Sporting injuries can be caused by contact (e.g traumatic) or non-contact (e.g overuse) mechanisms in nature, with contact injuries more often being associated with extrinsic risk factors, which are out of the control of the athlete in a single, identifiable incident [1-5].

Causes of Non-Contact Injuries

Although oftentimes due to a multifaceted cause, non-contact injuries are typically not as well defined by a single athletic event, and are often associated with accumulation of many ‘micro-traumatic’ repetitive movements controlled primarily by intrinsic risk factors [1-5]. It’s important to consider the multitude of potential intrinsic risk factors that affect non-contact injury occurrence in order to put preventative measures into place and to, hopefully, reduce the risk of injury occurrence. Lack of muscular strength, compromised range of motion (ROM), and previous injury, are all intrinsic risk factors thought to contribute to non-contact injury occurrence/recurrence [6-17]. Other intrinsic risk factors for non-contact injury include: loss of neuromuscular control (via fatigue) [18-23], drastic changes in training load [23-28], and low levels of fitness [28-31], among others. The nature of non-contact injury is multifaceted; no single intrinsic risk factor is the sole cause of injury.

The Role of the Hip in Ice Hockey

The importance of having healthy hips for ice hockey performance cannot be overstated. The locomotion within the ice hockey skating pattern requires unique hip involvement, compared with land-based maneuvers [32-38]. Increased motion and activity of hip abductors, external rotators, flexors, and extensors, are characteristics of on-ice acceleration and sprinting prowess [33-35, 39-42]. While the hip is responsible for the concurrent explosive abduction, external rotation, and extension during forward propulsion of skating [33-35, 43], hip flexion, adduction, and internal rotation predominate to stabilize and decelerate the lower limb during the recovery phase of the ice skating stride [13]. This synchrony of hip movements can put the hip in precarious positions, and when supplemented with the high loads/stresses that routinely pass through the hip during skating, the risk for non-contact hip injury increases [33-35, 39-41].

Better Players Have Greater Hip Involvement

These contributions at the hip joint are exacerbated in high-caliber players, compared with low-caliber players. High-caliber players achieve higher ice skating acceleration rates and sprint speeds than their low-caliber counterparts [32, 38, 44-48]. High-caliber players typically exhibit higher stride rates, as well as increased knee and hip flexion rates when loading during on-ice acceleration [38, 46-48]. Although a paucity of research currently exists, the greater amount of hip flexion when returning from the recovery phase of the skating stride is thought to allow for greater concentric contraction during the propulsive phase, resulting in the increased speed observed in high-caliber skaters [48]. Theoretically, the increased hip flexion should result in an increased amount of hip abduction, allowing the hip to maintain an ideal propulsive angle for efficient forward movement on-ice [49, 50].

Summary

The relationship among multiple intrinsic, modifiable risk factors seem to be the primary cause of non-contact injuries in sport, whereas contact (e.g traumatic) injuries are often  associated with extrinsic risk factors, which are out of the control of the athlete. It’s quite clear that compromised hip function can drastically impair on-ice movement capabilities, which can increase risk for non-contact injury and reduce on-ice performance. The finer details of the ice hockey movement biomechanics reviewed must be appreciated in order to develop appropriate ice-hockey-specific hip screening protocols and training interventions. Click here to move on to Part 2, which outlays how common hip injuries occur and discusses what can be done to prevent them.

To see how susceptible the hip is to injury and the risk factors for groin strains, go here.

To see the different types of hip/groin injuries that can occur, go here.

To see the costs (financial and other) of injury, including hip injury, go here.

To see how to develop a hip screening and monitoring protocol, go here.

To see how to treat different types of hip pain, go here.

To see how early ice hockey specialization (i.e. year-round participation) can negatively impact the hips, go here.

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