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Reference values for the Copenhagen hip and groin outcome score

Reference values for the Copenhagen hip and groin outcome score

By GuoJunjun (Own work) [CC BY-SA 3.0], via Wikimedia Commons

Reports of ‘hip injury’ in professional sports seem to be more frequent, but also are media reports of total hip replacements in retired players, many of whom had no record of a diagnosed femoral-acetabular injury. The lack of diagnostic criteria and awareness of the cam and pincer architecture no doubt contributed to the lack of data in earlier generations of players. Earlier reports indicated that up to 70% of players in any one season reported some hip or groin injury, based on time-loss data.

Today, these conditions are frequently considered to be due to overuse, have an insidious onset, and fluctuating symptom frequency and intensity. The Copenhagen Hip and Groin Outcome Score (HAGOS) was developed as a patient-reported survey to evaluated hip and groin-based disability, using a 0-100 scale (100=no problems, 0=severe disability); patients with long standing hip and groin pain had scores of less than 50 in subscale scores related to activity. While population reference values have been published, there does not appear to be any referent values for healthy soccer players. This 2011 project collected referent values for HAGOS in hip and groin injury-free male soccer players. Thorborg’s colleagues surveyed 444 groin injury-free soccer players (mean age=23.6 ± 4.4 years) from 40 clubs (divisions 1–4) in Eastern Denmark, who trained 3.4 ± 1 times per week. All players were free of hip and groin injury at the time of inclusion. Of the 444 players, 301 reported no hip or groin pain in the current or the previous season while 143 reported that they had experienced hip pain, groin pain, or both in the previous season. Those 143 players displayed lower HAGOS scores than the 301 injury-free players for all HAGOS subscales (P<0.001).

These findings were independent of age and playing level. Median HAGOS subscale scores in hip and groin injury-free soccer players are in proximity to the maximum score (100 points). The 95% reference ranges for injury-free soccer players in the previous or present season were: pain: 80.1–100, symptoms: 64.3–100, activities of daily living: 80.3–100, sport and recreational activities: 71.9–100, participation in physical activity: 75–100 and quality of living: 75–100.

Thorborg, K. S Branci, F Stensbirk, J Jensen, P Holmich.
Copenhagen hip and groin outcome score (HAGOS) in male soccer: reference values for hip and groin injury-free players.
Brit J Sports Med 2013. doi:10.1136/bjsports-2013-092607 [BJSM]

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Don Kirkendall
Don is a lifelong player and licensed coach with a PhD in exercise science who continued his love of The Beautiful Game’ by studying soccer on multiple levels. With over 80 published peer-reviewed publications, many focused on soccer, Don brings a broad perspective on training, nutrition, and specific topics in football medicine. He sits on the US Soccer Sports Medicine Advisory Committee.

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