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.

Introduction

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.  

Quick Summary

• 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

What Is the Adductor Squeeze Test?

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.  

Why It Is Used

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

What It Assesses

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

Who It Is Useful For

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.  

When to Use This Test

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

When Not to Use or When to Be Cautious

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.

Equipment Required

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.

Step-by-Step Protocol / Practice

Setup

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.”

Client Position

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

Examiner / Professional Position

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

Hand Placement

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

Stabilisation

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

Movement or Force Direction

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.

Instructions

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.  

Positive Finding

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

Negative Finding

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

Stopping Criteria

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

Safety Notes

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

Positive and Negative Test Interpretation

Positive Test

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

Negative Test

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

Sensitivity, Specificity and Diagnostic Accuracy

The Adductor Squeeze Test has more evidence for pain provocation, force monitoring, reliability and injury-risk association than for stand-alone diagnostic accuracy.

Diagnostic Accuracy for Specific Groin Pathology

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.  

Injury Risk and Screening Evidence

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.  

How to Interpret These Values

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.

Reliability and Validity

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 and Limitations

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

Practical Applications

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.

How to Record This in Measurz

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

Related Tests / Internal Links

• FADIR Test
• FAIR Test
• Hip Quadrant Test
• McCarthy Test
• Piriformis Test
• Femoral Nerve Tension Test
• Copenhagen Hip and Groin Outcome Score / HAGOS
• Lower Extremity Functional Scale

FAQs

What is a positive Adductor Squeeze Test?

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.

Which hip angle should be used?

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.  

Can the Adductor Squeeze Test diagnose groin injury?

No. It can support assessment reasoning, but it does not diagnose or confirm groin injury on its own.

Is the test useful for strength monitoring?

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.

Does a pain-free squeeze rule out groin pain?

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.

Can this test be used for return-to-sport decisions?

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.

Key Takeaways

• 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.

References

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