Over the weekend I posted a video at HockeyStrengthandConditioning.com of a former (and hopefully future) division 1 lacrosse player that I’ve worked with over the last few months at Endeavor Sports Performance. What makes this player unique is that he’s undergone 4 hip surgeries (2 on each side) secondary to femoroacetabular impingement (FAI) and bilateral sports hernia surgery. The video alludes to the importance of recognizing individual limitations and teaching the athlete how to move within his or her own confines.
Working with this athlete also highlights the importance of understanding these so-called abnormalities. When he first came to Endeavor, light jogging wasn’t even an option. In other words, his range of motion was so poor, damage so significant, and overall comfort level with athletic movements so degraded that we really had to start slow. A few months later, he’s sprinting, cutting, and jumping explosively and without pain; he’ll be the first to tell you that he’s never felt better. My ability to effectively work with athletes like this stems directly from the amount of time I’ve spent studying the relevant research. I think this information is valuable for anyone that trains anyone, but if you work with hockey players, it’s absolutely essential. The amount of research in this area has exploded over the last decade; understanding the causes and implications of FAI will help you more effectively train players that present with these injuries (which is most) and help to prevent unnecessary complications.
Illustrating “normal” hip joint anatomy and FAI abnormalities
Below is a brief review of some of the current literature:
High prevalence of pelvic and hip magnetic resonance imaging findings in asymptomatic collegiate and professional hockey players
The prevalence of cam-type femoroacetabular deformity in asymptomatic adults
Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers
Hip flexor muscle fatigue in patients with symptomatic femoroacetabular impingement
Can we predict the natural course of femoroacetabular impingement?
Treatment of athletes with symptomatic intra-articular hip pathology and athletic pubalgia/sports hernia: a case series
In my experience, most players do very well when they understand the limitations in their joint anatomy and are taught how to move within these confines. Because the primary suggested mechanism underlying athletic pubalgia involves a tug of war across the pubic symphysis between the adductors and abdominals AND because those with FAI tend to have very dense/fibrotic adductors, many players will benefit from some soft-tissue work in this region, especially in the area of the proximal adductor magnus attachment. Also, because posterior capsule density can push the femoral head forward in the joint and put excess stress on the anterior/superior labrum, this is another area worth having a manual therapist look at. The manual method itself is less important than the proficiency of the therapist. It can be tough to find someone that is comfortable working in that area, but it is well worth the trouble when you do!
To your success,
P.S. If you’re interested in learning more about hockey hip injuries and associated assessments and corrective strategies, I highly encourage you to check out my presentation “Hockey Hip Assessments: An In-Depth Look at Structural Abnormalities and Common Hip Injuries”, which is now available at Hockey Strength and Conditioning
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Kevin has rapidly established himself as a leader in the field of physical preparation and sports science for ice hockey. He is currently the Head Performance Coach for the Boston Bruins, where he oversees all aspects of designing and implementing the team’s performance training program, as well as monitoring the players’ performance, workload and recovery. Prior to Boston, Kevin spent 2 years as an Assistant Strength and Conditioning Coach for the San Jose Sharks after serving as the Director of Performance at Endeavor Sports Performance in Pitman, NJ. He also spent 5 years as a Strength and Conditioning Coach with USA Hockey’s Women’s Olympic Hockey Team, and has been an invited speaker at conferences hosted by the NHL, NSCA, and USA Hockey.