Hip pain has become a significant issue in the sport of hockey. I’d imagine that hip pain has always been an issue in the sport, but maybe our ability to identify and diagnosis it has become more acute. Hip pain can come from a number of different injuries in hockey. Getting hit against the boards or falling hard on the ice can cause a hip bursitis or hip pointer injury. Hip flexor strains can occur from overstretching or from contracting a muscle that is not properly warmed-up or is deconditioned. Most of these injuries are fairly easy to correct and will usually not lead to any long-term disability or loss of significant playing time. The hip injury that is proving to be the most troublesome is called hip impingement.
Hip impingement is caused by a friction rub between the ball and socket of the hip joint. Skating mechanics cause the ball of the hip to travel rapidly through the socket and can create asymmetry. The result can be bony growth in the form of degenerative spurs on the outer rim of the ball and/or socket of the hip joint. Usually, this will cause pain in the front of the hip, but some athletes will feel pain in their groin area or in their back or buttock regions as well. Typically, the hip will feel like it has a limited range of motion. Sometimes it will feel like it needs to “pop” to provide temporary relief.
Hip impingement can also lead to cartilage and labrum damage of the hip joint. Cartilage is found at the end of bones to make them slide and rotate smoothly. The labrum is a soft tissue layer that runs from the outer rim of the socket and helps hold the ball of the hip joint in place. Both the cartilage and the labrum can be worn down and torn by excessive friction caused by hip impingement.
Hip impingement can be diagnosed by a healthcare provider that is educated about this type of injury. Typically, the diagnosis can be made from the history of the injury and certain hip tests that your healthcare provider will perform. X-rays and MRIs can help confirm the diagnosis and quantify the extent of damage to the surrounding structures.
The first step in recovering from this type of injury is specific stretching and strengthening exercises to bring some symmetry back to the hip joint (see videos below). The goal of exercise should be to decrease the intensity and frequency of hip pain. A combination of visual pain scales and hip-related questionnaires can be used to monitor progress. If after 3 months of consistent rehabilitation the athlete isn’t showing progress, then a surgical consultation should be considered.
At HockeyOT.com, we strive to provide training routines that not only will boost your performance on the ice, but will keep you healthy and playing injury free. Some of the areas that we have built into every program, are specific core stabilization and hip/shoulder mobility and strengthening. This approach will help maintain the health of your hip joints, and if you are already having hip pain, should help reduce your symptoms. Below are a few of the hip exercises that you should try if you are having hip impingement pain. Remember to seek guidance from your healthcare provider before trying these exercises.
Video #1 Hip Flexors Stretch with Gluteal Activation: It is important to lengthen the hip flexors around the hip impingement. Tight hip flexors will cause hip asymmetry and most hockey players have extremely tight hip flexors! Do 10 3-second contraction stretches for each hip 3-4 times daily.
Video #2 Hurdler Lead Leg/Trail Leg Lifts: Do 16 lifts for the lead and trail leg on each side daily. Keep your back straight on this exercise.
Video #3 3D Reach Sequence: Do 8 reaches for each position daily.
Video #4 Hip Circuit: Keep your trunk muscles active and stable to reap the benefits of this exercise. Do 12 slow repetitions for each side/position daily.
Dr. Chad Moreau is the President of HockeyOT.com, an online training site dedicated to improving the fitness level of hockey players of all levels. He was the former Strength & Conditioning/Nutrition Consultant for the Edmonton Oilers (NHL) and the Long Beach Ice Dogs (ECHL). For more information please visit hockeyot.com.