Common Hockey Injuries | Prevention and Treatment

Field hockey is one of the most popular sport, with an injury rate of 6.3% per 1000 athletes. The mechanism of injury can be intrinsic or extrinsic, the extrinsic injury may be caused by a stick or a ball and intrinsic injury may be caused due to overuse or internal force acting on the muscles that include, shin soreness, tendonitis, plantar fasciitis, and many more. Being a fast-paced collision sport with non-stop furious action, players in this game are at risk of injury at any moment. They can sustain injuries to the head, face, shoulder, arm, thigh, and knee and to prevent these injuries the players need to ensure that the muscles and the joints are properly warmed up. These warm-up exercises should be done under the guidance of a physiotherapist. In this blog, we will discuss the common injuries suffered by field hockey players and tips for their prevention.

Prevention of Hockey Injuries

To help prevent or reduce the risk of hockey injuries the player should follow a proper conditioning training program.

• Proper Warm-up exercises like stretching should be done to prepare the body for activity.
• Wear proper protective gear.
• Maintain proper nutrition and hydration to help perform better during training and to heal faster after injury.
• Cooldown and stretching exercises should be done after the game.
• Proper Exercise programs should be maintained to build endurance and balance thus preventing injury.

 Common injuries in hockey players

Concussion

• Concussion is a brain injury the can occur due to a sudden blow to the body and head by a stick or elbow or by bone crunching. Symptoms may include headaches, dizziness, nausea, balance issues, mood changes, etc. Immediate medical advice is required in case of concussion. If a concussion is suspected, the player should not return to play until the symptoms decrease. The physiotherapist recommends rest in the initial days both mental and physical rest.

 Bruises and Contusions

• Contusions or bruises occur due to the rupture of the small blood vessels. Resulting in the discoloration of the skin, it might appear black and blue, due to the leakage of the blood under the skin. The player feels pain with a swollen red bruised area if it is a large bruise then immediate rest is the best treatment.

Whiplash injury

• Whiplash injury can happen by an abrupt or unexpected backward or forward motion of the neck. Falling suddenly or getting hit causes the head to jerk and the neck gets strained. It occurs commonly in contact sports, like hockey causing pain, numbness in the arms due to minor or major soft tissue damage to muscles and ligaments in the neck and vertebrae. The recovery of the player depends upon the severity of the injury.

 Acromioclavicular joint injury

• The prevalence of shoulder injuries is high in hockey. The most commonly seen shoulder injury is Acromioclavicular (AC) joint injury, also known as a shoulder separation. This injury occurs due to direct contact hit into the shoulder. The severity can vary from a sprain to a complete tear of the involved ligaments. The physiotherapy treatment includes immobilization by rest in a sling followed by isometrics and gentle ROM exercises.

Rotator cuff injury

• The most common cause of a rotator cuff tear is repetitive microtrauma, which can occur over some time. Bruising or swelling occurs due to the repeated rotator cuff injury by pinching or straining, catching, or squeezing the rotator cuff tendons. Physiotherapist focuses on reducing inflammation and pain. The therapist recommends ROM exercises, isometric exercises, and capsular stretching, followed by isotonic exercises and aggressive pain-free strengthening.

 Groin strains

• Groin or medial thigh pain is the most common injury in hockey players. The player feels tenderness and swelling. The strain of the hip flexors and adductors occur as a result of quick movements and change in the direction while playing. Initially, RICE is given. Gradually ROM, stretching and strengthening exercises including, active ROM exercises of hip and isometric exercises, straight leg raises (SLR), quadriceps are recommended. Followed by aquatic deep water pool running, stationary bicycling with no resistance.

Hamstrings injury

• A hamstring injury occurs due to a lack of flexibility, strength, and muscle imbalance of hip flexors, quadriceps gluteals, and lower back muscles.  Muscle imbalance and fatigue between hamstring, quadriceps, and gluteal. The injury also occurs due to a lack of warm-up exercises so the muscles are making it vulnerable to injuries. Physiotherapy treatment is directed towards the restoration of strength and flexibility of the muscles. After RICE, Isometric exercises are initiated, further replaced by isotonic exercises with light weights. When the player is pain-free.  a high-speed, low-resistance isokinetic exercise program is initiated with pool walking and stationary bicycle with no resistance.

Meniscal injury

• Medial meniscal injury usually occurs due to sudden rotation on a fixed foot. Damage occurs when the foot is partially flexed with the foot on the ground and rotational forces are applied to the knee. Lateral meniscal injuries occur less frequently than medial meniscal injuries. Damage to the lateral meniscus occurs when the foot is fully flexed with the foot fixed on the ground and both rotational and compressive forces are applied. Physiotherapy treatment aims to reduce pain and inflammation, maintain joint ROM, further improve strength, proprioception, and balance, using techniques like walking, running, squatting, and hopping and minimize chances of re-injury.

Anterior cruciate ligament (ACL)

• The anterior cruciate ligament (ACL) is the ligament in the front of the knee joint. Injuries to ACL occur most commonly in hockey, as there is a tremendous amount of side-to-side movement, cutting, pivoting movements, etc. An ACL sprain or tear occurs when an athlete turns while their foot stays on the ground. The physiotherapist recommends RICE and bracing. Followed by exercises for hyperextension- prone hang towel stretches, heel props, and wall slides.

 Shin splint

• Hockey players are often at risk of developing shin splints. This injury occurs due to the hard and unyielding nature of the artificial turf. Fascia, a connective tissue attaches along the edge of the tibia, when tension is put on muscles behind the leg, it causes inflammation or injury along this fascia. Repetitive bending and compression force may also cause bone stress. Physiotherapy aims to improve flexibility followed by isometrics exercises and progressed to Theraband practices and balance training.

Ankle strain

• Hockey puts a lot of stress on the ankles, causing ankle strain. This injury occurs when the ligament is stretched by rolling inward, causing a ligament tear. The damage can range from mild to severe. The patient feels immediate pain, swelling, and tenderness around the ankle. Physiotherapist instructs to take to RICE i.e. rest, ice, compress, and elevate. Followed by ROM, stretching, and strengthening exercises.

 Emotional stress can be caused due to pressure to win, sports are fun to play, and winning should not be considered as an important aspect of sports. Stress should be laid on being physically active and fit and above all feel good.

This article was first published at CB Physiotherapy