In a fast-paced, contact sport like hockey, injuries are bound to occur.  Some injuries are from high speed contact and are difficult to prevent such as shoulder separation, but other injuries from over-use or improper training/mechanics can be decreased or prevented with proper identification and intervention.  Over the past few years in my physical therapy practice, I have seen an influx of adolescent hockey players with low back pain, more specifically lumbar stress fractures.  Spondylolysis is defined as a non-displaced stress fracture of a spinal vertebra a.k.a. pars stress fracture.

The majority of young athletes who present to their doctor or physical therapist’s office will describe a spontaneous onset of low back pain that is exacerbated by extending their back.  They may have pain that radiates into their buttocks area and a feeling of tight hamstrings.  Rest will usually decrease their symptoms.  Athletes that are at risk often times have an increase arch in their low back.  Hockey players, due to their position for skating, tend to develop this increased low back arch. 

Improper skating technique and/or poor muscular control throughout the lower abdominal muscles can significantly increase the risk of a low back stress fracture in a hockey player.  When a player skates without engaging their lower abdominals it creates an increased low back curve.  As the player strides or rotates their trunk while shooting/passing, they increase the stress on the lower back structures.  Gluteal muscles are crucial in preventing an over-extension of the low back during a hockey stride.  Hockey players that do not engage their gluteals while taking a stride tend to recruit their low back extensors to compensate.  The over-use of low back extensors and poor lower abdominal strength combine to pose a recipe for low back pain. 

Proper training throughout the year is crucial to decreasing the risk of a low back stress fracture that can keep a player off the ice for months.  The training focus should be on lower abdominals (core) strength, gluteus maximus/medius strength, and maintaining proper hamstring and hip flexor flexibility.  Also, proper rest/recovery periods are extremely important throughout the year to allow an athlete’s body to recover and prevent the occurrence of these over-use injuries. 

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About TRIA Orthopaedic Center

TRIA is a comprehensive center for orthopaedic medicine, providing incomparable clinical and surgical care, world-class research, and innovative programs. TRIA Orthopaedic Center has over 40 highly-trained physicians with a variety of sub-specialties such as sports medicine, acute injury, shoulder, hip, knee, spine, hand and wrist, foot and ankle, and fractures. TRIA’s sports medicine specialists have served as official team physicians for Minnesota’s professional sports teams for over 25 years. TRIA offers walk-in care through the Acute Injury Clinic, 8:00 a.m. to 8:00 p.m. seven days a week, no appointment needed. From diagnosis to treatment, to rehabilitation and even surgery, it is all at one convenient location at I-494 and France Avenue in Bloomington, Minnesota. For more information, visit tria.com.

The post What’s Up With Low Back Pain? appeared first on Minnesota Hockey Magazine.

Over the past number of years, I have had the privilege to rehabilitate numerous hockey players, some being professionals.  Whether working with an NHL hockey player or a Pee Wee, the rehab can be very similar or drastically different.

The player position may influence their rehab significantly.  A goalie’s body may require different movements than a forward or defenseman.  Also, hockey players have a wide variety of injuries including concussion, shoulder sprains, low back pain, hip impingement, and knee ligament issues.

The first key component in working with hockey players is understanding how their specific injury can impact their ability to compete.  Some injuries are minor and the athlete may be able to continue to compete at a high level, where other injuries are more major and require sitting out from competition.

All athletes are motivated to return to their competition, but for the professional athlete their sport is also their job.  Professional athletes have a “team” of supporting personnel that all need to work together in their recovery.  This “team” consists of doctors, physical therapists, athletic trainers, agents, strength/conditioning coaches, and any other professionals that may be needed in their care.

It is crucial that this “team” communicates well to ensure continuity of care and the best possible outcome for the athlete.  Everyone has their specific role and needs to carry out their responsibility to allow that athlete to return to the highest level of competition.

The professional athlete’s drive to compete often needs a checks and balance system.  As a healthcare professional, I need to have the difficult conversations with them when their body is not ready to return.  The health of their body is crucial to their career and also a large investment for their team.  We need to ensure that we protect the athlete from returning too soon to competition and risking another injury.

As the hockey player improves, we progress them to rehab activities that simulate their sport.  We focus on specific muscle groups that matter most for a hockey player and help them transition into more challenging activities.  Once the athlete can prove in a clinic setting that they are ready to advance, we will allow them to return to the ice with a gradual progression.

This transitional period enables the athlete to increase their confidence as they make their return to full competition.

About TRIA Orthopaedic Center

TRIA is a comprehensive center for orthopaedic medicine, providing incomparable clinical and surgical care, world-class research, and innovative programs. TRIA Orthopaedic Center has over 40 highly-trained physicians with a variety of sub-specialties such as sports medicine, acute injury, shoulder, hip, knee, spine, hand and wrist, foot and ankle, and fractures. TRIA’s sports medicine specialists have served as official team physicians for Minnesota’s professional sports teams for over 25 years. TRIA offers walk-in care through the Acute Injury Clinic, 8:00 a.m. to 8:00 p.m. seven days a week, no appointment needed. From diagnosis to treatment, to rehabilitation and even surgery, it is all at one convenient location at I-494 and France Avenue in Bloomington, Minnesota. For more information, visit tria.com.

The post Checks and balances appeared first on Minnesota Hockey Magazine.