar groin or adductor pain.
A negative test may decrease suspicion of adductor-related pain if the client’s symptoms are expected to be provoked by resisted adduction and the test is performed in a relevant position.
However, a negative test does not fully exclude:
adductor-related groin pain
hip-related groin pain
early-stage groin symptoms
load-dependent symptoms
symptoms that only occur at high speed or high fatigue
other causes of groin pain
A negative result is more meaningful when:
multiple squeeze positions are pain-free
resisted adduction is pain-free
adductor palpation is not tender
sport-specific activities are tolerated
related hip and groin tests are also negative
The Adductor Squeeze Test has more evidence for pain provocation, force monitoring, reliability and injury-risk association than for stand-alone diagnostic accuracy.
High-quality diagnostic accuracy evidence reporting sensitivity, specificity and likelihood ratios for the Adductor Squeeze Test as a stand-alone test for one exact groin pathology appears limited.
A large athletic groin pain study reported that the Adductor Squeeze Test was sensitive for athletic groin pain but not specific for individual pathologies. This means the test may help identify that hip/groin symptoms are relevant during resisted squeeze, but it does not identify one exact structure or diagnosis by itself.
A prospective elite football study found that lower hip adductor strength measured with the Adductor Squeeze Test was associated with increased groin injury incidence across a season. Force values lower than 465.33 N and relative force lower than 6.971 N/kg were associated with increased probability of groin injury in that cohort.
Another report cited a pre-season sphygmomanometer squeeze score below 225 mmHg as predicting groin injury with:
Sensitivity: 0.70
Specificity: 0.78
This was related to groin injury prediction in male elite Gaelic football players, not diagnosis of a current injury.
These values should be interpreted carefully because:
they relate to specific athletic populations
they are based on specific devices and protocols
they may not apply to general fitness clients
they may not apply across sports, age groups or sexes
they do not diagnose a current injury
they do not clear someone for sport
Higher sensitivity may make a negative screening result more useful for decreasing suspicion of future injury risk in a similar population, but it does not exclude injury risk. Higher specificity may make a low score more useful for increasing suspicion of risk in that specific cohort, but it does not confirm that an athlete will be injured.
Likelihood ratios are not consistently reported for the exact squeeze-test protocols, so they should not be invented.
The Adductor Squeeze Test has useful reliability evidence, especially when the protocol and device are standardised.
A study in Gaelic games athletes evaluated intrarater reliability using a sphygmomanometer across 0°, 45° and 90° hip flexion test positions. The study was designed to determine whether a commercially available sphygmomanometer could reliably measure adductor squeeze values in athletes.
Research comparing 0°, 45° and 90° hip flexion found that the 45° position produced the greatest adductor muscle activity and maximum squeeze pressure values, supporting its use as a standardised monitoring position in non-injured Gaelic games athletes.
A 2022 reliability study in academy basketball players examined intra-day and inter-day reliability of 0° and 45° short-lever adductor squeeze tests using handheld dynamometry, highlighting the importance of standardised position, device placement and repeated testing when monitoring change.
A 2025 review of hip adductor strength testing noted that hip adductor strength testing is widely used in sport, but inconsistent protocols remain a limitation and clearer guidelines are needed for implementation.
Reliability is stronger when you standardise:
hip flexion angle
lever length
device type
device placement
warm-up
number of trials
rest between trials
effort instructions
pain recording
trial selection method
retest timing
Validity is stronger when the test result is interpreted with:
pain location
adductor palpation
resisted adduction findings
training-load history
sport exposure
HAGOS or related outcome measures
strength and functional tests
Common errors include:
calling the test diagnostic on its own
not recording the hip flexion angle
changing between 0°, 45° and 90° across sessions
using a fist at baseline and a device at retest
not recording pain location
not asking whether pain is familiar
not recording force or pressure units
allowing pelvic rotation
letting the device slip
not standardising effort instructions
testing too aggressively in irritable symptoms
over-interpreting a single result
Limitations include:
pain can come from multiple groin-related structures
strength values depend on the device and protocol
diagnostic accuracy for exact pathology is limited
cut-offs may not generalise across sports or populations
maximal squeeze may be inappropriate in acute or irritable symptoms
results may be affected by fatigue, apprehension and recent training
a high score does not clear the client for sport
a pain-free squeeze does not rule out groin-related pathology
The Adductor Squeeze Test can be used to:
monitor groin pain over time
record baseline adductor squeeze force
compare pain response across hip angles
support groin injury risk monitoring in sport
identify whether adductor loading provokes familiar symptoms
guide further assessment planning
track response to training modifications
support communication between practitioners and coaches
For athletes, the test can be useful during:
pre-season screening
in-season monitoring
post-injury reassessment
return-to-running progressions
return-to-kicking progressions
change-of-direction progressions
For general clients, the test may help monitor whether groin symptoms are changing with strengthening, walking, running or gym activity.
Record:
test name: Adductor Squeeze Test
side tested: left, right, bilateral or central symptoms
hip position: 0°, 45° or 90°
knee position
lever length: short lever or long lever
device used: fist, ball, sphygmomanometer, dynamometer or groin strength device
result: positive, negative, unclear or unable to test
pain score during squeeze
symptom location
symptom quality
whether symptoms are familiar
force or pressure value
units: N, kg, mmHg or device-specific units
trial number
best trial, average trial or selected trial method
comparison side or baseline
dominance if relevant
training status
recent activity or fatigue
irritability
compensations
reason for stopping, if relevant
confidence in result
related findings:
adductor palpation
resisted adduction
hip ROM
HAGOS or other PROMs
running or kicking tolerance
interpretation notes
retest date
referral or further assessment notes if appropriate
Recording these details improves:
repeatability
communication
client education
assessment reasoning
monitoring over time
team consistency
reporting quality
A positive test is usually reproduction of the client’s familiar groin or adductor-region pain during a resisted squeeze. It may increase suspicion of adductor-related groin pain when it matches the history and other findings, but it does not confirm a diagnosis.
Common angles are 0°, 45° and 90°. Research in Gaelic games athletes found that 45° hip flexion produced the greatest adductor muscle activity and pressure values, so it is commonly used for monitoring.
No. It can support assessment reasoning, but it does not diagnose or confirm groin injury on its own.
Yes, when performed with a sphygmomanometer, dynamometer or force device. Strength monitoring is more repeatable when hip angle, device placement, trial number and instructions are standardised.
No. A negative test may decrease suspicion in some contexts, but it does not fully exclude groin-related pathology, especially when symptoms occur only during sprinting, kicking, fatigue or high-speed change of direction.
It can support return-to-sport reasoning, but it should not be the only measure. It should be combined with strength, range of motion, running, kicking, change-of-direction exposure, symptoms, confidence and professional judgement.
The Adductor Squeeze Test assesses groin pain provocation and, when measured, adductor squeeze force.
A positive test reproduces the client’s familiar groin or adductor symptoms.
A positive test may increase suspicion of adductor-related groin pain but does not confirm a condition.
A negative test does not fully exclude groin-related pathology.
The 45° hip flexion position is commonly used and has evidence for higher adductor activation and pressure values.
Diagnostic accuracy for exact groin pathology is limited.
Reliability improves when position, device, instructions and trial selection are standardised.
Measurz should record hip angle, device, pain, symptom location, force value, units, trials, comparison, compensations and retest plan.
Delahunt, E., Kennelly, C., McEntee, B. L., Coughlan, G. F., & Green, B. S. (2011). The thigh adductor squeeze test: 45° of hip flexion as the optimal test position for eliciting adductor muscle activity and maximum pressure values. Manual Therapy, 16(5), 476–480. https://doi.org/10.1016/j.math.2011.02.014
Delahunt, E., McEntee, B. L., Kennelly, C., Green, B. S., & Coughlan, G. F. (2011). Intrarater reliability of the adductor squeeze test in Gaelic Games athletes. Journal of Athletic Training, 46(3), 241–245. https://doi.org/10.4085/1062-6050-46.3.241
Moreno-Pérez, V., Travassos, B., Calado, A., Gonzalo-Skok, O., Del Coso, J., & Mendez-Villanueva, A. (2019). Adductor squeeze test and groin injuries in elite football players: A prospective study. Physical Therapy in Sport, 37, 54–59. https://doi.org/10.1016/j.ptsp.2019.03.001
Mosler, A. B., Weir, A., Serner, A., Agricola, R., Eirale, C., Farooq, A., Thorborg, K., Whiteley, R. J., & Hölmich, P. (2016). Athletic groin pain: A prospective anatomical diagnosis of 382 patients. British Journal of Sports Medicine, 50(7), 423–430. https://doi.org/10.1136/bjsports-2015-095382
Thorborg, K., Branci, S., Nielsen, M. P., Langelund, M. T., & Hölmich, P. (2017). Copenhagen five-second squeeze: A valid indicator of sports-related hip and groin function, pain and severity. British Journal of Sports Medicine, 51(7), 594–599. https://doi.org/10.1136/bjsports-2016-096675
Weir, A., Brukner, P., Delahunt, E., Ekstrand, J., Griffin, D., Khan, K. M., Lovell, G., Meyers, W. C., Muschaweck, U., Orchard, J., Paajanen, H., Philippon, M., Reboul, G., Robinson, P., Schache, A. G., Schilders, E., Serner, A., Silvers, H., Thorborg, K., Tyler, T., Verrall, G., de Vos, R. J., Vuckovic, Z., & Hölmich, P. (2015). Doha agreement meeting on terminology and definitions in groin pain in athletes. British Journal of Sports Medicine, 49(12), 768–774. https://doi.org/10.1136/bjsports-2015-094869
