Physical Therapy Corner: Groin Strains in Ice Hockey
By Kendrick Summers, MSPT, ATC
Groin injuries are among the most common injuries seen in sports. This injury is more prevalent in ice hockey. These injuries can be quite debilitating and lead to a lot of missed time on the ice. There are many structures in the body that can cause groin pain when injured. However, adductor strains have shown to be among the most common in ice hockey. Studies have found that over 40% of muscle strains in elite ice hockey involve the adductor region. Another study found that groin strains in professional hockey accounted for up to 10% of all injuries with a possible recurrence rate of more than 30%. This means that not only did injuries of this nature affect a significant percentage of players, but these injuries also went on to plague players for an extended amount of time.
Why are there so many groin stains in the sport of ice hockey? One’s first assumption would be to attribute it to the aggressive nature of the sport, but research states otherwise. Ninety percent of all groin injuries manifested from non-contact activities. One could also easily assume that this injury comes solely from a lack of flexibility in the adductor muscles of the groin. Although somewhat true, poor flexibility alone has been debunked as the primary risk factor of groin strains. Researchers found that the preseason hip adductor flexibility of NHL players who sustained groin strains were no different than those who did not. This suggests that stretching alone is not an effective measure in preventing groin strains. However, researchers did find that preseason hip adductor strength in players who suffered groin injuries was 18% lower than those players who remained healthy. The study also found that hip adduction strength was 95% of hip abduction strength in healthy players in comparison to 78% in those who sustained a groin injury. These findings indicate that an imbalance between the hip abductors and adductors play a key role in the onset of groin injuries.
A major contributor to this hip imbalance is the fundamental movement of the skating stride. During the skating stride the glutes and hamstrings are the prime movers during the acceleration (stride) phase, while the hip adductors and flexors are the prime stabilizers during the deceleration (return to starting position) phase. In ice hockey, it is during the deceleration phase that the strain occurs. At this traumatic moment the muscle is lengthened past its ability to handle the load and a tear of the muscle occurs.
Fortunately, it’s possible to reduce your risk of groin strain, but you must take a proactive approach. Start incorporating adductor strengthening exercises into your normal offseason training program, a dynamic warm up, and sports specific drills. And remember, progressing too fast can lead to injury.
Want to learn more, contact Kendrick at ksummers@achievortho.com or by phone at (630) 891-3980.
Resources:
Molsa J, Airaksinen O, Näsman O, Torstila I. Ice hockey injuries in Finland: a prospective epidemiologic study. American Journal of Sports Medicine J Sports Med. 25:5, 1997
Tyler TF, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The Effectiveness of a Preseason Exercise Program to Prevent Adductor Muscle Strains in Professional Ice Hockey Players. The American Journal of Sports Medicine 30:5, 2002.
Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The Association of Hip Strength and Flexibility with the Incidence of Adductor Muscle Strains in Professional Hockey Players. The American Journal of Sports Medicine 29:2, 2001.