Comparing the effects of Hölmich protocol exercise therapy and joint mobilization training on pain, balance, function of the lower limb, and muscle activity in soccer players with athletic groin pain

Athletic groin pain is a common issue among soccer players, often leading to impaired performance and prolonged rehabilitation. This randomized clinical trial aimed to compare the effects of Hölmich protocol exercise therapy (HT) and joint mobilization training (JMT) on pain, dynamic balance, functional performance, and muscle activity in soccer players with athletic groin pain. A total of 27 male amateur soccer players aged 18–35 were recruited, with 14 assigned to HT and 13 to JMT. Both interventions were administered over 12 weeks, three sessions per week. Outcome measures included the Visual Analog Scale (VAS) for pain, Y Balance Test for dynamic balance, T-Test and Edgren Side Step Test (ESST) for functional agility, and surface electromyography (1) for muscle activity onset. Significant within-group improvements were observed in both HT and JMT groups across pain (VAS), balance (YBT), and function (T-Test, ESST) (p < .001). However, the HT group showed significantly greater post-intervention improvements in pain reduction (VAS: 2.17 vs. 3.50; p < .001), agility (T-Test: 9.61 vs. 10.30; p = .007), and side step performance (ESST: 27.43 vs. 24.77; p = .002). Regarding muscle activity onset, HT demonstrated significantly improved activation in the Rectus Abdominis (p < .001), Adductor Longus (p = .048), and Gluteus Medius (p < .001), compared to JMT. These findings suggest that Hölmich protocol exercise therapy is more effective than joint mobilization training in reducing pain, enhancing functional performance, and optimizing neuromuscular activation in soccer players with groin pain.