With the Stanley Cup finals now complete and the champions crowned (GO BLUES!), reports of injuries players played with throughout the playoffs are making their way to the surface. I was astonished to see the injuries suffered by Bruins players. In case you haven’t seen it, check out the picture below (Twitter @connorryan).
The fact that these guys played through these injuries, Miller being the only player not to play in the majority of games, goes to show their desire to win the Stanley Cup. But it doesn’t matter who you are, when you are beat up like this, individually and as a team, you cannot play at your best. And I know that at this time of the year everyone is dealing with injuries and nobody is playing at 100% after a grueling season, but it seems to me that the team that is able to remain the healthiest has the best chance at winning.
As far as I am aware, the Blues played most of the playoffs with a pretty healthy lineup. Word has come out that O’Reilly, Tarasenko and Thomas played through some injuries, with Tarasenko and Thomas undergoing surgery after celebrating their victory. And I believe that was the difference in the final two rounds of the playoffs for the Blues.
I had tweeted earlier about Karlsson suffering from a groin injury that affected his play in game 5 and kept him out of game 6 against the Blues. With a guy like Karlsson, who can take over the game for any team, out of the lineup the Blues easily took the Sharks in 6 games.
Another example of this is with the Toronto Raptors (GO CANADA!) winning the NBA title, and using Khawi Lenoard sparingly throughout the season as a load management tactic to manage a quad tendon injury that kept him out of all but 9 regular season games last season. The fact that Leonard was able to play and perform like he did in the playoffs, carry the Raptors to the finals and beat the Golden State Warriors in 5 games has changed basketball in Canada forever. But even Lenoard said in multiple reports that he couldn’t have done it if he had have played the whole regular season.
The point I’m making is that sports medicine teams play a huge roll in player and team success. In fact, I came across in one of John Snyder’s articles – Ice Hockey Injuries: Who Gets Hurt and Why Does It Matter? this interesting table that showed that over a 5-year span in the NHL from 2010-2015, teams with the least amount man games lost were more successful and won more cups. In other words, the healthier teams had more success than the teams plagued by injuries.
Now don’t get me wrong, hockey players are some of the toughest athlete’s around. And I give full respect to these players for playing through these injuries. I also understand that injuries happen and are not a thing that we can always prevent. But this tweet from Eric Cressey got me thinking, do we put enough emphasis on the use of sports medicine professionals in sports like hockey as well?
Here’s 3 reasons why sports medicine professionals (PT/ATC/Chiro/CSCS/MT/Sports Doc etc.) are vital for individual and team success.
Injury prevention
Most sports have high demand for specific movements. Through the repetitive nature of these sports, athletes fall into compensatory movement patterns from muscle imbalances caused by the sport. The compensatory movement patterns can lead to common overuse injuries such as muscle strains and tendinopathies. With a team of sports medicine professionals, they can identify these faulty movement patterns, work on correcting them and reduce the risk of injury before any overuse injury occurs. Hockey players tend to have tight hips. If the players can’t move well through the hips, the body will take the path of least resistance in order to move, in this case usually through the back. By managing the effects of playing on a regular basis to maintain appropriate hip range of motion with proper soft tissue care, mobility work and strengthening, we can reduce the risk of players developing compensatory movement patterns and injuries.
Sports medicine professionals also often know the risk factors associated with certain injuries. Their knowledge of such information can help them identify athletes with these risk factors and work on modifying these risk factors to reduce the risk of injury. One common injury in hockey players are groin strains. Research has suggested that a primary risk factor for this injury is as hip adduction:hip abduction ratio of less than 80% (Tyler et al., 2001). If identified early, the sports medicine team can work on increasing that ratio and reduce the risk of groin strains in hockey players.
By reducing the risk of injury, players are able to play at a high level for longer, and possibly be healthy throughout the playoffs. Again, looking back to the Sharks vs Blues series, if Karlsson wasn’t affected by that nagging groin injury, the Blues might not have made it past the Sharks and the Sharks could be Stanley Cup Champions.
Injury management
Injuries are inevitable in an athlete’s season and career. This is where sports medicine professionals thrive. Most athletes get banged up during the season and playoffs, therefore it is important to address any issues before they become severe injuries. For example, hockey players are known to suffer from groin injuries. But even worse is that they often don’t just suffer from one, they are too often a reoccurring injury (not trying to pick on Karlsson but…) (Tyler et al., 2001).
It’s important for athletes to get in and get treated early in order to minimize the damage. Most overuse injuries are manageable in the early stages with some proper soft tissue care, mobility work and strengthening without missing much playing time. It’s when athletes don’t communicate with the sports medicine team early and they continue to exacerbate it that it can reach the point where players have to sit out weeks and months in order to recover. And when those injuries are starting to pop up at the end of the season and in playoffs, nobody wants to be sitting in the stands with an injury that could’ve been managed early on.
There is also a role for sports medicine professionals after the injury is healed, in managing workload and monitoring symptoms just like the Raptors did with Leonard. Especially in athletes who have been out of the game for a prolonged period of time, we don’t want to spike their workload because that can put them at a higher risk of reinjury or another injury (Murray et al., 2017). So managing their practice time, ice time, workouts, etc. in order to make sure they make a healthy return but are continuing to make progress. And also continuing to monitor workload and symptoms throughout the season and playoffs in order to catch any reinjury early and begin managing it immediately.
Performance enhancement
Going back to my point earlier on correcting compensatory movement patterns for reducing the risk of injury, the same can be said for improving performance. When players fall into these compensatory movement patterns, the body is using the path of least resistance meaning it is being the most efficient. But the most efficient movement pattern isn’t always the best one.
One example is the skating stride. Recent research has shown that high caliber skaters use a greater total hip abduction range of motion than lower caliber skaters (Buckeridge et al., 2015). Going back to the same example of hockey players having tight hips, these players may lack extension and abduction range of motion. Again, the compensatory movement will likely be from the back because it is the path of least resistance for the body. This makes the movement more efficient for the body in this situation but a less efficient and less powerful for skating stride due to the lack of hip extension and abduction. Working with sports medicine professionals can help identify this issue, optimize the range of motion and maximize the skating stride throughout the season and playoffs.
Sports medicine professionals can do so much more than just help you return to playing after an injury. Find yourself one that you trust and one who knows the ins and outs of your sport and see them on a regular basis to make sure you are healthy and at your best when the game is on the line.
Matt Kelly, PT
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References
Buckeridge, E., LeVangie, M. C., Stetter, B., Nigg, S. R., & Nigg, B. M. (2015). An on-ice measurement approach to analyse the biomechanics of ice hockey skating. PloS one, 10(5), e0127324.
Tyler, T. F., Nicholas, S. J., Campbell, R. J., & McHugh, M. P. (2001). The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. The American journal of sports medicine, 29(2), 124-128.
Murray, N. B., Gabbett, T. J., Townshend, A. D., & Blanch, P. (2017). Calculating acute: chronic workload ratios using exponentially weighted moving averages provides a more sensitive indicator of injury likelihood than rolling averages. Br J Sports Med, 51(9), 749-754.