Hockey Injuries

Hockey Injuries

Hockey Injuries

Every Fall, thousands of Okanagan hockey players return to the local rinks. Although most will have a great year of pain free hockey, many will suffer an injury during the season.
The most common types of lower body hockey injuries suffered are to the groin and hip flexor muscles. These muscles cross the hip joint from the pelvis and either pull the thigh across the midline of the body (adduction) or upward into flexion. A certain amount of hip rotation also occurs during this. These actions are key movements during skating. They occur when pulling the leg back under your body, prior to push off or when turning and performing crossovers. These same muscles are also under stress when used to control end-range extension and abduction (hip movement away from midline of the body) during the push phase of the stride. In fact, it is during this controlled muscle lengthening (eccentric contraction) that the muscle most commonly fails and a strain occurs. These important muscles are also used to stabilize the body during shooting, brace during body contact, and when a player slips or catches an edge.
Hip strength imbalances, decreased hip mobility, poor core/trunk stability, and lack of a good dynamic warm up have all been associated with increased risk for these injuries. The age of the athlete and a previous hip injury are also predictive factors. An athlete can’t change their age or go back in time and erase a previous injury, but they can be proactive about the other factors.
Research suggests that hip adductor (groin) strength should be no less than 80 percent of abduction strength (outer hip muscles). This can be worked on by including hip exercises such as lunges that step into 45 degree quadrants and lateral directions as well as forward and back (lunge matrix). I also like the use of the lunge matrix because it works on hip mobility and hip stability in positions your hip often gets into during hockey. You can also focus on your core stability during these movements. Training your trunk to stabilize during the skating and shooting motion is paramount.
A dynamic warm up is a series of sport specific movements that are designed to prepare the muscles for use and are performed in a safe controlled fashion. In hockey these can include movements such as squatting, lunging and high knees to name a few. With the hockey teams I work with, I will often go through a series of 10 to 15 movements off ice before getting equipment on. As a Physiotherapist, my personal routine is to usually target a few specific movements by performing air squats and lunges with rotation in the dressing room prior to lacing up my skates.
Even with the best prevention, an injury can still occur. Hockey is an explosive game with quick changes of direction and plenty of incidental contact. If you do suffer an injury to the groin region that you think is a strain, I suggest you ice the injured area for the first couple days and abstain from pain provoking activities. You should not return to skating until you can walk and lunge without pain. Optimally, you should make your first session back a skating only session and not put yourself into a game until you know you can tolerate skating. If you do have pain that does not settle in a couple days, or you experience other symptoms such as pain with coughing, or numbness into your groin, you should have it assessed by your doctor or Physiotherapist. There are other conditions that can occur in the region that are more serious than a muscular strain and these should be ruled out. Recovery from injuries to the groin can take anywhere from 3 to 5 weeks and they have the potential to become chronic if not treated properly.
If you suffer from this type of injury, talk to your Physiotherapist about the best course of treatment so you can get back on the ice sooner.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
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Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
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Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info

ACL Rehabilitation

There are four main ligaments that provide stability of the knee joint – the medial and lateral collateral ligaments on either side of the knee, and criss-crossing deep inside the joint are the posterior and anterior cruciate ligaments. The anterior cruciate ligament (ACL) is a thick ligament that attaches from the lower surface of the femur (thigh bone) onto the upper surface of the tibia (shin bone) in a way that will resist the tibia from slipping too far forward or rotating too far inwards on the femur. If – as can happen during sports that involve twisting, jumping, or pivoting – the knee twists too far with a lot of force, then part of all of the ACL can be torn.

ACL injuries are one of the most common knee injuries and they are managed in different ways depending on the severity of the injury and the age and activity level of the person.

Non-operative management consists of physiotherapy treatment with focus on reducing the inflammation and working through a strengthening protocol in order for the muscles around the knee to support the knee joint as much as possible. In these cases the surrounding muscle support is crucial as the knee will be lacking some stability if the ACL hasn’t been repaired. A knee brace may also be useful to provide extra support once the person is taking on more activity at the end of the rehab and beyond.

In many cases surgery will be required. The repair is normally made with a graft taken from the persons own hamstring or patellar tendon. Once the surgery is done, the rehab begins immediately. Whereas in the past the knee might have been put in a cast and rested, current protocols involve early weight bearing and range of motion exercises. It is very important to regain the knee range of motion early on otherwise it can be hard to progress and achieve goals further down the line.

A strengthening program, developed by your physiotherapist, will be started post operatively in order to begin to regain some of the knee strength and stability. The strengthening program for ACL reconstruction rehab is quite specific because the exercises need to strengthen all of the important muscles without placing too much stress on the healing ACL graft. A gradual progression of strengthening is done, beginning with simple light exercises and building up until eventually more complex exercises that are specific to your sport can be achieved.

By the end of the rehab the goal is to have sufficient strength in the muscles and ACL graft to give the knee the functional stability it needs to cope with the demands placed on it during activity. A return to sport is typically achieved in around 9-12 months following surgery.