1. Water: Hydration is key to your performance and overall health. Athletes need to drink before, during and after activity. Along with your water bottle you can bring a sports drink. These sports drinks can be helpful especially if you are a heavy sweater, or need some carbs for energy during your skate. The key is to continue drinking small amounts of water or other fluids between shifts. Remember with your equipment on you will sweat even if you’re playing outdoors in the cold.
2. Snacks: Fuel is a must for pre-game or in between periods. This can be a protein source, granola bar or even a simple peanut butter and jelly sandwich. Pick small, quick foods that you enjoy. Ideally, you want something light and simple to eat 15 – 30 minutes before your skate starts, and a light snack option for in between periods. Keep your between period snacks small to avoid any bloated or “full feeling” going into the next period.
3. First Aid Supplies: Depending on where you are skating, you may not have access to medical staff or supplies. It is important to be prepared with supplies such as Band-Aids, gauze, anti-biotic spray, and instant ice packs in your bag. You never know what could happen at the rink. Let’s say you block a shot, you’re probably going to need to ice the injury for 15 – 20 minutes every hour. Maybe you take a high stick, then you would need some gauze and a bandage. Make sure you clean cuts first then apply anti-biotic ointment before covering.  If you have medications that are taken regularly be sure to have those that you might need in an emergency, such as an inhaler, or epi-pen.  Of course, tape can be a handy item to have not only for supporting an injured wrist or ankle but also to tape your stick or socks.
4. Emergency Contact Info: While most leagues require this on enrollment forms, it’s never a bad idea to have a card in your wallet or on a bag tag. Be sure it includes important information such as your name, date of birth, allergies, medications and any chronic medical conditions.

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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 Hockey bag essentials appeared first on Minnesota Hockey Magazine.

TRIA’s 4 things coaches must know prior to an emergency

Emergencies can happen at any time and in the youth sports arena, the coaches are on the frontline to respond. It is critical for the coach and their staff to act fast and efficiently when an emergency occurs.

Establishing and rehearsing an emergency action plan (EAP) prepares the coach and their team to do just that.  An EAP outlines the information necessary to respond to an emergency and assigns roles & responsibilities to ensure the athlete receives medical attention in the most efficient manner.

To get started, there are four important locations a coach needs to identify to be prepared to handle any emergency. Knowing these locations prior to an emergency will decrease reaction time for responding.

• Working Telephone: This could be a cellular phone or land line. It is important to make sure that the cellular phone has service in all areas of the facility.  Coaches should know where the closest accessible land line is located. Facilities may differ so if using a land line, be sure to note if a prefix such as *9 needs to be dialed first.
• Automated External Defibrillator (AED): The AED should be located somewhere near the practice and competition area.  It should also be clearly marked and accessible at all times.
• Location: The address of the practice/game facility as well as the specific field or entrance must be identified by the person calling 911.  It is also helpful to include a cross street or intersection as well as a door or field number to direct EMS to the emergency.
• Trained Medical Staff: Coaching staff should know if and where any medical personnel are located on site to help with the emergency situation. This would include an athletic trainer or physician.  In some situations where an athletic trainer or physician is not onsite, coaches should know who on staff is trained in CPR and the use of an AED.

Once these locations are identified it is important to review with your staff the actions that need to be taken when a life threatening emergency occurs such as who is responsible for calling 911, starting CPR, and getting the AED.  These actions need to happen simultaneously to have the greatest chance of success.

Coaches should assign roles to their staff and players to ensure each action item is covered and understood. In addition to the EAP, coaches should have access to a well-stocked first aid kit, awareness of allergies and medical conditions, and emergency contact information for the players.

This preparation helps everyone involved feel confident in their role of the emergency action plan.

The post Coach prep goes beyond X’s and O’s appeared first on Minnesota Hockey Magazine.

Like many Minnesotans, I grew up in a hockey rink. From playing youth hockey, to managing my high school teams, to coaching, and now as a Certified Athletic Trainer on the bench, I have seen my fair share of on ice injuries. As an athletic trainer, we focus on making sure our athletes stay healthy, help to prevent and manage injuries when they occur. However, it is not just the players that get injured; hockey referees are often included in my evaluations during games.

Referees are often the forgotten athletes on the ice. They typically work multiple games in a single day, and often are working back-to-back days. Out on the ice for every minute of every game, these individuals do not get a break in the action to rest. Contusions, lacerations, broken fingers, dehydration, and leg and hip strains are some of the most common conditions I see. So, how do we keep these individuals healthy? The following tips are designed to help minimize the risk of injury during a game.

1. Develop Cardiovascular Endurance.

Whether it’s biking, running, or Zumba class, start getting your heart, lungs, and muscles in shape at least 4 to 5 weeks before the season begins. Having good cardiovascular endurance at the beginning of the season allows you to hustle on every play and keep up with the pace of the game. It will also help you to be more focused and alert of what is happening around you and allow you to quickly recognize and get out of a dangerous position.

2. Good Dynamic Warm Up.

Before your first game, you should take part in a 10 to 15 minute full body dynamic warm up. Dynamic exercises increase the blood flow and the temperature of muscles, which helps to reduce the risk of injury and prepares the body for more strenuous activities. An example of a pre-game warm up would include: 3 to 5 minute jog, high knees, butt kicks, high skips, lateral shuffle, grape-vine, walking T or Frankenstein’s, side to side hip swings, and forward and backward arm circles. Whatever your dynamic warm up entails, it should be done as close to game time as possible to ensure your muscles are warm and they haven’t cooled down.

3. Proper Positioning.

Whether you are working the two or three official system, two simple body positioning rules will drastically reduce your risk of injury. First, always keep your toes pointed toward the puck. The front side of your body has a lot more padding than your side or back, so if a puck is coming your way, it is more likely to make contact with padding if you are square to it. Second, use your hands to protect yourself. If you are square to the puck and players are bumping into you, place your hands on their back. This will let the players to know you are there and you will glide backwards safely instead of getting pushed around. If your toes are not pointing towards the puck and a player falls they are more likely to land on the outside of your leg and cause you to sustain a knee injury.

4. Communication is Key.

Many of the acute injuries I have seen could have been prevented with simple communication. Players are not always aware of where you are on the ice, so talk with them. A simple “heads up” as they make a break along the boards, or a “ref on the boards” as they wind up to clear the zone, can act as a reminder to the players of where you are. If the centers are starting to get a little wild with their sticks during a face off, remind them to keep the sticks down. Players most likely don’t always realize some of their actions are putting you at risk for injury, so talk to them.

5. Hydration

Even though you are working on ice and not out in the sun, hydration is still important. Dehydration can cause muscle cramps, fatigue, decrease in concentration, and increase your risk of heat illness (yes this does occur in cold climates). Make sure that you are drinking water or an electrolyte drink between periods and games, as well as the night before you work and when you get done. Everyone sweats at different rates so be sure to drink before you get thirsty.

Implementing these five tips can help reduce your risk of on ice injuries. However, as we all know, accidents happen. I highly recommend that every referee pack a small first aid kit in their bag. Something as simple as having bandages, gauze, a pair of medical gloves, antibiotic ointment, and tape can go a long way until you can see a medical professional.

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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 Officially healthy appeared first on Minnesota Hockey Magazine.

Hockey is a very physically demanding and high intensity sport. The nature of hockey includes rapid changes in direction, incredible hand-eye coordination, and forceful impact from opposing players. It’s no surprise that this amazing game also comes with some injuries. Among the various injuries associated with hockey, medial collateral ligament (MCL) injuries in the knee are the second most common injury in NCAA hockey behind concussions (Grant, Bedi, Kurz, Bancroft & Miller, 2013).

The MCL is one of four primary stabilizing ligaments in the knee and connects the femur and tibia on the medial (inside) aspect of the knee. The role of the MCL is to prevent excessive stretch or movement associated with the inside portion of the knee. The most common cause of an MCL sprain includes a direct blow on the outside of the knee and/or twisting motion at the knee with a planted foot. More specifically in hockey, this injury may result from getting checked low by an opponent or simply by catching a skate edge and twisting your knee.

Here are a few points to know that can help ensure a proper and speedy return to the ice:

What is the correct immediate care?

Apart from initially being painful, the inside of the knee may begin to feel tight as swelling starts to set in. Initial treatment should include RICE (Rest, Ice, Compression, and Elevation) to help control the amount of swelling in the knee. This will create an optimal environment for healing to help get you back on the ice quickly. It is important to have a health care professional such as an athletic trainer or physician to evaluate your knee. Imaging is helpful to determine the severity of the injury, and rule out any other related structures commonly associated with MCL tears such as the ACL or meniscus. Once you have a diagnosis it is vital to begin supervised rehabilitation with an athletic trainer or physical therapist to start the road to recovery.

How bad is my injury?

There are three grades of severity with all ligament injuries including the MCL. Grade I sprains can be described as an “overstretching or slight tear” of the ligament, typically resolving in 1-2 weeks. Grade II sprains are larger tears that are still partially attached and generally resolve in 3-4 weeks. Lastly, grade III sprains are complete ligament tears, typically resolving in 4-6 weeks, but can take longer depending on severity and post-injury treatment. Recovery is typically non-surgical if appropriate measures are taken, but in some grade III injuries surgery may be recommended. Recognizing the severity of the injury is a vital step towards a full recovery and prevention for re-injury.

How to get back on the ice?

It is important to understand that in most cases you can expect a full recovery. Sports equipment such as a knee brace and/or sleeve can help add support during the healing process. In addition, proper knee stabilization and strength are essential pieces of rehabilitation. Common strengthening exercises for the leg include squats and lunges while stabilization and balance are addressed with single leg standing and side to side shuffles/bounding. A well rounded rehabilitation program will also integrate the hips, core, and cross training into the recovery. In time, you will advance from dry land rehab to once again lacing up the skates for sport specific training on the ice.

Lastly, remember that everybody’s body is unique and every injury is unique. Which is why it’s important to work with health care professional(s) who specialize in sports injuries to help you attain your goals on and off the ice.

Reference

Grant, J.A., Bedi, A., Kurz, J., Bancroft, R., & Miller, B.S. (2013). Incidence and injury characteristics of   medial collateral ligament injuries in male collegiate ice hockey players. Sports Health: A Multidisciplinary Approach, 5(3), 270-272.

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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 Collateral damage appeared first on Minnesota Hockey Magazine.

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. 

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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.

The first thing to do if you think that you have suffered a concussion while playing sports is to get off the field of play and tell your coaches, parents, or athletic trainer.  Athletic trainers have specialized training in concussion injuries and are your best resource for concussion injuries in the community.

Athletic trainers are available at most high schools to evaluate athlete injuries.  TRIA also has an athletic training room open Monday through Thursday from 2:00-6:30, Friday from 2:00-5:30, and Saturday from 9:00-12:00 to assess your injuries and advise on whether further medical care is necessary.  Coaches have to do mandatory concussion training.  Letting one of these people know can help you get to the right person to manage the injury. 

Do not try to play through the concussion symptoms that you are experiencing.  Trying to play through concussion symptoms only makes the injury worse.  Most athletes will start to experience more headaches, dizziness, fogginess, nausea, and fatigue by pushing through their symptoms. This only delays the brain’s recovery after a concussion.

The brain will use up all of its energy reserves while trying to heal so it needs to borrow energy stores from muscles and other areas of the body.  If you work out too much then you deprive the brain of the energy it needs to recover and your symptoms will last longer.

Seek a medical evaluation by an appropriate health care provider specifically trained in concussion management, such as a sports medicine physician or athletic trainer.  According to MN state law, athletes with concussion symptoms need medical clearance before returning to play.

Concussions are often difficult injuries to assess.  Unfortunately, we do not have one single test to diagnosis a concussion or predict the length of recovery.  That’s why it is important to have a full medical evaluation to make sure the injury is fully assessed and a treatment plan is in place.

TRIA has assembled a specialized concussion care team to handle concussion injuries and return to play decisions.  Our goal is to accurately diagnosis concussions, develop treatment plans individualized for each athlete, and identify those at risk for longer term symptoms. 

Rest is important for the reasons previously described and so you do not feel worse during the day.  Pacing your daily activities and tasks will help you manage academic requirements so that athletes do not get too far behind in their studies.

Getting far behind in school often leads to anxiety and a sense of being overwhelmed.  Being in the right frame of mind, feeling well physically, and having a positive outlook on your recovery, will help you manage concussion symptoms better.

Once you’re feeling back to normal with day-to-day routines are you ready to jump right back into play?  NO!  Before returning to the field of play, you should follow a stepwise return to play protocol that tests your body’s response to physical exertion.  Sometimes after a concussion injury you will feel fine at rest but when you exercise or do coordinated athletic drills, concussion symptoms will return.

Following the recommended five step return to play protocol helps an athlete know whether symptoms are completely gone before risking further injury in a game setting.

5-Step Return to Play Protocol to be started once symptom free at rest:

Step 1: Light aerobic activity
The Goal: Only to increase an athlete’s heart rate.
The Time: 5 to 15 minutes.
The Activities: Exercise bike, walking, or light jogging.
No resistance training, jumping or sprinting.

Step 2: Moderate activity
The Goal: Limited body and head movement.
The Time: Reduced from typical routine.
The Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting

Step 3: Heavy, non-contact activity
The Goal: More intense but non-contact
The Time: Close to typical routine
The Activities: Running, high-intensity stationary biking, the player’s regular weightlifting routine, and non-contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.

Step 4: Practice & full contact
The Goal: Reintegrate in full contact practice.

Step 5: Competition
The Goal: Return to competition.

The post Getting your head examined appeared first on Minnesota Hockey Magazine.

In the state of hockey, kids and teens are exposed to the game of hockey all year round.  Hockey players learn how to skate, stick handle, shoot on net, and the importance of wearing protective equipment, especially a helmet.

Despite the fun of the game, there is a potential risk for injury.

I see quite a few shoulder injuries among hockey players due to the amount of contact, speed, and force a player’s body encounters.  Three of the most common injuries we see include:

• A shoulder separation—this occurs at the AC joint where the clavicle and scapula meet.
• Another is a clavicle fracture.
• The third, less frequent, shoulder injury we see is a shoulder dislocation, where the shoulder comes out of its socket due to excessive force.

Treatment options for nonsurgical shoulder injuries are usually easy to implement.  Treatment typically involves immobilization with a sling, ice and pain medications, a course of rest, and certainly doing formal rehab with physical therapy to address pain, strength, and range of motion issues.

If a dislocation has occurred, players may need a shoulder brace to help stabilize the shoulder joint when playing.

However, since most parents and athletes would rather avoid an injury all together, there are several things to ensure safety while playing the game.

Certainly making sure you play fair and avoid cheap shots helps minimize injuries. When you’re going to go into the boards, try and avoid getting your shoulder down too low.

Making sure you have up to date, well- fitting equipment can help dissipate the contact force against other players and the boards.  Finally, making sure your shoulder muscles are stabilized and as strong as they can be goes a long way in injury prevention.

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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 Shoulder injuries nothing to shrug at appeared first on Minnesota Hockey Magazine.

Working with concussion patients, I hear a lot of questions and concerns from both the athlete and their families surrounding the diagnosis of concussion. Hockey players at all levels make up a large percentage of our patient population. Here are a few of the most commonly heard misconceptions surrounding concussion management.

1. You must avoid all activities after a concussion.
   • Avoiding activities that trigger an increase in symptoms are important to limit early on, but avoiding all activity is not necessary. A progressive, symptom – dependent progression of activity is recommended. A full return to sports should be done after being cleared by an appropriate medical professional.
2. To truly have a concussion, you must lose consciousness or “blackout”
   • Only five to ten percent of concussions result in a loss of consciousness. A concussion is caused by either a direct blow to the head, neck, face, or by a force directed somewhere else in the body that transmits force to the head. Symptoms can occur immediately or may evolve over time. In fact, there is debate on whether a loss of consciousness can even be an indicator of concussion severity. Recent consensus states that a loss of consciousness does not affect the long term prognosis or the overall recovery for a patient post-concussion.
3. The best helmet or mouth guard can prevent a concussion.
   • There is no evidence that protective equipment will prevent a concussion. Mouth guards and helmets have an important role in preventing dental and skull injury as well as more severe traumatic brain injuries so should still be worn for those reasons, but do not provide prevention against a concussion. The risk of concussion is not affected by the brand, age or style of a helmet or a mouth guard.
4. It is important to awaken a person post-concussion every 20 minutes, and shine a light in their eyes to check their status.
   • A change in pupil reaction, or large change in mental status indicates a more serious brain injury. These changes would not occur if the patient had suffered only a concussion. A clinical evaluation by an appropriate medical professional can help assist in the diagnosis of a concussion versus a more serious brain injury.
5. MRI/CT are necessary to diagnose a concussion.
   • A concussion is a functional change rather than a structural injury to the brain, so no abnormalities are typically seen on standard imaging like an MRI or CT scan. A brain MRI or CT scan contributes little to the diagnosis of a concussion and should only be used if the medical professional is suspicious of a structural problem – for example, hemorrhage, skull fracture etc.
   • The diagnosis of a recent concussion usually involves a clinical assessment of several domains such as:
     1. Symptoms – headache, fogginess, emotional symptoms
     2. Physical signs – amnesia, potential loss of consciousness
     3. Behavior changes – irritability
     4. Cognitive impairments – slowed reaction time
     5. Sleep disturbance – such as insomnia

Some of the information above was taken from the Consensus Statement on Concussion in Sport: the 4th International Conference on Concussion in Sport.

Do you have a question for TRIA’s team of sports medicine experts? Click the image below to learn more and your question may be featured in a future TRIA article.

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 5 Misconceptions about Concussions appeared first on Minnesota Hockey Magazine.

This coming season will be my third year working as Sports Medicine Staff for the Minnesota Magicians, sixth season working junior hockey for the North American Hockey League. Junior hockey can be very strenuous on a player’s body, especially younger players new to the league and are not used to the pace or the grueling season of the NAHL.

With this, injuries usually come about. Most of the injuries that I see and deal with week to week, tend to be in the hip region. Groin strain, hip flexor strain, quad contusion and hamstring strain are just a few of these types of hip injuries that can occur either acutely or from overuse.

Hockey players spend most of their time standing on forward-angled skates with their torsos upright and their hips flexed, a position that usually leads to large quads, inactive glutes and tight hip flexors.

Unfortunately, living in this position further tightens the hip flexors and removes the glutes—the largest and most powerful muscle group in your body—from the skating stride

The body always takes the path of least resistance, so the active hip flexors usually take over for weak and inactive glutes. Your hip flexors help you push off the ice and pull your knee up toward your chest in preparation for your next stride. Although they were not intended to contribute to backside mechanics, the hip flexors now do so at the expense of your spine.

In reality, the glutes should be the first muscles that fire when you push off the ice, followed by the external rotators, the quadriceps (which straighten the knee) and the hamstrings (which extend the hip)

Below are a few exercises for strength and stability that will keep hips and knees healthy. These can be done easily at home with minimal equipment.

Crawling: Forward and Reverse Bear Crawls- Crawling mimics the movement pattern of skating, while training the core to remain completely motionless. It reinforces stride mechanics, and you get a killer core workout.

Single-leg Goblet Squat: When you stand on one leg, the muscles attached to your hip work overtime to keep you stable, improving your core and hip support. This exercise should be done with body weight first working on proper mechanics before an athlete should load up with weight. Sit back and down into your hip (like sitting on a chair), then drive your hips up and forward as you stand back up.

Eccentric Leg Curls: Strong hamstrings reduce the risk of groin pulls, because they reinforce co-contraction of the hamstrings and glutes. These can be done from a bridge position laying on your back, making sure that your feet can slide on a surface. Contract your glutes as you bridge your hips up, flexing your knees and bringing your heels toward you. Eccentric phase comes when you slowly lower and extend your knees back down, should take 3-5 seconds.

Single leg Deadlift: The slightly bent knee position of the Single-Leg Deadlift mimics the position that the leg and hip assume during the contact phase of skating. You promote proper muscle recruitment and a faster, more efficient stride. Key here is maintaining a neutral pelvis and not arching low back or allowing any hip rotation.

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 Getting hip to leg injuries 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.

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