FEATURE ARTICLE
HIP AND GROIN HEALTH AND PERFORMANCE IN
HOCKEY PLAYERS
POSTURAL ASSESSMENT
Hockey players may present with two possible on-ice posture
scenarios: 1) anteriorly tilted pelvis with relatively straight leg
and forward upper body lean (Figure 4) and 2) posteriorly tilted
pelvis where the upper body is more upright (Figure 5). In the
first scenario, the hip is almost fully extended and the shin angle
is almost neutral, which may not be optimal for stride length
and force production. This type of posture may also put the
athlete at risk for lower back pain and/or hip flexor pain. In the
second scenario, the torso is upright and posteriorly shifted
center of mass, which may stress the abdominal musculature and
is not biomechanically optimal for forward locomotion (2). An
appropriate skating posture would be one where the athlete has a
neutral pelvis and spine, and positive shin and torso angles (Figure
6). The frontal position of the knee relative to the hip, lateral
tilting, and hip rotation are other areas of concern when assessing
the posture of a hockey player. The most common area of concern
for hockey players is the presentation of excessive anterior pelvic
tilt which typically relates to a combination of poor motor control
of the pelvis, excessive tone in hip flexors and back extensors, and
weakness in lower abdominal and gluteal musculature.
MUSCLE FUNCTION AND MOVEMENT ASSESSMENT
The function of hip musculature and movement quality should also
be a component of the assessment of risk. These can include lying
hip abduction (with and without resistance), seated psoas testing
(with and without resistance), Functional Movement Screen or
variation, and the ability of the athlete to perform basic movement
patterns (i.e., squat and hip hinge) both bilaterally and unilaterally.
Assessment of core endurance is also necessary to ensure the
abdominal muscles are fit to help maintain lumbopelvic-hip
control during periods of fatigue. Two tests to identify core
endurance include front and side planks, where two minutes of
holding with perfect posture should be the goal.
INTERVENTION/PREVENTION
The intervention/prevention program should target areas specific
to the individual and hockey players in general. The basic structure
of this program should focus on four main points (see Table 1 for
sample program): 1) inhibition of tonic tissue, 2) muscle length and
joint mobilization, 3) muscle activation, and 4) postural control
and integration. These program components will help minimize the
risk factors above and aid in teaching the athlete how to control
their lumbopelvic-hip complex.
INHIBITION OF TONIC TISSUE
There may be areas in which the soft tissue is tonic and short,
and these must be addressed prior to joint mobilization work.
This can be done by a professional in manual therapy or by the
athlete, utilizing various self-myofascial release (SMR) techniques
such as foam rolling, rolling on a soft ball or lacrosse ball, or a
massage stick. Common concerns for hockey players include
tonic hip flexors, tensor fasciae latae (TFL), rectus femoris, lateral
hamstrings, and possibly spinal erectors. It \?[\\?]]?H??[????^H ^Y\?? ????\?? \?H \?X?[\?\?X\? ?[H ?[?[??[?H [YH? Z\?[?]?Y X[ ??[H\?X\?\?Y[?Y?YY \?[??\??\??Y[? ???UT??HS??S???S?S?SV?US??Y?\?Y ?\??[??]\??[\? ?K ?\?[?\?[??[?[??[??[?[^?][? ?[ ? ??[?H \???YY ??X]H[?[] H[? B???[??XZ[?Z[?[?[] KY?Y\]X]K?\?H ?[ ? ??[???\??[ [?\??[?[?
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