Prevalence of Groin Strain and Its Impact on Quality of Life among Field Hockey Players of Islamabad: Cross-Sectional Study

Abstract

Background: Groin strain is a condition in which the inner thigh muscles, the adductors, are overstretched, causing pain. This is a common injury among athletes in many sports, especially those involving sudden twisting or rapid changes of direction. Groin strains are highly prevalent in field hockey due to sport-specific biomechanics; however, data on prevalence and quality-of-life (QoL) impact in Pakistani athletes is limited. Hence, understanding the prevalence and impact of groin strains can help identify common risk factors in developing prevention and treatment strategies to reduce injury rates. This study aims to determine groin strain prevalence and its association with QoL using HAGOS in Islamabad field hockey players. Methods: A cross-sectional study of 134 male field hockey players (20–51 years) from Islamabad Sports Complex assessed groin strain prevalence using the Copenhagen Hip and Groin Outcome Score (HAGOS). Groin strain was defined as HAGOS ≤70. Descriptive statistics characterized demographics; ANOVA with effect sizes (η²) compared HAGOS domains between impaired/non-impaired groups; and multiple regression identified quality-of-life (QoL) predictors. Results: The study identified a 31.3% prevalence (n=42) of clinically significant groin strain (HAGOS ≤70) among male field hockey players in Islamabad. Athletes with groin strain exhibited severe functional deficits across all HAGOS domains (p<0.001), with the largest impairments in Pain (Δ=31.4, η²=0.626) and Symptoms (Δ=30.4, η²=0.567). Paradoxically, Physical Activity participation was preserved despite symptoms (lowest η²=0.119), reflecting cultural norms prioritizing athletic persistence over symptom reporting. Regression analysis revealed Pain (β=0.3479, p=0.003), Daily Function (β=0.2484, p=0.018), and Symptoms (β=0.2112, p=0.024) as key predictors of diminished Quality of Life (QoL), collectively explaining 52.7% of variance. Conversely, Sports Function showed no QoL association (β=-0.0008, p=0.992), highlighting a critical disconnect between athletic performance and holistic wellbeing. Conclusion: Groin strain prevalence in Pakistani hockey players reflects region-specific risks, with pain—not mechanical dysfunction—driving severe disability. Athletes prioritize sport participation over wellbeing, decoupling performance from holistic health. Culturally adapted interventions must target pain neuroscience education, load management on natural turf, and institutional QoL monitoring to reconcile athletic resilience with sustainable health.