Execution
- 1Take a sport-specific history and confirm that groin pain is exercise related.
- 2Palpate the adductors, iliopsoas, inguinal canal region, pubic symphysis, and hip structures.
- 3Perform resisted adduction, resisted hip flexion, abdominal or inguinal provocation, and hip joint provocation tests as indicated.
- 4Classify findings into adductor-related, iliopsoas-related, inguinal-related, pubic-related, hip-related, or other causes of groin pain.
- 5Record multiple categories if the athlete meets criteria for more than one clinical entity.
Positive outcome
This is not a positive or negative test. Adductor-related groin pain requires adductor tenderness and pain on resisted adduction; iliopsoas-related pain requires iliopsoas tenderness and is more likely with resisted hip flexion or hip flexor stretch; inguinal-related pain is located in the inguinal canal region and worsens with abdominal resistance or Valsalva; pubic-related pain has pubic symphysis tenderness. Hip-related groin pain is classified when hip joint tests or clinical features suggest the hip as a contributor.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Weir et al. (2015) — Delphi consensus | NA | NA | NA | NA | NA |
CommentThe Doha Agreement is a classification framework, not a single provocation test. It is useful because athletic groin pain often has overlapping contributors and multiple clinical entities can coexist. Value is low as a diagnostic accuracy item, but high conceptually for organizing assessment language.
Low Clinical Value