The Hip Adduction Strength Test measures the maximum isometric force produced during hip adduction with the hip positioned at approximately 45° of flexion. Using the Anker, the assessment provides an objective and repeatable measure of hip adductor strength in a mid-range hip position.

Testing hip adduction at 45° can provide useful information between neutral hip testing and 90° hip flexion testing. This position may be relevant for clients involved in running, cutting, kicking, skating, field sport, court sport and lower-limb strength profiling, where the hip often works through a range of flexion angles.

The primary muscles assessed include adductor magnus, adductor longus, adductor brevis, gracilis and pectineus. These muscles contribute to pelvic control, lower-limb alignment, force transfer and frontal plane stability.

When used with Measurz, the Anker records peak force and can calculate additional metrics including 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 draw the testing leg towards the midline while the hip is positioned at approximately 45° of flexion.

Testing at 45° may be useful because hip adductor force production can change depending on joint position. This angle gives a mid-range position that may be easier to standardise than more dynamic or sport-specific tasks while still providing useful strength information.

The Anker allows the test to be repeated consistently when the same client position, hip angle, load cell contact point and instructions are used during every assessment.

Step-by-Step Protocol

1. Prepare the client

Explain that the assessment measures how strongly they can pull their leg towards the middle while keeping the pelvis and trunk still.

Record any:

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

Complete one or two submaximal practice contractions before maximal testing.

2. Position the client

Position the client according to the Anker setup, maintaining:

• hip flexed to approximately 45°
• knee comfortably flexed if required by setup
• pelvis level
• trunk supported
• opposite limb positioned symmetrically
• testing limb relaxed before the contraction

The same position should be reproduced during every reassessment.

3. Position the testing limb

Ensure:

• the pelvis remains square
• the femur is aligned with the hip joint
• the knee remains in line with the thigh
• the limb begins in a neutral position

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

Avoid direct contact over the knee joint, medial femoral epicondyle or soft tissue close to the joint line.

Using the distal femur as the contact point helps standardise the lever arm and improves repeatability across retesting.

4. Stabilise the client

Prevent movement of:

• pelvis
• trunk
• lumbar spine
• opposite limb
• testing thigh position

The effort should be produced by hip adduction only, not by trunk lean, pelvic rotation or pushing through the foot.

5. Testing instructions

Use consistent verbal cues.

"Pull your leg towards the middle."

"Build the pressure gradually."

"Push as hard as you can."

"Hold."

"Keep breathing."

Use the same wording during every reassessment.

6. Record the assessment

Use:

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

Record either:

• highest force value, or
• average of recorded trials

Use the same scoring method during every reassessment.

7. Repeat the trial if

• the pelvis rotates
• the trunk leans
• the testing thigh lifts
• the opposite limb assists
• the hip angle changes
• the load cell slips
• the client pushes through the foot instead of the thigh
• pain limits maximal effort
• the client starts before instructed

Why It Is Used

The Hip Adduction Strength Test may be useful for:

• establishing baseline adductor strength
• comparing left and right limbs
• assessing strength across different hip angles
• monitoring changes over time
• lower-limb strength profiling
• athlete performance monitoring
• objective progress tracking in Measurz
• client education using measurable results

The assessment should support a broader assessment process and should not be used as a stand-alone diagnostic or clearance measure.

What It Measures

The primary outcome is peak isometric hip adduction force with the hip positioned at approximately 45° of flexion.

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:

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

Understanding the Result, Reference Values and What to Look For

Higher force values generally indicate greater hip adduction strength in the tested position.

Lower force values may reflect:

• groin pain
• hip pain
• fatigue
• reduced confidence
• previous injury
• poor familiarisation
• inconsistent positioning
• compensation from the trunk or pelvis

Interpret results by considering:

• the client’s previous results
• left versus right differences
• symptoms during and after testing
• confidence during the effort
• whether the same hip angle and contact point were used
• sport, work or daily-life demands

Published Anker-specific normative values are currently unavailable.

Hip adduction strength has been studied with handheld dynamometry, particularly in athletic populations, but values vary according to position, lever arm, stabilisation and scoring method. Because the 45° Anker setup may not directly match published protocols, comparison with the client’s own baseline and repeated testing under the same conditions is usually more useful than applying external cut-offs.

A side-to-side difference of approximately 10% or more may be worth reviewing more closely, especially when it aligns with pain, previous injury, reduced confidence or functional differences.

Assessing Different Client Populations

Youth

Use additional familiarisation trials and interpret results relative to growth, coordination, sport exposure and training age.

Adults

Useful for baseline strength testing, progress tracking and side-to-side comparison.

Older adults

Interpret alongside walking ability, balance, transfers, hip comfort and functional confidence.

Athletes

Relevant for sports requiring sprinting, kicking, cutting, skating, lateral movement and repeated acceleration.

Clients with persistent symptoms

Interpret alongside pain, confidence, movement quality and functional capacity rather than strength alone.

Common Errors and Limitations

Common errors include:

• pelvis rotating
• trunk leaning
• changing the hip angle during the test
• inconsistent load cell placement
• pressing through the foot instead of the thigh
• lifting the testing limb
• inconsistent cueing
• comparing 45°, 90° and 0° results as though they are the same test

Limitations include:

• results are specific to the testing position
• pain may reduce maximal force production
• strength alone does not determine function
• published Anker-specific normative values remain limited
• different hip angles should be tracked separately

Practical Applications

The assessment may be useful for:

• establishing baseline adductor strength
• comparing left and right limbs
• monitoring progress over time
• assessing strength across hip positions
• athlete monitoring
• lower-limb strength profiling
• objective reporting within Measurz
• educating clients using measurable outcomes

FAQs

What does the Hip Adduction Strength Test measure?

It measures maximal isometric hip adduction strength with the hip positioned at approximately 45° of flexion.

Why test hip adduction at 45°?

Testing at 45° provides a mid-range hip position and may help profile adductor strength across different joint angles.

Can this be compared directly with hip adduction at 0° or 90°?

No. Different hip angles should be recorded and interpreted separately because muscle contribution and force output may change with position.

Which metric should be used routinely?

Peak force is the primary routine outcome measure.

Should both hips be tested?

Yes. Bilateral testing allows side-to-side comparison and improves progress tracking.

Can this test diagnose groin injury?

No. It measures force only and should be interpreted alongside symptoms and other assessment findings.

Key Takeaways

• Measures maximal isometric hip adduction strength at approximately 45° hip flexion.
• Provides a mid-range adductor strength assessment between 0° and 90° positions.
• Peak force is the primary routine outcome measure.
• Measurz can provide additional force-time metrics when used with the Anker.
• Consistent hip angle, load cell placement and cueing are essential for repeatability.
• Compare results with the client’s own baseline and opposite limb rather than relying on broad population norms.

References

Bohannon, R. W. (1997). Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Archives of Physical Medicine and Rehabilitation, 78(1), 26–32.

Mentiplay, B. F., Perraton, L. G., Bower, K. J., Adair, B., Pua, Y. H., Williams, G. P., McGaw, R., & Clark, R. A. (2015). Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: A reliability and validity study. PLOS ONE, 10(10), e0140822.

Thorborg, K., Bandholm, T., Hölmich, P., et al. (2011). Hip adduction and abduction strength assessment using handheld dynamometry in athletic populations. British Journal of Sports Medicine.