Lower Limb Injuries in Field Hockey

Field hockey requires a rapid succession of movements and sudden changes in direction that place considerable stress on the lower extremity of athletes, making them susceptible to injuries.

Played on different kinds of surfaces – artificial turf, indoors or natural grass – hockey has evolved significantly in terms of modifications to equipment, rules and surfaces. All these have contributed to changes in the kinds of injuries that have been observed in the sport over the years.

With differing positions requiring the implementation of different tactics and techniques, the playing position of a hockey player can also determine the types and frequency of injuries; for instance, studies have shown that defenders and midfielders have the highest proportion of injuries compared to goalkeepers and strikers.

A clear understanding and identification of the varied risk factors involved in increasing an athlete’s predisposition to lower limb injuries can help in the effective management and prevention of hockey injuries.

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Mohamed Badr and Ahmed Gaballah, from the Damietta University in Egypt, conducted a study to examine injury patterns in Egyptian field hockey players by interviewing 75 players from eight teams about the injuries they had experienced in their professional careers.

Based on the information provided by the athletes, the authors established that the most injured anatomical sites were the pelvis and thigh region, with all players reporting a higher frequency of low back pain and cramps of the hamstring muscles.

This is an important observation as it helps focus on the need for adequate warm ups and muscle stretching both during training and before a match; individualised training programmes must take into consideration history of injuries and appropriate choice of protective gear to further reduce the risk of injury.

Julianne Ryan, from the Department of Clinical Therapies at the University of Limerick in Ireland, reviewed literature on the risk factors for groin/hip injuries in field-based sports such as hockey, identifying 11 significant risk factors for these type of injuries.

The most significant risk factor was observed to be player’s history of a previous injury followed by older age and weak hip adductor muscles; the clinical reasoning behind player’s history was given as remaining deficits in physical conditioning, scar tissue formation, inadequate rehabilitation, reduced proprioception, altered movement patterns, premature return to play after initial injury and frequency of injury.

As described by the author, “as the players age, their body’s collagen tissue changes in nature becoming less elastic and less able to absorb forces. This then results in the tissues being less adaptable to respond to quick force changes (characteristic of the biomechanics involved in field-based sports) or recover from fatigue”.

Improving weak hip adductor muscles can be accomplished through an active rehabilitation programme with stretching exercises designed to enhance hip external rotation and abduction in extension and flexion.

Such a programme should be implemented in conjunction with the use of customised foot orthotics such as MASS4D® which can help in the treatment and management of biomechanical discrepancies such as a hyperpronated foot that could potentially increase abnormal movement patterns of the lower limbs including the hip.

By minimising compensatory movements of the hip, active rehabilitation programmes have a higher probability of achieving successful outcomes and the athlete has a better chance of recovering faster whilst being protected from common hockey injuries of the lower limbs.

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Related Links
Treatment of Low Back Pain with Orthotics
Treating Hamstring Injuries with Orthotics
Active Rehabilitation Programmes

References:

1. Badr, M. A. M. A. A., Gaballah, A. M. A. (2015) Common Injuries among Male Field Hockey Players According to Playing Positions. Journal of Applied Sports Science: March 2015, Vol. 5, No. 1, pp. 19-26.
2. Ryan, J., DeBurca, N., Creesh, K. M. (2014) Risk Factors for Groin/Hip Injuries in Field-based Sports: A Systematic Review. British Journal of Sports Medicine: May 2014, Vol. 48, No. 14. DOI: 10.1136/bjsports-2013-092263

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