Hockey Knee Pain

One of the things that became painfully clear after a year working with a collegiate women’s hockey team is that females are plagued by knee injuries. The demands of the game and consequent injuries are considerably different between college men’s and women’s hockey. What I learned, though, is that many injuries that I heard about weren’t the result of anything hockey related.

At the beginning of the season, several girls complained about feeling a slight strain of their quads and hip flexors while sprinting. That doesn’t seem uncommon, except it was over 30 minutes into the session after an overly comprehensive warm-up, core work and jump training. It was also about 10 yards into a 30-yard sprint. In my experience, most muscle strains occur further out than that. I was perplexed. After some questioning, I learned that ALL of the girls with those complaints regularly ran for distance regularly or were consistently involved in spinning classes. Now we’re getting somewhere.

Some soft tissue work, anterior hip stretches, and posterior hip activation and strengthening cleared that up. A long discussion on the potential benefits (e.g. increase energy expenditure) and risks (anterior hip tightness, various overuse injuries, chronic knee, hip, and lower back pain) associated with spinning classes and distance running also helped them understand why they feel the way they do.

Recently, one of the girls told me about knee pain she’s had that has prevented her from running. She had actually been to a couple doctors and physical therapists and learned she had patellofemoral syndrome (which seems to be a garbage term for knee pain that is tossed around as much as shoulder impingement), and chondromalacia. None of her therapy time had lead to any long-lasting improvement in her symptoms.

I’m not going to delve into all the reasons females have a difficult time surviving the stresses of running, but the primary causes of these difficulties are a wider pelvis and just being weak. As you might imagine, this story has a happy ending.  Three weeks after starting a program I put together, she ran for 45 minutes pain free.  I don’t necessarily condone her decision to jump right back into a long run (and she knows that), but was pretty thrilled she was able to go for that long without any pain.

Check back in with me this week. In the next couple days I’ll be discussing the reason why many people don’t have long-term success with physical therapy. I’ll also be posting the exact program template that I gave the girl with the knee pain. She’s been running consistently over the last month or so without pain, so hopefully you can pick up on a thing or two from it that may help you or someone you know. As always, I’d be interested in hearing your feedback.

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