Which Criteria Determine Return-to-Play Decisions Following Hip and Groin Injuries in Soccer Players: A Scoping Review.

Abstract

Context: Return to play (RTP) following hip and groin injuries in soccer remains a complex and high-stakes component of athlete management. These injuries account for a substantial proportion of time-loss episodes and are characterized by high recurrence rates and variable recovery timelines. Despite their prevalence, there is currently no standardized or validated framework for RTP decision making, and applied criteria vary considerably across clinical and sport-performance settings.

Objectives: To identify, categorize, and synthesize the criteria used to guide RTP decisions following hip and groin injuries in soccer players and to evaluate their implementation across clinical, functional, and sport-specific domains.

Evidence acquisition: A comprehensive search was conducted across PubMed, Scopus, and SPORTDiscus databases from 2003 to September 2025, limited to English-language peer-reviewed publications. Studies were eligible if they investigated or described RTP criteria in soccer players recovering from hip and/or groin injuries, regardless of competitive level. Two reviewers independently performed screening, selection, and data extraction using the Rayyan web platform. The protocol was preregistered on the Open Science Framework (osf.io/8kzq3).

Evidence synthesis: Twelve studies met the inclusion criteria. Return-to-play criteria were organized into 3 domains: (1) clinical, (2) functional, and (3) sport-specific/on-field criteria. Recent evidence highlights a paradigm shift from symptom- to capacity-based RTP frameworks integrating objective strength testing, neuromuscular control, and GPS-derived workload replication. However, standardized thresholds and progression sequences remain undefined.

Conclusions: Return-to-play decision making after hip and groin injuries in soccer is inherently multidimensional. The most defensible approach combines clinical recovery, functional capacity, and sport-specific readiness verified by objective and reproducible benchmarks. The development of standardized, criterion-based, and sex-inclusive RTP frameworks-integrating physiological, biomechanical, and psychological domains-will enhance the accuracy, safety, and transparency of return-to-performance management.