The Hip Adduction Strength Test measures the maximum isometric force produced during hip adduction with the hip positioned in neutral (0° hip flexion). Using the Anker, the assessment provides an objective and repeatable measure of hip adductor strength in a standardised position.

Testing the hip in neutral differs from assessments performed at 45° or 90° of hip flexion, as the length of the adductor muscles and their mechanical advantage change with joint position. This assessment provides useful information about force production closer to standing posture and complements strength testing performed at other hip angles.

The primary muscles assessed include the adductor magnus, adductor longus, adductor brevis, gracilis and pectineus. Together these muscles contribute to pelvic stability, frontal plane control, lower-limb alignment and force transfer during walking, running, cutting and directional changes.

When used with Measurz, the Anker records peak force and can calculate force relative to body weight, impulse, torque (when the lever arm is entered), rate of force development, time to peak and fatigue index.

The assessment measures muscle force only and should always be interpreted alongside symptoms, movement quality and functional performance.

What Is the Hip Adduction Strength Test?

The Hip Adduction Strength Test is an isometric assessment where the client attempts to move the testing leg towards the body's midline while the hip remains in a neutral position.

Testing in neutral provides a different mechanical demand to testing at 45° and 90° hip flexion and may provide additional information about adductor function during standing and weight-bearing activities.

The fixed resistance of the Anker allows the assessment to be reproduced consistently when the same client position, hip angle, anatomical landmarks and verbal instructions are maintained.

Step-by-Step Protocol

1. Prepare the client

Explain that the assessment measures how strongly they can pull their leg towards the body's midline without moving the pelvis or trunk.

Record any:

• groin pain
• hip pain
• lower abdominal discomfort
• previous adductor injury
• recent injury
• previous surgery
• neurological symptoms
• fatigue

Perform one or two submaximal practice contractions before maximal testing.

2. Position the client

Position the client in long sitting or supine according to the Anker setup.

Maintain:

• hips in neutral (0° flexion)
• knees fully extended unless the protocol specifies otherwise
• pelvis level
• trunk supported
• lower limbs aligned
• toes pointing towards the ceiling

Maintain the same setup during every reassessment.

3. Position the testing limb

Ensure:

• the pelvis remains level
• the femur begins in neutral alignment
• the patella faces directly upwards
• the limb remains relaxed before testing

Position the Anker load cell against the medial aspect of the distal femur, approximately 5 cm proximal to the medial femoral epicondyle.

Avoid placing the load cell directly over the knee joint or medial epicondyle.

Record the contact point to ensure consistent retesting.

4. Stabilise the client

Prevent movement of:

• pelvis
• lumbar spine
• trunk
• opposite limb

The contraction should occur through the hip adductors only.

5. Testing instructions

Use consistent verbal instructions.

"Pull your leg towards the middle."

"Increase the pressure smoothly."

"Push as hard as you can."

"Hold."

"Keep breathing."

Use identical instructions during every reassessment.

6. Record the assessment

Use:

• 1–2 familiarisation trials
• 2–3 maximal trials
• 3–5 second contractions
• 30–60 seconds rest

Record either:

• highest force, or
• average of recorded trials

Use the same scoring method during future testing.

7. Repeat the trial if

• pelvis rotates
• lumbar spine moves
• opposite limb assists
• hip angle changes
• load cell slips
• pain limits effort
• the client begins before instructed

Why It Is Used

The Hip Adduction Strength Test may be useful for:

• baseline strength assessment
• side-to-side comparison
• monitoring progress
• lower-limb strength profiling
• athlete performance assessment
• monitoring response to exercise
• objective reporting within Measurz
• client education

The assessment supports broader assessment reasoning and should not be used as a stand-alone diagnostic tool.

What It Measures

The primary outcome is peak isometric hip adduction force with the hip positioned in neutral.

When analysed in Measurz, additional metrics may include:

• Peak force
• Force relative to body weight
• Impulse
• Torque
• Rate of force development
• Time to peak
• Fatigue index

The assessment does not directly measure:

• hip range of motion
• adductor tendon integrity
• balance
• movement quality
• readiness for sport or work

Understanding the Result, Reference Values and What to Look For

Higher force values generally indicate greater hip adductor strength in the testing position.

Lower force values may reflect:

• pain
• previous injury
• fatigue
• reduced effort
• poor familiarisation
• inconsistent positioning
• movement compensation

Interpret the assessment by considering:

• previous assessment results
• left versus right differences
• symptoms during testing
• movement compensations
• functional demands

Published Anker-specific normative values are currently unavailable.

Hip adductor strength has demonstrated excellent reliability using handheld dynamometry when testing position and stabilisation are standardised. Because force values vary between testing methods and lever arms, baseline comparison and repeated testing under the same conditions are generally more meaningful than comparing absolute force values between devices.

A side-to-side difference of approximately 10% or greater may warrant further assessment when consistent with symptoms or functional limitations.

Assessing Different Client Populations

Youth

Interpret relative to growth, coordination and sporting participation.

Adults

Useful for baseline assessment and long-term monitoring.

Older adults

Interpret alongside mobility, transfers and walking function.

Athletes

Useful for sprinting, kicking, skating and change-of-direction sports.

Clients with persistent symptoms

Interpret alongside pain, confidence and functional performance rather than strength alone.

Common Errors and Limitations

Common errors include:

• pelvic rotation
• lumbar extension
• opposite leg assisting
• inconsistent load cell placement
• inconsistent cueing
• changing hip position during testing

Limitations include:

• results are position-specific
• pain may reduce force production
• strength alone does not determine function
• published Anker normative values remain limited

Practical Applications

The assessment may be useful for:

• baseline assessment
• progress monitoring
• side-to-side comparison
• athlete profiling
• lower-limb strength assessment
• Measurz reporting
• client education

FAQs

What does the Hip Adduction Strength Test measure?

It measures maximal isometric hip adduction strength with the hip positioned in neutral.

Why assess hip adduction at multiple hip angles?

Hip position influences muscle length and force production. Assessing multiple positions provides a more comprehensive strength profile.

Which metric should be used routinely?

Peak force is the primary outcome measure.

Should both hips be assessed?

Yes. Bilateral testing allows meaningful side-to-side comparison.

Can this assessment diagnose groin pathology?

No. It measures muscle force only.

Key Takeaways

• Measures maximal isometric hip adduction strength in neutral.
• Complements testing performed at 45° and 90° hip flexion.
• Peak force is the primary outcome measure.
• Consistent positioning improves repeatability.
• Compare results with previous assessments and the opposite limb.
• Measurz provides additional force-time metrics.

References

Bohannon, R. W. (1997). Archives of Physical Medicine and Rehabilitation, 78(1), 26–32.

Mentiplay, B. F., et al. (2015). PLOS ONE, 10(10), e0140822.

Thorborg, K., et al. (2011). British Journal of Sports Medicine.