Core stability is associated with dynamic postural balance in soccer players

Key points

1. 01Players with groin pain had worse dynamic balance in both legs than pain-free players
2. 02They also had weaker trunk endurance and slightly reduced hip rotation on the injured side
3. 03Lower core endurance correlated with poorer balance, but pain and hip range of motion did not
4. 04This was a one-time observational comparison, so it shows association, not cause

How it was conducted

Design

Cross-sectional case-control study

Participants

42 male soccer players with unilateral adductor-related groin pain for at least 2 months without time-loss, and 42 asymptomatic players

Groups

Groin-pain group vs asymptomatic control group

Primary outcome

Dynamic postural balance via the Y-Balance Test (anterior, posteromedial, posterolateral, composite)

Other measures

Trunk endurance (flexion, extension, side bridge), hip rotation and abduction by goniometer, pain and groin issues via HAGOS

Analysis

t-tests, Mann-Whitney U, Pearson/Spearman correlations, and stepwise regression

What they found

• Y-Balance composite score was lower in the injured limb of the groin-pain group, 78.71 (5.96), than the dominant limb of controls, 92.37 (6.06), p < 0.001, d = 2.27
• Anterior reach was 74.03 (4.46) injured vs 82.96 (5.18) control, p < 0.001, d = 1.84; posteromedial 82.03 (8.89) vs 97.61 (7.53), p < 0.001, d = 1.89; posterolateral 80.07 (8.23) vs 96.53 (9.34), p < 0.001, d = 1.86
• Trunk flexor endurance was 62.33 (15.54) s in the groin-pain group vs 133.52 (27.24) s in controls, p < 0.001, d = 3.21
• Trunk extensor endurance was 70.00 (15.57) s vs 149.90 (31.46) s, p < 0.001, d = 3.21; side bridge on injured limb 53.19 (13.84) s vs 85.16 (19.47) s, p < 0.001, d = 1.89
• Within the groin-pain group, core stability correlated positively with dynamic balance, r = 0.13 to 0.61, p < 0.05 to 0.001
• Trunk extensor endurance explained 46.6% and 24.6% (p < 0.001) of posteromedial reach variance for injured and non-injured limbs; side bridge on the injured limb explained 29.5% of anterior reach variance (p < 0.001)
• No significant correlation was found between dynamic balance and either HAGOS pain or hip range of motion; hip rotation differences did not exceed the minimal detectable change

Limitations

• Cross-sectional design shows association only and cannot prove that weak core function causes poor balance
• Only male soccer players with non-time-loss adductor-related groin pain were studied, limiting how widely the findings apply
• Modest sample of 84 players with measures taken at a single time point
• Correlations ranged from weak to moderate (r as low as 0.13), so some links were small

Why it matters

For patients

If you are a soccer player with lingering groin pain, your balance and trunk endurance may be reduced in both legs, not only the sore side.

For clinicians

Assessing and training trunk endurance may be a practical target for improving dynamic balance in players with non-time-loss groin pain, more so than focusing on pain or hip range of motion.

For readers

This study links core endurance to balance in groin-pain players but, being observational, it cannot confirm that strengthening the core will fix the balance deficit.