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Journals / Gazi Beden Eğitimi ve Spor Bilimleri Dergisi / 2026 / Volume: 31 Issue: 1

Acute Effects of Copenhagen Adduction Exercise on the Stiffness and Soreness of the Hip Adductors: A Randomised Controlled Trial with Reliability Assessments

Gokhan Yagiz(AMASYA UNIVERSITY)0000-0002-9214-1948
Sena Adanir0009-0008-0470-2989
Esedullah Akaras(ERZURUM TECHNICAL UNIVERSITY)0000-0002-0305-4632
Canan Aldırmaz(KOCAELI UNIVERSITY)0000-0001-8145-6066
Julian Owen(Bangor University)0000-0002-9609-8422
Pages
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Publication Date
2026-03-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These results indicate that CAE elicits a specific, short-term mechanical and perceptual response mainly in the adductor longus.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Groin injuries often happen in sports involving quick direction changes, kicking, and rapid movements, with the adductor longus frequently being affected.
📊
Key Findings & Data:This randomised controlled trial examined the immediate effects of a single CAE session on hip adductor stiffness and perceived muscle soreness in physically active adults, following the CONSORT 2025 guidelines.
💡
Conclusion & Impact:These results indicate that CAE elicits a specific, short-term mechanical and perceptual response mainly in the adductor longus.
🔬Design:Research Article
📍Scope:2025 Verileri
⚙️Variables:Elasticity · Injury prevention · Muscle hardness

Abstract

Groin injuries often happen in sports involving quick direction changes, kicking, and rapid movements, with the adductor longus frequently being affected. The Copenhagen Adduction Exercise (CAE) is commonly used to help prevent such injuries. This randomised controlled trial examined the immediate effects of a single CAE session on hip adductor stiffness and perceived muscle soreness in physically active adults, following the CONSORT 2025 guidelines. Twenty-six participants (16 females, 10 males) were randomly assigned to either a CAE group, performing three sets of ten repetitions, or a control group that did not exercise. Stiffness of the adductor longus and adductor magnus was measured with the MyotonPro device before and after the intervention, along with a 0-100-point soreness scale. Intra-rater test-retest reliability for stiffness measurements was high to excellent for both muscles (ICC ≥ 0.93). The CAE group showed a significantly greater increase in adductor longus stiffness (p=0.002) and soreness (p<0.001) compared to the control, while there was no significant difference for adductor magnus stiffness (p=0.162). Changes in adductor longus stiffness were moderately positively correlated with perceived soreness (R=0.543, R²=0.295, p=0.004), but no such relationship was observed for adductor magnus. These results indicate that CAE elicits a specific, short-term mechanical and perceptual response mainly in the adductor longus. Although these reactions likely reflect normal eccentric loading rather than injury, further long-term studies are needed to determine whether repeated CAE enhances adaptations related to groin injury prevention.

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Cite This Article

Yagiz, G., Adanir, S., Akaras, E., Aldırmaz, C., Owen, J. (2026). Acute Effects of Copenhagen Adduction Exercise on the Stiffness and Soreness of the Hip Adductors: A Randomised Controlled Trial with Reliability Assessments. Gazi Beden Eğitimi ve Spor Bilimleri Dergisi, Volume: 31 Issue: 1. https://doi.org/10.53434/gbesbd.1835774

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References (58)

  1. Alonso-Calvete, A., Lorenzo-Martínez, M., Padrón-Cabo, A., & Rey, E. (2021). Effects of Copenhagen Adduction Exercise on the Architectural Characteristics of Adductors in U-17 Male Soccer Players: A Randomized Controlled Trial. Int J Environ Res Public Health, 18(24). https://doi.org/10.3390/ijerph182412956
  2. Alonso-Fernández, D., Fernández-Rodríguez, R., Taboada-Iglesias, Y., & Gutiérrez-Sánchez, Á. (2022). Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility. International Journal of Environmental Research and Public Health, 19(11), 6563.
  3. Alsirhani, A., Muaidi, Q., Thorborg, K., Husain, M., & Al Attar, W. (2025). Enhancing eccentric hip adduction strength in soccer players: A systematic review and meta-analysis of randomized controlled trials. Isokinetics and Exercise Science, 33. https://doi.org/10.1177/09593020241302732
  4. Alsirhani, A. A., Muaidi, Q. I., Nuhmani, S., Thorborg, K., Husain, M. A., & Al Attar, W. S. A. (2024). The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial. Phys Sportsmed, 52(5), 497–506. https://doi.org/10.1080/00913847.2024.2321958
  5. Barrett, J. M., Malakoutian, M., Fels, S., Brown, S. H. M., & Oxland, T. R. (2024). Muscle short-range stiffness behaves like a maxwell element, not a spring: Implications for joint stability. PLOS ONE, 19(8), e0307977. https://doi.org/10.1371/journal.pone.0307977
  6. Bizzini, M., & Mannion, A. F. (2003). Reliability of a new, hand-held device for assessing skeletal muscle stiffness. Clinical Biomechanics, 18(5), 459–461.
  7. Brazier, J., Maloney, S., Bishop, C., Read, P. J., & Turner, A. N. (2019). Lower Extremity Stiffness: Considerations for Testing, Performance Enhancement, and Injury Risk. J Strength Cond Res, 33(4), 1156–1166. https://doi.org/10.1519/jsc.0000000000002283
  8. Brydges, C. R. (2019). Effect Size Guidelines, Sample Size Calculations, and Statistical Power in Gerontology. Innovation in aging, 3(4), igz036–igz036. https://doi.org/10.1093/geroni/igz036
  9. Burnett, D., Smith, K., Smeltzer, C., Young, K., & Burns, S. (2010). Perceived Muscle Soreness in Recreational Female Runners. Int J Exerc Sci, 3(3), 108–116.
  10. Charnock, B. L., Lewis, C. L., Garrett, W. E., Jr., & Queen, R. M. (2009). Adductor longus mechanics during the maximal effort soccer kick. Sports Biomech, 8(3), 223–234. https://doi.org/10.1080/14763140903229500
  11. Chuang, L. L., Wu, C. Y., & Lin, K. C. (2012). Reliability, validity, and responsiveness of myotonometric measurement of muscle tone, elasticity, and stiffness in patients with stroke. Arch Phys Med Rehabil, 93(3), 532–540. https://doi.org/10.1016/j.apmr.2011.09.014
  12. Coratella, G., Milanese, C., & Schena, F. (2015). Unilateral eccentric resistance training: A direct comparison between isokinetic and dynamic constant external resistance modalities. Eur J Sport Sci, 15(8), 720–726. https://doi.org/10.1080/17461391.2015.1060264
  13. Creze, M., Nordez, A., Soubeyrand, M., Rocher, L., Maître, X., & Bellin, M. F. (2018). Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol, 47(4), 457–471. https://doi.org/10.1007/s00256-017-2843-y
  14. Esteve, E., Rathleff, M. S., Bagur-Calafat, C., Urrútia, G., & Thorborg, K. (2015). Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials. Br J Sports Med, 49(12), 785–791. https://doi.org/10.1136/bjsports-2014-094162
  15. Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods, 41(4), 1149–1160. https://doi.org/10.3758/brm.41.4.1149
  16. Feng, Y. N., Li, Y. P., Liu, C. L., & Zhang, Z. J. (2018). Assessing the elastic properties of skeletal muscle and tendon using shearwave ultrasound elastography and MyotonPRO. Scientific reports, 8(1), 17064. https://doi.org/10.1038/s41598-018-34719-7
  17. Ferenczi, M. A., Bershitsky, S. Y., Koubassova, N. A., Kopylova, G. V., Fernandez, M., Narayanan, T., & Tsaturyan, A. K. (2014). Why muscle is an efficient shock absorber. PLOS ONE, 9(1), e85739. https://doi.org/10.1371/journal.pone.0085739
  18. Harøy, J., Clarsen, B., Wiger, E. G., Øyen, M. G., Serner, A., Thorborg, K., Hölmich, P., Andersen, T. E., & Bahr, R. (2019). The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med, 53(3), 150–157. https://doi.org/10.1136/bjsports-2017-098937
  19. Hody, S., Croisier, J.-L., Bury, T., Rogister, B., & Leprince, P. (2019). Eccentric Muscle Contractions: Risks and Benefits. Frontiers in physiology, 10, 536–536. https://doi.org/10.3389/fphys.2019.00536
  20. Hopewell, S., Chan, A.-W., Collins, G. S., Hróbjartsson, A., Moher, D., Schulz, K. F., Tunn, R., Aggarwal, R., Berkwits, M., Berlin, J. A., Bhandari, N., Butcher, N. J., Campbell, M. K., Chidebe, R. C. W., Elbourne, D., Farmer, A., Fergusson, D. A., Golub, R. M., Goodman, S. N.,…Boutron, I. (2025). CONSORT 2025 statement: Updated guideline for reporting randomised trials. PLOS Medicine, 22(4), e1004587. https://doi.org/10.1371/journal.pmed.1004587
  21. Ishøi, L., & Thorborg, K. (2021). Copenhagen adduction exercise can increase eccentric strength and mitigate the risk of groin problems: but how much is enough! Br J Sports Med, 55(19), 1066–1067. https://doi.org/10.1136/bjsports-2020-103564
  22. Lettner, J., Królikowska, A., Ramadanov, N., Oleksy, Ł., Hakam, H. T., Becker, R., & Prill, R. (2024). Evaluating the Reliability of MyotonPro in Assessing Muscle Properties: A Systematic Review of Diagnostic Test Accuracy. Medicina (Kaunas), 60(6). https://doi.org/10.3390/medicina60060851
  23. Ley, C. D., Valdes, E. M., Murtagh, C. F., Power, J., Nobes, L., & Drust, B. (2025). MyotonPRO Is Not Comparable to Shear Wave Elastography in the Measurement of Rectus Femoris Muscle Stiffness due to Interference of Subcutaneous Adipose Tissue. Scandinavian Journal of Medicine & Science in Sports, 35(8), e70095. https://doi.org/https://doi.org/10.1111/sms.70095
  24. Li, Y.-P., Liu, C.-L., & Zhang, Z.-J. (2022). Feasibility of using a portable MyotonPRO device to quantify the elastic properties of skeletal muscle. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 28, e934121–934121.
  25. Li, Y., Yu, J., Zhang, J., Zhang, Z., & Wang, X. (2022). Quantifying the stiffness of lumbar erector spinae during different positions among participants with chronic low back pain. PLoS One, 17(6), e0270286. https://doi.org/10.1371/journal.pone.0270286
  26. Lorimer, A. V., & Hume, P. A. (2016). Stiffness as a Risk Factor for Achilles Tendon Injury in Running Athletes. Sports Medicine, 46(12), 1921–1938. https://doi.org/10.1007/s40279-016-0526-9
  27. Marcucci, L., & Reggiani, C. (2020). Increase of resting muscle stiffness, a less considered component of age-related skeletal muscle impairment. European journal of translational myology, 30(2), 223–233. https://doi.org/10.4081/ejtm.2020.8982
  28. Markovic, G., Šarabon, N., Pausic, J., & Hadžić, V. (2020). Adductor muscles strength and strength asymmetry as risk factors for groin injuries among professional soccer players: A prospective study. International Journal of Environmental Research and Public Health, 17(14), 4946.
  29. Martins, T. B., Martins, T. B., Migliorini, F., Maffulli, N., & Okubo, R. (2025). Risk Factors Associated with Groin Pain in Athletes: A Systematic Review. Life, 15(11), 1688.
  30. Milerská, I., Lhotská, L., & Macaš, M. (2018). Biomechanical Parameters of Muscles, Objective Assessment Using MyotonPRO. 2018 IEEE International Conference on Bioinformatics and Biomedicine (BIBM).
  31. Mirbagheri, M. M., Cheng-Chi, T., & Rymer, W. Z. (2004, 1–5 Sept. 2004). Abnormal intrinsic and reflex stiffness related to impaired voluntary movement. The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.
  32. Muckelt, P. E., Warner, M. B., Cheliotis-James, T., Muckelt, R., Hastermann, M., Schoenrock, B., Martin, D., MacGregor, R., Blottner, D., & Stokes, M. (2022). Protocol and reference values for minimal detectable change of MyotonPRO and ultrasound imaging measurements of muscle and subcutaneous tissue. Sci Rep, 12(1), 13654. https://doi.org/10.1038/s41598-022-17507-2
  33. Needle, A. R., Baumeister, J., Kaminski, T. W., Higginson, J. S., Farquhar, W. B., & Swanik, C. B. (2014). Neuromechanical coupling in the regulation of muscle tone and joint stiffness. Scand J Med Sci Sports, 24(5), 737–748. https://doi.org/10.1111/sms.12181
  34. Pippas, C., Gioftsos, G., Korakakis, V., & Serner, A. Strength effects of the Copenhagen adduction exercise vs an adductor squeeze exercise in male football players – A randomized controlled trial. Science and Medicine in Football, 1–10. https://doi.org/10.1080/24733938.2024.2419659
  35. Proulx, L., Brizzolara, K., Thompson, M., Wang-Price, S., Rodriguez, P., & Koppenhaver, S. (2024). Characterizing Chronic Pelvic Pain: The Relationship Between Extrapelvic Muscle Stiffness, Pain Level, Health History, and Pelvic Floor Symptoms in Women With Chronic Pelvic Pain. The Journal of Women's & Pelvic Health Physical Therapy, 48(3), 165–175. https://doi.org/10.1097/jwh.0000000000000309
  36. Pruyn, E. C., Watsford, M. L., & Murphy, A. J. (2016). Validity and reliability of three methods of stiffness assessment. J Sport Health Sci, 5(4), 476–483. https://doi.org/10.1016/j.jshs.2015.12.001
  37. Quintana-Cepedal, M., de la Calle, O., Diez-Solorzano, P., Sanchez-Martinez, B., Crespo, I., & Olmedillas, H. (2025). The Copenhagen Adduction Exercise Effect on Sport Performance and Injury Prevention: A Systematic Review With Meta-Analysis. Scand J Med Sci Sports, 35(8), e70119. https://doi.org/10.1111/sms.70119
  38. Römer, C., Czupajllo, J., Zessin, E., Fischer, T., Wolfarth, B., & Lerchbaumer, M. H. (2022). Muscle and Tendon Stiffness of the Lower Limb of Professional Adolescent Soccer Athletes Measured Using Shear Wave Elastography. Diagnostics, 12(10).
  39. Schaber, M., Guiser, Z., Brauer, L., Jackson, R., Banyasz, J., Miletti, R., & Hassen-Miller, A. (2021). The Neuromuscular Effects of the Copenhagen Adductor Exercise: A Systematic Review. Int J Sports Phys Ther, 16(5), 1210–1221. https://doi.org/10.26603/001c.27975
  40. Schneider, S., Peipsi, A., Stokes, M., Knicker, A., & Abeln, V. (2015). Feasibility of monitoring muscle health in microgravity environments using Myoton technology. Medical & Biological Engineering & Computing, 53(1), 57–66. https://doi.org/10.1007/s11517-014-1211-5
  41. Serner, A., Jakobsen, M. D., Andersen, L. L., Hölmich, P., Sundstrup, E., & Thorborg, K. (2014). EMG evaluation of hip adduction exercises for soccer players: implications for exercise selection in prevention and treatment of groin injuries. Br J Sports Med, 48(14), 1108–1114. https://doi.org/10.1136/bjsports-2012-091746
  42. Seyedahmadi, M., Minoonejad, H., Karimizadeh Ardakani, M., Heidari, Z., Bayattork, M., & Akbari, H. (2022). What are gender differences in lower limb muscle activity during jump-landing tasks? A systematic review and meta-analysis. BMC Sports Sci Med Rehabil, 14(1), 77. https://doi.org/10.1186/s13102-022-00469-3
  43. Shan, X., Otsuka, S., Okubo, T., Takeuchi, T., Fukushige, K., & Naito, M. (2024). Assessing site-specificity of the biomechanical properties of hamstring aponeuroses using MyotonPRO: A cadaveric study. Clinical Biomechanics, 114, 106230. https://doi.org/https://doi.org/10.1016/j.clinbiomech.2024.106230
  44. Stensø, J., Andersen, T. E., & Harøy, J. (2022). Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study. BMJ Open, 12(9), e060611. https://doi.org/10.1136/bmjopen-2021-060611
  45. Taddei, U., Matias, A., Ribeiro, F., Bus, S., & Sacco, I. (2020). Effects of a foot strengthening program on foot muscle morphology and running mechanics: A proof-of-concept, single-blind randomized controlled trial. Physical Therapy in Sport, 42. https://doi.org/10.1016/j.ptsp.2020.01.007
  46. Takahashi, K., Tozawa, H., Kawama, R., & Wakahara, T. (2025). Redefining muscular action: human “adductor” magnus is designed to act primarily for hip “extension” rather than adduction in living young individuals. Journal of Applied Physiology, 138(4), 1088–1099. https://doi.org/10.1152/japplphysiol.00600.2024
  47. Takeuchi, K., Akizuki, K., & Nakamura, M. (2021). Time course of changes in the range of motion and muscle-tendon unit stiffness of the hamstrings after two different intensities of static stretching. PLOS ONE, 16(9), e0257367. https://doi.org/10.1371/journal.pone.0257367
  48. Tantipoon, P., Praditpod, N., Pakleppa, M., Li, C., & Huang, Z. (2023). Characterization of Flexor Digitorum Superficialis Muscle Stiffness Using Ultrasound Shear Wave Elastography and MyotonPRO: A Cross-Sectional Study Investigating the Correlation between Different Approaches. Applied Sciences, 13(11), 6384.
  49. Thomson, A. (2014). THE RELATIONSHIP BETWEEN MUSCULOSKELETAL STIFFNESS AND LOWER LIMB INJURY IN ATHLETES: A SYSTEMATIC REVIEW. British Journal of Sports Medicine, 48(7), 665. https://doi.org/10.1136/bjsports-2014-093494.280
  50. Thorarinsdottir, S., Amundsen, R., Larmo, A., Pedersen, R., Andersen, T. E., Bahr, R., & Møller, M. (2024). Groin injuries in women's premier league football in Norway: A two‐season prospective cohort study describing clinical and imaging characteristics. Scandinavian Journal of Medicine & Science in Sports, 34(4), e14611.
  51. Thorborg, K., Krommes, K. K., Esteve, E., Clausen, M. B., Bartels, E. M., & Rathleff, M. S. (2017). Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes. Br J Sports Med, 51(7), 562–571. https://doi.org/10.1136/bjsports-2016-097066
  52. Trybulski, R., Kużdżał, A., Wilk, M., Więckowski, J., Fostiak, K., & Muracki, J. (2024). Reliability of MyotonPro in measuring the biomechanical properties of the quadriceps femoris muscle in people with different levels and types of motor preparation [Original Research]. Frontiers in Sports and Active Living, Volume 6 - 2024. https://doi.org/10.3389/fspor.2024.1453730
  53. Tyler, T. F., Silvers, H. J., Gerhardt, M. B., & Nicholas, S. J. (2010). Groin injuries in sports medicine. Sports health, 2(3), 231–236.
  54. Watsford, M. L., Murphy, A. J., McLachlan, K. A., Bryant, A. L., Cameron, M. L., Crossley, K. M., & Makdissi, M. (2010). A prospective study of the relationship between lower body stiffness and hamstring injury in professional Australian rules footballers. Am J Sports Med, 38(10), 2058–2064. https://doi.org/10.1177/0363546510370197
  55. Werner, J., Hägglund, M., Ekstrand, J., & Waldén, M. (2019). Hip and groin time-loss injuries decreased slightly but injury burden remained constant in men’s professional football: the 15-year prospective UEFA Elite Club Injury Study. British Journal of Sports Medicine, 53(9), 539–546.
  56. Whittaker, J. L., Small, C., Maffey, L., & Emery, C. A. (2015). Risk factors for groin injury in sport: an updated systematic review. Br J Sports Med, 49(12), 803–809. https://doi.org/10.1136/bjsports-2014-094287
  57. Wiegner, A. W., & Watts, R. L. (1986). Elastic properties of muscles measured at the elbow in man: I. Normal controls. J Neurol Neurosurg Psychiatry, 49(10), 1171–1176. https://doi.org/10.1136/jnnp.49.10.1171
  58. Zinder, S. M., & Padua, D. A. (2011). Reliability, validity, and precision of a handheld myometer for assessing in vivo muscle stiffness. J Sport Rehabil, 20(3). https://doi.org/10.1123/jsr.2010-0051