By Cory Szostowski, PT, DPT, Cert. DN
The most common area for hockey players to sustain injuries is in their hips. A study in 2013 by Marc Philippon et al. found about 1/2 of the 10-12 year old hockey players had a labral tear. The
prevalence/severity of these structural changes increased with age, with almost all 16-19-year-olds
having a labral tear with signs of femoroacetabular impingement. These changes can have a dramatic effect on a player’s physical health and overall performance if not managed appropriately.
What Causes Loss of Symmetry in Hockey Players?
Hockey season is right around the corner, so now is the time to get players ready to return to the ice and minimize their risk of in-season injuries. Hockey is a highly demanding sport that requires the body to move in all planes of motion. Thus, it’s important players maintain full range of motion bilaterally and optimal joint position to ensure proper movement patterns. Players can develop dominant patterns based on if they are right or left-handed, skating preferences, and position they play. These dominant patterns can lead to loss of symmetry and compensatory movements up/down the chain. Once a player loses neutral alignment and gets stuck in a pattern/position, problems arise due to inability to achieve alternating movement. Unequal stress is placed through joints/muscles and musculature being put in suboptimal positions to work. A good analogy to this is when a car is out of alignment and pulling to one side causing unequal wear on the tires. To remedy this, we must restore proper balance to the system.
Techniques to Address Loss of Symmetry and Restore Neutral Alignment
There are several repositioning techniques from PRI, which can be incorporated into a player’s exercise routine to assist in restoring neutral alignment as well as reciprocal movement to the body. The most common pattern talked about in PRI is Left AIC, where the left pelvis rotates forward resulting in over-activation of the anterior interior chain (diaphragm/illiacus/psoas/TFL/vastus literalis/bicep femoris).
This leads to one getting stuck on their right side with the left hip positioned into external rotation/abduction and right hip in internal rotation/adduction. These adaptations, with loss of triplana movement, can increase the chance of a hockey player developing femoralacetabular impingement, hip labral tears, adductor strains, and affect skating mechanics.
Here are videos and steps to 4 exercises that can be performed to help a player correct this pattern. If strength or mobility deficits still exist after doing these exercises for a period of time, pursue additional corrective exercises.
90/90 Hip Lift
- Lie on your back with feet flat on wall and knees bent at 90 degrees
- Place a 4-6 inch ball between your knees
- Inhale through your nose and exhale through your mouth performing a pelvic tilt so tailbone is
lifted off of mat. Low back should stay flat on mat
Sidelying Resisted Right Glut Max
- Lie on your left side with hip/knees bent at 60-90 degrees.
- Places your ankles on 3-5 inch bolster and feet firmly on the wall.
- Place tubing around both thighs slightly above knees.
- Shift right leg forward until you feel slight stretch on outside of right hip.
- Keep feet flat on wall and lift right knee upward feeling outside of right hip engage
- Hold this position while taking 4-5 breaths, in through nose and out through mouth
- Relax and repeat 4 more times
Sidelying Left Adductor Pullback
- Lie on right side with feet on wall, back rounded and pillow under head
- Place a bolster under 3-5 inches between ankles so right knee is lower than the ankle and towel
- Begin by inhaling slowly through your nose as you pull back your left leg making sure to no
rotate through lower back
- Exhale through your mouth as you squeeze your left knee down into towel hold for 3 seconds
- Inhale again pulling left leg back further and then exhaling squeezing left knee into towel
- Continue sequence until you have completed 4-5 breaths
- Relax and complete sequence 4 more times
Wall Squat with Right Arm Reach
- Squat back so your hips/back are resting flat against the wall with pillow/ball between knees
- Reach forward with right arm on exhalation without losing contact with your back on the wall
- Should feel ribs come down and core engage
- Pause for a 3-5 seconds then repeat sequence for 4-5 breaths
- Relax and repeat sequence 4 more times
A huge part of any sport is strength training, rest, and recovery. Be sure to check out our guide on post-sport recovery for great ways to keep yourself at peak performance. If you have any questions or need help performing any of the exercises covered on our website, be sure to get in touch with one of our trainers today.