Frequent shoulder injuries

Given that field hockey is a contact sport, and that some contact injuries can be quite severe, traumatic injuries are very common. The shoulder is the second most frequently injured body part in high school and junior field hockey players (1,3). Several types of injury can occur in this region, but acromioclavicular (A/C) sprain is the most common (1,2, 5). The post-injury physical examination is crucial, as it is important to rule out fracture of the clavicle and humeral head, as well as subluxation/luxation of the shoulder, before concluding that an A/C sprain has occurred. Medical treatment, rehabilitation and recovery times differ widely for these categories of injury (3).

In the case of an A/C sprain, mobility and strength in the shoulder will be reduced, and localized palpation of the A/C will be painful. In the case of severe sprains, a deformity commonly referred to as a “piano note” may be visible. To assess the severity of the sprain, a plain X-ray is recommended (4). Rehabilitation time is based on the grade of the injury. According to the literature, a period of 2 to 4 weeks is required for mild to moderate sprains, while 6 to 8 weeks is possible for more severe sprains. However, each player is unique and recovery times can vary greatly. Finally, when surgery is indicated, which is uncommon in field hockey due to the high risk of recurrence, recovery takes 4 to 6 months (4).

Good rehabilitation is essential, as the A/C sprain will limit the field hockey player’s ability to throw and check, both when giving and receiving (2). There are ways to prevent an injury of this magnitude, such as developing good musculature in this area to absorb impact, and adopting good checking technique (3). However, it must be borne in mind that field hockey is a contact sport and that, despite all the provisions put in place, illegal hits are omnipresent at all levels, thus increasing the risk of suffering a traumatic injury(1,5).

Written by: Jocelyn Mallet, Physiotherapist

References :
1. Beson, Brian et al. Ice Hockey Injuries. Med Sport Sci, 2005, vol 49, pp 86-119.
2. Agel, Julie et al. Descriptive epidemiology of collegiate men’s ice hockey injuries: national collegiate athletic association injury surveillance system, 1988-1989 through 2003-2004. Journal of athletic training, 2007; 42(2) : 241-248.
3. Matic, George et al. Ice hockey injuries among United states high school athletes from 2008/2009-2012/2013. Phys Sportsmed, 2015; 43(2): 119-125.
4. LaPrade, Robert et al. Epidemiology, identification, treatment and return to play of musculoskeletal-based ice hockey injuries. Br J Sports Med, 2014; 48 :4-10.
5. Molsa, Jouko et al. Injuries to the upper extremity in ice hockey: analysis of a series of 760 injuries. The american othopaedic society for sports medicine, 2005, vol 31, no 5.