Background <p>Adductor-related groin pain syndrome is the most common problem for athletes in many sports which often significantly reduces athletic performance and activity.</p> Objective <p>This study aimed to investigate the effectiveness of the Modified Holmich protocol on hip adductor strength, functional performance, and injury prevention in U-19 female footballers with groin discomfort.</p> Methods <p>An experimental study was conducted with a total of 34 U-19 female footballers from Olympus Sports Club in Noida. Participants were randomly assigned to either the experimental group (<i>n</i> = 17) or the conventional group (<i>n</i> = 17). The experimental group followed the Modified Holmich protocol, while the conventional group followed a general strengthening protocol. Baseline measurements of hip adductor strength, functional performance (measured using the Edgreen Side Hop Test), and groin-related issues (assessed using the HAGOS questionnaire) were obtained.</p> Results <p>The Modified Holmich Protocol group showed significant strength gains (Left: 18.3 ± 2.3 to 20.4 ± 2.2; Right: 19.6 ± 2.4 to 21.1 ± 2.4; <i>p</i> &lt; 0.001) and functional improvement (ESST: 10.7 ± 1.9 to 12.1 ± 1.6, <i>p</i> &lt; 0.001), outperforming conventional training (ESST post: 12.1 ± 1.6 vs 10.6 ± 1.5, <i>p</i> = 0.01). HAGOS subscales demonstrated clinically meaningful improvements (Pain: 63.4 ± 4.2 to 69.7 ± 4.1; Symptoms: 63.8 ± 4.7 to 68.9 ± 4.0; ADL: 62.7 ± 5.6 to 70.0 ± 4.0; Sports: 67.8 ± 4.5 to 72.6 ± 3.1; all <i>p</i> &lt; 0.001), confirming the protocol's effectiveness for enhancing both physical capacity and patient-reported outcomes in female footballers.</p> Conclusion <p>The findings suggest that the Modified Holmich protocol is effective in improving hip adductor strength, functional performance, and reducing groin-related issues in U-19 female footballers with groin discomfort.</p> Trial registration <p>Clinical Trials Registry-India (ICMR-NIMS) registry no. CTRI/2023/02/049371.</p>