Russell Gunner, C.A.T. (C)
It seems like yesterday that we were just finishing the play-offs in April and saying we will see you in September. Well, September seemed to arrive much quicker than we wanted it to. But it is time for another long and grueling hockey season. Over the summer, most athletes will have kept active in some way, either through an off-season conditioning program or playing other sports. Unfortunately, injuries will occur throughout the summer and these problems need to be addressed before the long season begins. This is where the pre-season medical can be extremely beneficial.
Although there are several ways to prevent injuries, the main one should be determining before competition if the athlete will be predisposed to injuries in the upcoming year. There are several ways a trained professional (Athletic Therapist, Physiotherapist, Medical Doctor) can determine this.
A pre-participation exam should always start with a questionnaire regarding the athlete's past and present medical problems. Most teams already do this, but once they notice a problem, are they equipped to deal with a particular situation. If a child notes that they are epileptic (seizures) or diabetic, does the coaching staff understand how to deal with this emergency situation when it arises. The pre-participation exam questionnaire should consist of emergency phone numbers, the child's health card number, and several questions regarding any present or past medical conditions this particular athlete has had, so that the situation can be dealt with effectively.
The next step would be to conduct a simple postural evaluation. Through a postural scan, the examiner can scrutinize for several problems, such as uneven curvatures of the spine (Scoliosis), knee dysfunctions, poor posture of the shoulders (which often lead to sore necks and backs) and far more. Through this evaluation, the professional can recommend several stretches and strengthening exercises that can easily correct these problems. Some problems require further medical attention to fix the condition, but most of the time when the kids are growing up, a few simple exercises can correct this. If these problems go unattended, chronic injuries are far more likely to occur.
Osgoode Shlatter's is a good example of a common chronic injury that kids experience in the knees. Pain will often be located just below the kneecap over the tendon. This problem often occurs due to a rapid growth spurt which kids go through between the ages of 11-16. The femur (large leg bone) grows extremely quickly, however, the quadriceps (thigh muscles) can not keep up with this rapid growth. This will correspond to the muscle becoming tighter, which causes undue stress upon the kneecap. The kneecap problem will then lead to excessive stress upon the tendon that attaches the kneecap to the lower leg. This problem can be easily avoided with proper stretching of the quadricep muscle group, and correction of postural dysfunctions of the pelvis.
Furthermore, the knee and shoulder tend to be the most commonly injured joints in hockey. Therefore, the pre-season medicals should address these two problem areas. Ligament stress tests of the joints can give the examiner an idea whether the athlete may be predisposed to injuries in the upcoming year. An athlete can often have loose ligaments, and not know this. When it comes to a simple stop or cut on the ice, these ligaments may not be able to handle the excessive stress, and give way. The loose ligaments can only be surgically repaired, but a proper exercise program to strengthen the muscles around the joint can help avoid these unnecessary ligament injuries.
Another stage that needs to be addressed is the actual physical fitness level of the athlete. A physical fitness test should be conducted that is hockey specific. Therefore, one should look at the strength and flexibility of the lower extremity, and the cardiovascular condition of the player. Often examiners will perform a vertical jump test to determine the leg strength of the hockey player, but when was the last time your player needed to jump up 15" to catch a puck? These tests should be guided to the age of the athlete, and the particular sport they are participating in. At Canadian Sports Therapy, we would not test a baseball player and hockey player with the same tests, because they use completely different muscles for their particular sport.
On a side note, did you know that 40% of all hockey injuries are either muscle pulls or contusions. These can be easily prevented through proper equipment fitting and conditioning of the athlete. An in-season off-ice exercise program would also be strongly recommended in the overall goal of preventing injuries. This would be especially important for athletes who have participated in some form off-ice program over the summer. The strength that was built up over the four months may fade unless the athlete continues some form of conditioning away from the rink. Professional hockey players will continue to work out off the ice all year long, even when they are playing and practicing every day.