“Groin Pulls” in Ice Hockey Players
Dr. Jason Kobrick, BSc, DC
Active Release Provider (ART®)
With the Hockey season beginning, players of all ages will start to show their hero colours of “black and blue”. Of all the hockey injuries, one in particular can make the season very difficult and frustrating to return to at 100%. Adductor muscle strains, the so-called “groin pull”, are the most common injuries seen in NHL ice hockey players. This injury is common whether it’s a professional or a minor leaguer or a recreational hockey player. These injuries are preventable and treatable. However, how does a player know he/she is susceptible to such an injury? The purpose of this article is to educate players about the function of the muscles and biomechanics of the groin. The better the athlete’s understanding of how their body works, the better they can learn to control their movements and in turn train themselves so that these movement patterns become engrained in what is called motor memory. Motor memory is how the body reacts to a certain stimulus without consciously thinking about the movement before hand.
Ice hockey players are at high risk for non contact musculoskeletal injuries because of the excessive force generated during the acceleration and deceleration phases of skating. During the skating stride the big glut muscles (hip extensors and abductors) are the prime movers, while the groin (hip flexors and adductors) act to stabilize the hip and decelerate the leg. In other words the power comes from your big muscles in your rear-end and the stabilizing and controlling muscles come from the long muscles down the inside of your thigh.
In ice hockey players, adductor strains may be caused by the force exerted while attempting to decelerate the leg during the toe-off phase of a stride. A strength imbalance between the propulsive muscles and stabilizing muscles has been proposed as a reason for adductor muscle strains in athletes.
Preseason training has shown to decrease the occurrence of adductor strains seen in NHL players. These muscles need a variety of dynamic exercises and a variety of different positions to strengthen the muscles in all possible positions encountered in ice hockey. Most groin injuries occur at the largest stretch of the muscles. A hard lateral cut and switch in directions on the ice can leave the groin muscles in compromising positions of length and direction. The muscle is forced to fire while decelerating, and if too much stress occurs, the fibres of the adductors can tear. In order to enhance performance and decrease the risk of injury it becomes important to implement a strength and conditioning program that emphasizes on the mechanics of ice hockey, working on flexibility and strength of the stabilizers and propulsive muscles using a variety of dynamic exercises. That is why a number of dry-land training facilities have implemented for all ages a specific program that has exercises to enhance the stability and strength of the adductors; such as single-leg strength training, a skating and stick-handling program, core and yoga and most importantly a biomechanical assessment to help identify early muscle imbalances that may put these muscles and other body areas in a susceptible position for injury). These programs are not just for the off-season months, but should continue throughout the year.
Treating the muscle imbalances incorporates a proper biomechanical/functional assessment that can be done by a therapist who understands the sport of hockey, the sport specific movements, and the training programs involved. The therapist must understand functional anatomy and be able to evaluate all the soft tissues, whether it is muscle, tendon, ligament, nerve, or fascia.
Adductor strains occur at the myofascial junction and most frequently in the muscle called adductor longus. The myofascial junction is where muscle and tendon mesh in order to attach muscle to bone. Treatments such as ice, compression, range of motion exercises are effective in the early stage of injury, but preventative and chronic issues can be dealt with myofascial release of the involved muscles and get significant results. It is important to know that the groin is particularly prone to re-injury if activities are resumed too early. A proper treatment plan with rehabilitation and conditioning exercises can drastically shorten the athlete’s recovery period and slow down the muscle dysfunctions that occur with injury. Also with a positive collaborative environment amongst therapists, strength and conditioning specialists and the player’s coaching staff will provide the best benefit for the athlete.
Ice hockey players have a high threshold for pain causing them to present late with chronic groin pulls that have been present for weeks at a low level of discomfort but tolerated by the player. Leaving this injury unmentioned and unmonitored can cause the muscles of the groin a minimum of 12 weeks to heal. This is far too much of a hockey season to sacrifice, when the proper precautions of training and therapy can be utilized starting today. If the player suspects that there is something “not right”, the best thing they can do is to seek the appropriate advice and care and not wait to do so.
If you are suffering from a groin pull or wanting to learn more preventing groin pulls, do not hesitate to contact Sheddon Physiotherapy and Sports Clinic at (905)849-4576.