Adductor Injuries in Major League Soccer: A 10-Year Analysis of Injury Rate and Return to Play, and Performance Metrics by Player Position

Background: Adductor injuries are common in professional soccer, leading to prolonged recovery, compromised player performance, high recurrence rates, and variable outcomes despite advancements in injury prevention and management. Purpose/Hypothesis: This study aims to assess trends in return-to-play (RTP), reinjury rates, and performance effects in Major League Soccer (MLS) players. It was hypothesized that RTP times and performance metrics after adductor injuries vary by time period (2010-2015 vs 2016-2021) and player position, with changes in injury management influencing outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Adductor injuries in MLS players (2010-2021) were analyzed November 8, 2024, using the MLS Injury Surveillance database. All recorded injuries were included and cross-referenced with publicly available data. Injuries were compared across 2 time periods (2010-2015 vs 2016-2021). Injured players were matched 1:2 with noninjured controls by position, age, and MLS experience. RTP duration, reinjury rates, and pre- and postinjury performance metrics were evaluated by time period and player position. Independent t tests and chi-square tests were used to assess differences in RTP duration, reinjury rates, and injury rates. Multivariate regression was performed to identify predictors of RTP. Results: Between 2010 and 2021, a total of 1706 players with adductor injuries were identified. RTP times increased from 14.4 ± 10.1 days (2010-2015) to 19.7 ± 15.2 days (2016-2021; P = .0475). Multivariate linear regression identified significant predictors of prolonged RTP, including injury type, onset, and field surface. Compared with acute contact injuries, acute noncontact injurieswere associated with a 12.5-day shorter RTP (β = −12.50; P = .010) and chronic injuries with an 18.4-day shorter RTP (β = −18.44; P = .001). Osteitis pubis was associated with a 37.2-day increase in RTP duration compared with nonrupture injuries(β = 37.24; P = .007). Injuries occurring on grass were associated with a 9.6-day shorter RTP than those on artificial turf (β = −9.56; P = .010). Reinjury rates remained stable between the 2 time periods (21.14% vs 23.18%; P = .513). After injury, all player positions experienced declines in games played and minutes logged, with defenders exhibiting the most pronounced reductions. Conclusion: Adductor injuries in MLS athletes were associated with increasing RTP durations over time, with notable position-specific performance effects. Acute contact injuries had the longest RTP duration. RTP durations were significantly longer in 2016-2021 compared with 2010-2015, suggesting evolving trends in injury management. These findings underscore the need for individualized rehabilitation strategies tailored to player position and injury characteristics.