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Objectives: Groin injuries represent a substantial problem in male football, with the Adductor Strengthening Programme (ASP) being the only exercise programme demonstrated to significantly reduce the risk of groin problems. We aimed first, to use the Reach Adoption Effectiveness Implementation Maintenance (RE-AIM) framework to investigate attitudes, beliefs and behaviour to the ASP among primary delivery agents of injury prevention exercises in Norwegian male professional football teams. Second, we aimed to identify a real-world application of the ASP protocol used in a professional team setting., Design: A descriptive cross-sectional survey, using a questionnaire designed to cover all five dimensions of the RE-AIM framework., Setting: The top two divisions of Norwegian male professional football., Participants: 32 primary injury prevention delivery agents., Primary and Secondary Outcome Measures: Primarily, the proportion of respondents being aware of the ASP and its effect; having adopted it; having implemented it as intended; and considering maintaining using it. Secondary, the most often used ASP modifications., Results: Twenty-nine (91%) participants responded. All (100%) respondents were aware of the ASP and its injury preventive effect. The two most stated reasons for using the ASP were its injury preventive effect and that it does not require equipment. The ASP was adopted by all (100%) delivery agents, but only 10% used it in accordance with the original protocol. The main modifications were that the players in 72% of the teams were instructed to perform a non-progressive number of repetitions during pre-season, and in 86% of the teams instructed to perform more sets, but fewer repetitions per set, during in season. In total, 97% of the delivery agents planned to continue using the ASP., Conclusion: The delivery agents have positive attitudes and beliefs to the ASP, but they frequently modify it. We identified and reported a real-world application of the ASP protocol., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Groin injuries represent a considerable problem in male football. Previous groin-specific prevention programmes have not shown a significant reduction in groin injury rates. An exercise programme using the Copenhagen Adduction exercise increases hip adduction strength, a key risk factor for groin injuries. However, its preventive effect is yet to be tested., Aim: To evaluate the effect of a single-exercise approach, based on the Copenhagen Adduction exercise, on the prevalence of groin problems in male football players., Methods: 35 semiprofessional Norwegian football teams were cluster-randomised into an intervention group (18 teams, 339 players) and a control group (17 teams, 313 players). The intervention group performed an Adductor Strengthening Programme using one exercise, with three progression levels, three times per week during the preseason (6-8 weeks), and once per week during the competitive season (28 weeks). The control group were instructed to train as normal. The prevalence of groin problems was measured weekly in both groups during the competitive season using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire., Results: The average prevalence of groin problems during the season was 13.5% (95% CI 12.3% to 14.7%) in the intervention group and 21.3% (95% CI 20.0% to 22.6%) in the control group. The risk of reporting groin problems was 41% lower in the intervention group (OR 0.59, 95% CI 0.40 to 0.86, p=0.008)., Conclusion: The simple Adductor Strengthening Programme substantially reduced the self-reported prevalence and risk of groin problems in male football players., Trial Registration Number: ISRCTN98514933., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)