Month: May 2012

Managing Structural and Functional Asymmetries in Ice Hockey: Part 2

Part 1 of this series described anatomical asymmetries that all humans have, and how they can lead to predictable patterns and functional asymmetries. Part 2, below, will dive into how these patterns directly affect hockey performance and how they may contribute to common hockey injuries.

Influence on Hockey Performance
These positions are not inherently harmful. In fact, everyone should possess the ability to get into and out of these positions, bilaterally. Problems arise when an athlete gets stuck in a pattern and is unable to achieve the reciprocal position. This causes a shift in neutrality and increases the likelihood the athlete will need to push past joint end-range to achieve a functional outcome. Specific to skating in hockey:

A left hip positioned in a state of external rotation and abduction will make it more likely that the athlete will drive through end rage to achieve the desired stride length, which can cause compensatory SI joint stress and/or movement in forward skating.
A left hip positioned in a state of flexion will make it difficult to recover the leg fully under the body without standing up higher, which may cause some players to recover this leg slightly outside of their hips.
During crossover strides to the left, the left hip will be unable to adduct and drive under the right leg, a huge source of power.
During crossover strides to the right, the right hip will be more likely to drive through end range internal rotation and adduction, which can also cause a resultant gapping stress to the right SI joint.

Application to Common Hockey Injuries
Interestingly, femoroacetabular impingement (FAI) which affects the overwhelming majority of elite level hockey players involves a loss of hip flexion, adduction, and internal rotation. While the two types of FAI, CAM and pincer, differ in the site of bony overgrowth, it’s clear that these injuries can become worse over time as players continue to push through joint end range and force bone on bone contact. Referring to the list above, it’s apparent that a left hip positioned in a state of flexion will increase the probability that a player will drive through end range hip flexion on that side; likewise, a right hip positioned in adduction and internal rotation provides a mechanism for excessive bony contact on that side. In other words, this same pattern provides a mechanism through which hockey players can develop FAI on both sides.

Similarly, because the left hip is positioned in a state of external rotation and abduction, the adductors are positioned long. As the stride leg is extended, these adductors are forced to decelerate the leg near their end-range, making it more likely that these muscles will become overstretched/strained and tear. In addition to the compensatory SI joint movement that the forward stride can create on the left side, driving through end-range external rotation can also cause a forward migration of the femoral head within the joint, causing excessive strain and laxity across the anterior hip capsule. Both adductor strain and anterior hip capsule laxity are common causes of “groin pain” in hockey players. Laxity in the capsule also allows for excessive accessory motion within the joint, which can cause labral damage and eventual osteoarthritis.

On the opposite side, the right adductors are positioned short and can become extremely dense and fibrotic. The predominant thought currently is that sports hernias are caused in large part because of a tug of war across the pubic symphysis between dense adductors and weak abdominals. The adductors progressively win this battle in an erosion-like fashion, which causes a fraying of the structures in the area of the superior surface of the pubic bone. Not surprisingly, sports hernias are more commonly found on the right side.

Naturally, early recognition is key. Indeed, while not every hockey player I’ve tested falls into one of PRI’s patterns, every hockey player with a history of hip injuries that I’ve tested does.

Subjectively, players may report having a more difficult time turning or crossing over to one side compared to the other. Similarly, they may have a preference for or feel more explosive when stopping and/or pivoting on one side compared to the other. While structure clearly influences function, function similarly influences structure. Simply, as players bias toward a certain position or pattern, all of their body’s systems, most notably their nervous and musculoskeletal systems, will adapt to the stresses. Often times, a small bias can snowball into a glaring asymmetry later down the road. This process may take years to develop, but can have dire consequences on a player’s health, performance, and career longevity.

Superimposed Occupational Biases
The discussion on structural and functional asymmetries is further complicated by occupational biases. In this sense, “occupation” simply refers to the asymmetrical patterns that players of different handedness and positions perform regularly throughout their seasons. For example, a right-handed player will likely perform THOUSANDS of high velocity, high power rotations toward the left (think slap shot) that they will not perform toward the right during a season. A goalie will likely bias toward a side-bent positioned on his stick side. These occupational tendencies are superimposed upon the asymmetries discussed above, and can help alleviate or further exacerbate some of the aforementioned consequences.

Wrapping Up
In addressing these issues, it’s necessary to keep the player’s injury history, current structural and functional presentation, and current and future occupational demands in mind. Often times, it is wise address asymmetries secondary to a loss of joint neutrality first, as it is impossible for muscles to function optimally if they are positioned poorly. Using repositioning techniques from PRI, typically breath-driven exercises involving asymmetrical targeting of specific muscles, can help restore and reinforce neutrality, and interrupt a downward spiral of compensatory adaptations. The off-season is an appropriate time to assess players for these imbalances, and to increase the volume of strategically asymmetrical exercises. Players should be monitored periodically throughout the season to help minimize the cumulative damage a season of play from a non-neutral position can create. Ultimately, following this approach can help fend off many of the acute, progressive, and chronic non-contact injuries players face throughout their careers.

To your success,

Kevin Neeld

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Managing Structural and Functional Asymmetries in Ice Hockey: Part 1

Ice hockey places a huge multiplanar demand on the structures of the hip and thorax. As such, it’s imperative that players achieve and maintain full range of motion (ROM) in these areas. Complete ROM necessitates that the involved joint starts in, or at least is able to achieve, a neutral or centrated position. Unfortunately, many players suffer from one or more quite predictable losses of joint centration that negatively impact neighboring and remote joint position, function, and as more time is spent in these positions, structure. This topic has been addressed in depth by the Postural Restoration Institute (PRI) as it pertains to humans in general, and to specific sport populations, but little information is available as to the application of these concepts to hockey players.

Predictable Asymmetries
Regardless of what sport you compete in, all human beings share a similar anatomical make-up with inherent asymmetries. For example, we all have a heart and pericardium tissue in our left upper chest cavity that is not present on the right. We have three lobes of lung on the right, two on the left. The right hemi-diaphragm is 2/3 larger than the left, and is supported by the liver, which is not present on the left. These anatomical asymmetries, in conjunction with asymmetrical sensory and movement tendencies, create an environment whereby we, as humans, bias toward certain postures and positions, which affect joint neutrality, consequent ROM, and eventually structure.

PRI describes these patterns using uniquely named myofascial chains within the body, most notably the Anterior Interior Chain (AIC), Posterior Exterior Chain (PEC) and Brachial Chain (BC). If you’re unfamiliar with this terminology, I’d encourage you to read more about PRI at their site: Postural Restoration Institute. In the interest of simplicity, the most common pattern humans exhibit can be described as being stuck in the right stance phase of the gait cycle. This involves:

A weight shift to the right
A more supinated right foot and pronated left foot
A pelvis that is oriented to the right
A right hip positioned in a state of internal rotation, adduction, and extension
A left hip positioned in a state of external rotation, abduction, and flexion
A left lower rib flare and consequent loss of left diaphragm zone of apposition
An upper thorax that is rotated left to be positioned straight ahead
A right scapula that is depressed, protracted, and anteriorly tipped
A left scapula that is elevated, retracted, and posteriorly tipped

Note the orientation of the pelvis to the right and the compensatory rotation of the upper thorax back to the left

This is just a snapshot of the adaptations, as every joint from the distal phalanges of the foot to the lateral pterygoid of the cranium is affected. From a testing standpoint, these patterns present as a loss of or significant limitation to left hip adduction, left hip extension, left shoulder horizontal abduction, left shoulder flexion, and right shoulder internal rotation. The exact opposite patterns are commonly found on the opposite side. All of these limitations can be screened out in a few minutes using tests familiar to most medical professionals.

PRI’s “Adduction Drop Test”, a modified version of “Ober’s Test”

Additional hip assessments to consider. Note that a shift in rotation ROM from one side to another in these tests (e.g. same total ROM but different internal/external between sides) is potentially further evidence for a shift in joint orientation as per PRI’s philosophy

Part 2 of this series will describe how these patterns directly affect hockey performance and how they may contribute to common hockey injuries.

To your success,

Kevin Neeld

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The Myth of Wrist Strength in Hockey

As long as I’ve been around the game, I’ve heard players and coaches preach about the importance of wrist strength. As a player, I bought in hard. I had an old skate lace wrapped around a broken stick, with a weight plate at the far end. I actually had a few, with different weights at the end. At some point, a coach had convinced me that doing that exercise would improve my wrist strength, which would improve my shot power. I still hear players talking about this now. And, although the athletes at Endeavor have come to expect my skepticism regarding mainstream training practices, many are still surprised to hear me dismiss the importance of doing extra exercises to improve the wrists/forearms. Let me explain.

Will this improve your shot power? Not likely.

Where does the power come from?
There are several specific ways to train off the ice for improved shot power. Naturally, if we’re training with a specific goal in mind (as we always should be), we need to have a comprehensive understanding of the movement patterns and involved musculature that we’re targeting. Simply, if we can’t see the target, we’re unlikely to hit it.

When most players think of shot power, they think of the wrists. The wrists are an important piece of the puzzle, but they’re FAR from the primary power generators. The overwhelming majority of the power comes from the hips and core, which is then transferred through the shoulders, arms, and refined by the wrists. The relative and absolute amount of power generated through the hips and core differs depending on the type of the shot. This power path is easy to visualize in a slap shot, but it’s still present in snap shots, wrist shots, and back hands. In realizing this, consider the amount of musculature involved in the hips, core, and shoulder musculature, and then compare it to that of the forearms.

The wrists are more active in force transfer and directional refinement than power generation.

If you want to improve shooting power, you need to develop massive legs and hips, a strong core, and maintain appropriate mobility through the hips and thoracic spine. The benefit of this approach is that it’ll also make you substantially faster on the ice.

I had a conversation with Mike Boyle several years ago where he only half-jokingly said something along the lines of “it doesn’t matter how strong their wrists are, they’re too slow to get to the puck anyway.” Conveniently, the best approach for the overwhelming majority of players to develop a stronger shot is also the same approach they should take to get faster.

Diaper and partial convulsions optional. Heavy training mandatory.Movement vs. Muscles
Another major argument against players performing extra wrist work lies in the lack of specificity in the movement pattern. For starters, the velocity of traditional exercises (e.g. all forms of wrist curls) doesn’t come REMOTELY close to that of shooting. Also, with the understanding that shooting power is largely synonymous with rotational power, performing repeated wrist flexion/extension exercises doesn’t seem very appropriate. A better option would be to use a variety of rotational medicine ball exercises to develop this quality.

Med Ball Shotput w/ Rapid Step Behind & Partner Toss

Front Standing Med Ball Scoop w/ Partner Toss

These videos are a couple years old. As an aside, 5 of the 6 kids in the first two videos have moved on to play NCAA D1 hockey (the 4^th is playing D3). Of the players in the third video, one advanced to play in the ECHL (as a former D3 player), one was already playing D1, two more have moved on to play D1, and one has a full ride commitment to Boston College and is playing in the USHL. Simply, training hard works.

Overlooked Forearm Work
Finally, most players do drastically more forearm work than they probably realize. If your program encompasses exercises like trap bar deadlifts, stiff-legged deadlifts, dumbbell reverse lunges, dumbbell RFE split squats, farmer’s walks, and any other exercise that involves holding something heavy in your hands, like it should, the stimulus to the forearm and wrist musculature is huge. I’m aware there are different forms of grip, but in general I think performing these exercises in parallel with some periodic puckhandling and shooting on or off the ice is sufficient to meet the needs across the wrist joint.

Take Home Message
Doing some extra forearm work throughout the off-season likely won’t hurt, but it’s far from necessary and should NEVER take the place of more purposeful off-ice training. If your goal is to improve your shooting power, focus on improving lower body and core strength, maintaining good mobility through your hips and thoracic spine, and on rotational power exercises, such as those in the videos above.

To your success,

Kevin Neeld

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Strength and Conditioning Internships

Over the past several months, we’ve had more internship applications flood in for this Summer than we’ve had for any term in the 4 years that I’ve been at Endeavor. This, I believe, is a result of some of the networking we’ve done with local universities/colleges and the fact that Endeavor has become increasingly visible in the area and on a national scale, as we’ve received applications from students all over the country and a few from abroad. I’m always humbled when someone wants to intern and/or spend time observing at our facility, and am happy to see students being proactive about their future.

Throughout my interactions with these prospective interns, I’m realizing more how much of a wake-up call some students need. It seems that some students are more interested in making $8/hour standing on the floor of their local gym than they are about making sacrifices to pursue a quality learning experience. This is something that I’ve heard other coaches reference in the past, but I hadn’t seen much of it. I recognize that it isn’t always easy for students to volunteer their time in unpaid positions for several months. That said, not easy and not worth it are completely different things. It’s interesting that students will spend between $20,000-$150,000+ in a college education, much of which won’t directly translate into improved ability in a strength and conditioning setting, but can’t find a way to muster up a roughly $1,500 sacrifice in living expenses to intern. My friend, colleague, and former internship supervisor Eric Cressey wrote a great article on this topic that I highly recommend reading:

To backtrack slightly, I think some students view internships as a necessary evil to get college credits and finish their degree. “Why do I have to work for free?” In reality, internships are, by far, the best opportunity to learn training theory, program application, the art of coaching, and build a network of professionals in the field, all of which are critical to finding quality job opportunities in the future. If you want to get a decent job in collegiate or professional strength and conditioning, you’ll have to pay your dues.

For what it’s worth, I’m not preaching here. Over the course of my college experience, I interned at the University of Delaware working with football, men’s basketball, women’s volleyball and field hockey, at a private high school working with the athletes in every sport (where I was provided with an opportunity to write the programs and run the sessions), UMass Amherst with men’s ice hockey, women’s basketball, men’s soccer, and men’s and women’s skiing, and finally at Cressey Performance, where I gained exposure to training in a private setting with a wide range of clientele, from high school athletes to bad-ass senior citizens. Throughout those years, I’ve also taken advantage of opportunities to visit and observe at Michael Boyle Strength and Conditioning, Boston University, Holy Cross, Quinnipiac, and Nick Tumminello’s place in Baltimore.

The summer I interned at Cressey Performance I passed up an opportunity to run a series of hockey clinics in the Delaware area, and paid out of pocket to take a Functional Anatomy class that was part of BU’s DPT program. It’d be tough to directly quantify this, but I’d estimate that this decision, to live in Worcester, take a class at BU, and intern at CP was probably a $10,000-15,000 swing in the negative direction. And I can say, without hesitation, that it was the single best decision I’ve ever made. My only regret is that I didn’t wise up and start interning earlier.

To provide a quick illustration of the power of networking through these experiences, I volunteered under Chris Boyko at UMass Amherst. Chris introduced me to Eric at a seminar that Eric was speaking at, and Chris and I attended. This is where I talked to Eric about interning, which I received in part because of Chris’ recommendation. During my internship at CP, Eric introduced me to Mike Potenza, who was and still is the Strength and Conditioning Coach for the San Jose Sharks. Mike has become a friend, an incredible resource, a business partner, and has provided me with an opportunity to come out to help with their prospect camp and pre-season training camp. Eric also put a great word in about my coaching ability to Mike Boyle, who later provided me an opportunity to work with the USA Women’s National Hockey program. In other words, just about every experience I’ve had in professional and national team programs can be traced back to an introduction made through an internship experience I pursued. And this is strictly a discussion of the power of networking, let alone the indescribable amount I learned in all of these experiences about strength and conditioning, coaching, business, and family, among other things. I’ve also neglected to message the number of other coaches I’ve been fortunate to be introduced to, who collectively have been a huge educational resource for me, many of which have also become friends.

Everything I’ve been able to accomplish I owe to the terrific mentors I’ve had over the years, many of which I met directly or indirectly through internships. My situation isn’t at all unique. Almost every coach I know has a similar history of internships, volunteer experiences, and assistantships that have provided them with what they needed to be successful at jobs they enjoy, to live their dream. So when I hear students say things like “I can’t afford to spend a Summer interning”, I can’t help but think, “you can’t afford not to.”

To your success,

Kevin Neeld

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This Week in Hockey Strength and Conditioning

We’re wrapping up another busy week at Endeavor. I’m really excited for the weekend. Tomorrow morning I’ll be heading up to Boston with David Lasnier, Matt Siniscalchi, Anthony Vittese (a local PT that we’ve worked with a bit), and Ryan Podell (the Assistant Strength and Conditioning Coach for the Flyers) for the Boston Sports Medicine and Performance Group‘s Summer Conference. This has been the highlight of my continuing education endeavors for the last 4 years, and this year’s event will be the best to date. I’m looking forward to all of the presentations, and catching up with a lot of friends/colleagues that will also be in attendance. Hopefully I’ll see some of you there!

Over the last week I wrapped up a two-part segment on structural and functional barriers to optimal skating performance, and a simple coaching cue to help improve players’ confidence on the ice. If you haven’t already, check them out at the links below:

Also, I encourage you to check out this article on USA Hockey’s American Development Model if you didn’t last week: Understanding USA Hockey’s ADM

It was a slower week for us over at Hockey Strength and Conditioning content wise, but a few really good discussions are going on in the forums. Check out this off-season training program and video of two great barbell complexes to help improve lifting technique, while warming up the athletes:

Summer 2012 Phase 1 from Sean Skahan
Complex lifts as Pre-Strength Training Warm-Ups from Mike Potenza

Also, make sure you check out these discussion threads on the forum:

BioForce and First Beat HRV
How many days per week?
BSMPG
The Strength Coaches Combine
Recovery and Performance Compression Apparel
Whose Program to Implement
Shoulder Injury and Core Training
On-Ice Warm-Up/Cool-Down for PeeWee’s

Finally, don’t forget to weigh in on our new poll: “In the players you work with/see, what do you feel is the major limiting factor to their game speed?”

That’s a wrap for today. As always, if you aren’t a member yet, I encourage you to try out Hockey Strength and Conditioning for a week. It’ll only cost $1, and if it’s not the best buck you’ve ever spent, I’ll personally refund you!

To your success,

Kevin Neeld

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