Lower Back Injury Prevention for Hockey Players
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Imagine if you didn’t have to suffer from that niggly lower back pain caused by playing as much hockey as you do. The lower back is one of the most common injury sites in hockey (Barboza et al., 2018; Dick et al., 2007; Murtaugh, 2009). The low positions and repeated forward flexions performed in hockey mean that the lumbar spine experiences a great deal of stress. As you will find yourself in half-rotated positions on a regular basis and perform frequent lunges and tackles in low shapes, you are putting certain tissues and joints under more load. Studies have shown that up to 53% of hockey players report some degree of lower back pain (Reilly and Heaton, 1990). Other research has found equivalent rates of lower back pain when compared with other sports, but even so, over half of respondents reported this problem (Haydt et al., 2012). Clearly, this is a problem in the hockey world and one that many players are experiencing. Before continuing, please always seek out medical guidance if you are experiencing ongoing pain. This is not individual advice, and if you are worried, please seek out a qualified professional for diagnosis. How can I improve my lower back pain? Research suggests that there are 3 main areas to focus on when seeking to improve lower back pain in hockey players: 1) Improve lumbosacral and hip joint range of motion 2) Increase trunk strength and capacity 3) Strengthen the posterior chain, including the glutes Improve lumbosacral and hip joint range of motion Female hockey players experiencing lower back pain have been found to have between 18-24 degrees less total lumbosacral (lower back/pelvis) range of motion than pain-free and control group athletes (Fenety and Kumar, 1992). This would suggest a link between how much range we can cope with and the incidence of back pain. It’s important to note that some of this research was completed a while ago, and the game of hockey has moved on significantly since. However, the principle remains the same - improved mobility can have a positive effect on the incidence of lower back pain in hockey players. M This makes a lot of sense, as the less range of motion you are able to achieve, the more stress you will experience per unit of tissue cross-sectional area. In layman's terms, the more range you can achieve, the more you can dissipate stress over a larger area. This means less repeated loading on the areas of the body most at risk. Therefore, mobility has been linked to improved lower back pain in hockey players. Some great hip and lower back mobility exercises are as follows:
​ Strength training around the muscles of the trunk is key. Muscles including the rectus abdominis and obliques help to ‘stiffen’ the spine, reducing the shear forces and the need for the lumbar muscles to perform additional work (Willard et al., 2012). Peak eccentric trunk extension torque scores have been found to be weaker in hockey players experiencing lower back pain (Fenety and Kumar, 1992). In simple terms, the greater the forces that can be resisted in lower back extension, the lower the prevalence of lower back pain. A stronger trunk may therefore help to reduce this issue. Some great exercises to strengthen the lateral trunk muscles (obliques/transverse abdominis) include:
Some great exercises to strengthen the anterior trunk muscles (rectus abdominis) include:
Aim to complete 150-300 reps of a combination of anterior and lateral trunk exercises as part of a circuit. This should take you around 7-12 minutes to complete. Strengthen the posterior chain, including the glutes​ The final area to target when aiming to reduce lower back pain is strengthening the posterior chain. This is especially important around the glutes, which act as major force producers at the hip and prevent excessive lumbar muscle work in hip extension. Exercises to strengthen the glutes include the following:
References Barboza SD, Joseph C, Nauta J, van Mechelen W, Verhagen E. (2018) Injuries in Field Hockey Players: A Systematic Review. Sports Med. 48(4):849-866. Barboza SD, van Mechelen W, Verhagen E. (2017) Monitoring Field Hockey Injuries: The First Step For Prevention. British Journal of Sports Medicine. 51:312. Dick R, Hootman JM, Agel J, Vela L, Marshall SW, Messina R. (2007) Descriptive epidemiology of collegiate women's field hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2002-2003. J Athl Train. 42(2):211-20. Fenety A, Kumar S. Isokinetic trunk strength and lumbosacral range of motion in elite female field hockey players reporting low back pain. J Orthop Sports Phys Ther. 1992;16(3):129-35. doi: 10.2519/jospt.1992.16.3.129. PMID: 18796763. Haydt, Richard & Pheasant, Steven & Lawrence, Kevin. (2012). The incidence of low back pain in NCAA division III female field hockey players. International journal of sports physical therapy. 7. 296-305. Kennedy, J. E. (2014). The Effect of Low Back Pain on Hip Range of Motion and Gluteus Medius Function in Field Hockey Players (Thesis, Master of Physical Education). University of Otago Murtaugh K. (2001) Injury patterns among female field hockey players. Med Sci Sports Exerc. 33(2):201-7. Murtaugh K. (2009) Field hockey injuries. Curr Sports Med Rep. 8(5):267-72. Reilly T, Seaton A. Physiological strain unique to field hockey. J Sports Med Phys Fitness. 1990 Jun;30(2):142-6. PMID: 2402133. Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. (2012) The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat.221(6):507-36. ​ |
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