Hip and groin injuries are commonplace among hockey players of all ages[1]. The elite hockey level accounts for 20% of all injuries[2]. A young goalie focuses much of their attention in strengthening their stance when developing their skills. A lot of the stress is placed on the hip joints. Research tells us that during the growing years of a young hockey athlete, there is an association with increased risk for developing hip injuries [4]. I will summarize the details of a recent study and provide you with tips for how to prevent and heal hip and groin injuries.

A recent study looked at the prevalence of hip impingement (Femoroacetabular impingement – FAI) in young ice hockey players and found a significant correlation between age and elevated angles of the hips[3]. Some suggest that constant irritation and dysfunction of the hip joint in sport may leads to increased bony overgrowths around the hip bones that leads to hip pain. These hip impingement deformities can lead to tears of the hip ligaments, poor biomechanics and further developmental issues, thus reducing player performance! This is especially noticeable among young, developing athletes, where they are more susceptible to hip impingement injury [4].

Hockey goalies are more likely to develop hip impingements than forwards and defensemen, due to constant stress along the hips during stance and lateral movements. It is believed that poorly developed body mechanics during a goalie stance are secondary to fatiguing hip and back muscles. The fatigued muscles ultimately effect the amount of force on the hip, and in turn can lead to hip impingement. A more recent study showed that the prevalence of hip impingement is higher than reported among elite level hockey players[5]. It is important to understand the link to the athlete’s biomechanics and movement, when planning a strategy for their development.

How do we help prevent hip impingement?

It is important to screen young athletes for hip and back biomechanics. Scheduling screening at different levels of their advancement provides a benchmark and tracking point to identify the level of their affected muscles and ligaments. The screens will also test for strength and effectiveness of the muscles involved during various movements that the athlete will use as they mature through their development, programing and conditioning. This screening can help guide the athlete away from improper movements that can lead to hip injuries. After an athlete’s biomechanics are assessed using a screening method, the athlete can then be guided in their development to further correct any movement deficits and strengthen areas that are weak, thus preventing impingement, and improving performance. Thus, a movement screening program for hockey athletes can help identify biomechanical disadvantages that prevent hip injuries such as impingement.

A Hockey Functional Movement Assessment will assess the biomechanics of the knees, hips, back, mobility of the ankles, middle back, shoulders, and neck, as well as the activation of certain groups of muscles that help with activating muscles that are key for movements. This integrated assessment will also help the athlete understand where their flaws are, and how to monitor development. The health care provider that administers this assessment will often recommend exercises to help rehabilitate certain areas and use clinical interventions such as manual therapy, acupuncture, and chiropractic care to further assist in enhancing development and improving performance.

It is important to note that while most of the studies mentioned in this article are particular to goalie athletes, the non-goalie hockey player can benefit from the assessment and treatment management suggested above.

The Royal Chiropractic and Sports Injury Clinic offers this biomechanical hockey assessment for athletes of all ages to help guide them through their development during training.

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Dr. Nourus Yacoub, DC
Chiropractor & Medical Director
Royal Chiropractic and Sports Injury Clinic

References
[1] Brown RA, Mascia A, Kinnear DG, Lacroix V, Feldman L, Mulder DS. An 18-year review of sports groin injuries in the elite hockey player: clinical presentation, new diagnostic imaging, treatment, and results. Clin J Sport Med. 2008;18(3):221-226.
[2] Emery CA, Meeuwisse WH, Powell JW. Groin and abdominal strain injuries in the National Hockey League. Clin J Sport Med. 1999;9(3):151-156.
[3] Philippon MJ, Ho CP, Briggs KK, Stull J, LaPrade RF. Prevalence of increased alpha angles as a measure of cam-type femoroacetabular
impingement in youth ice hockey players. Am J Sports Med. 2013;41(6):1357-1362.
[4] Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53(3):406-419.
[5] Lerebours F, Robertson W, Neri B, Schulz B, Youm T and Limpisvasti O., Prevalence of Cam-Type Morphology in Elite Ice Hockey Players. The American Journal of Sports Medicine, 2016; 44 (4).
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