Preventing field hockey injuries

Daily exercise is part of a winning recipe for keeping fit and healthy. While the positive repercussions of youth sports are innumerable, it can also have its share of disadvantages. One of them is the risk of injury. Indeed, sport is the leading cause of injury among young people(1). Fortunately, much is being done to reduce the risks, and there are effective strategies to prevent injury. These include education programs, changing the rules of the game, wearing safe equipment, and pre-season and in-season training programs. Here are just a few examples of how science has had a positive impact on the health and safety of field hockey players.

Education programs
Education programs can be used to improve the knowledge of players, parents and coaches with the aim of preventing injuries. For example, Think First Canada, a foundation dedicated to the prevention of brain and spinal cord injuries, has produced a video explaining the causes and symptoms of concussions, as well as recommendations on how to prevent them. Not only did the players who saw the video demonstrate greater risk awareness, they also modified their on-ice behavior, unlike the players who didn’t watch it. In fact, there was a significant reduction in the number of double-checks and back-checks among players who took part in the screening(2). This is just one example of how education has brought about positive changes on the ice. It’s for this reason that SciencePerfo has made it its mission to increase the knowledge of the people who gravitate around field hockey through its articles, conferences and other interventions.

Regulations
In the U.S., approximately 98,000 injuries a year are the result of breaking a playing rule(3). In other words, compliance with these rules would probably reduce the number of sports-related injuries. An example of a regulation that has been derived directly from scientific observations is the age at which checking should be introduced. Many experts claim that learning to check at an early age promotes better technique and is therefore protective for future years. However, some studies invalidate this argument. In fact, players who have been exposed to body checking as early as the Pee-wee level are at greater risk of injury not only at the Pee-wee level, but also at the Bantam(4) level. SciencePerfo will be keeping a close eye on studies into the impact of Hockey Québec’s new regulation banning body checking at the Bantam CC and Midget CC levels.

The equipment
A simple example where the choice of equipment has a direct impact on the risk of injury is when choosing a field hockey helmet. While no helmet prevents the risk of concussion, there is a clear difference in injuries to the face, eyes and teeth when full face protection is used. Wearing a half-visor increases the risk of injury compared with wearing a full-face helmet, but still reduces the risk compared with a helmet without a visor(5). These discoveries led to changes in the NHL, where the current half-visor is mandatory for new players making their league debut.

Specific training program
One way to reduce the risk of injury during the season is to prepare well physically and maintain an optimal level of fitness throughout the year. It’s in this area of injury prevention that SciencePerfo’s kinesiologists, biomechanists and physiotherapists specialize.

The identification of certain risk factors guides the intervention strategy specific to each situation. For example, an athlete who has suffered a lower-body injury is twice as likely to suffer another lower-body injury than a player who has never had one. Therefore, an injury prevention program will be designed according to the injury history to reduce the risk of recurrence. This is a good strategy for protecting players identified as being at greater risk of injury(6).

Other risk factors can be identified and mitigated through a specific exercise program. A concrete example in field hockey is the normalization of hip adductor muscle strength to prevent groin injuries in at-risk players(7). Although the risk cannot be completely eliminated, the exercise program used in this study helped reduce the risk of suffering such an injury by almost 80%. In planning exercises, particular attention is paid to risk factors identified through injury history and player-specific assessment.

In short, whether through teaching, modifying the rules of the game, using adapted equipment or training, the above examples demonstrate that it is possible to reduce the risk of injury and mitigate the negative effects of sport.

Written by Maxime Provencher, M. Physiotherapy

References:
1. Andrea S. Goldberg & coll. Injury Surveillance in Young Athletes A Clinician’s Guide to Sports Injury Literature. Sports Med 2007; 37 (3): 265-278.
2.Cook, D.J., M.D. Cusimano, C.H. Tator, & coll. Evaluation of the ThinkFirst Canada, Smart Hockey, brain and spinal cord injury prevention video. Inj. Prev. 9:361Y366, 2003.
3. Collins, C.L., Fields SK & Comstock RD. When the rules of the game are broken: what proportion of high school sports-related injuries are related to illegal activity?Inj Prev. 2008 Feb;14(1):34-8.
4. Macpherson, A., L. Rothman, and A. Howard. Body-checking rules and childhood injuries in ice hockey. Pediatrics. 117:e143Ye147, 2006.
5. Asplund C, Bettcher S, Borchers J. Facial protection and head injuries in ice hockey: a systematic review. Br J Sports Med 2009;43:993-999
6 Yang, J., S.W. Marshall, J.M. Bowling, et al. Use of discretionary protective equipment and rate of lower extremity injury in high school athletes. Am. J. Epidemiol. 161:511Y519, 2005.
7. Tyler TF, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional ice hockey players. Am J Sports Med. 2002 Sep-Oct;30(5):680-3.