Canucks limp into 2011/12 season: what Kessler, Nolan & Raymond should be doing

Blackhawks
(photo: hockeybroad)

The Vancouver Canucks had an amazing season and playoff run last year.  They did everything they could short of winning the Stanley Cup and they did it being one of the most injured teams in the league all season long.  That speaks to the depth the organization, the heart of the players and the support of the medical and training staff to get players back on the ice.  But why were we one of the most injured teams in the league?  Hockey is a tough sport and injuries are part of the game, but some injuries are preventable and some don’t have to be recurrent.  I believe the Canucks have a great medical team behind them, but I think they are missing out on a hidden gem that the Vancouver medical and physiotherapy community has brought to the world….and that is IMS acupuncture.

I have been a physiotherapist in Vancouver for eight years and a Canucks fan for thirty two.  I write this article to educate the public on the nature of pain and injury as it relates to hockey injuries like groin pulls, back pain and labrum tears.  I am not affiliated with the Canucks in any way, but I do have interest in seeing them win the Stanley Cup this year and hope to see the players get the best possible care available.  I do not have access to their rehab programs, but if the following information is new to the athletic therapists and doctors in the organization, I suggest they pursue the help of a physiotherapist that can provide IMS to the players.

Ryan Kessler is the best two way player in the NHL right now, but he has torn his labrum in both hips in the past few years.  Your labrum is a rubbery piece of cartilage that surrounds the socket of your hip to effectively make it deeper and create stability.  Tearing it is similar to tearing your meniscus in your knee.  It can screw up the mechanics of the joint and lead to pain in the groin, hip and leg.  The labrum doesn’t have a very good blood supply to it, so if you tear it, the body is unable to heal it properly and surgery is usually required to get players functioning properly again.  Kessler has had both hips operated on and is training to get back into form for November as far as I know.

Why are groin pulls and labral tears so prominent in hockey? 

I contribute it to four main factors:

  1. Hockey Hips: the nature of the skating stride tightens up all the hip external rotator muscles
  2. Falls on Bum: repeated hard falls on the butt and tail bone that don’t injure, but irritate the nervous system
  3. Rehab & Recovery: the intensive schedule can lead to treating symptoms more than the cause of pain
  4. Strength & Conditioning: some players need more movement training and less power lifting

Hockey Hips

Most sports will create a certain type of muscle imbalance it its athletes.  In hockey it tends to be the hips.  The hip is a big ball and socket joint capable of movement in all directions, but if you skate for a living, you are prone to getting some muscles tighter and stronger than others.  If you look at a model of your hip, you will see it effectively has a rotator cuff just like your shoulder.  There are a whole bunch of deep muscles in your hip that act to turn the leg outward and they are tug-of-war buddies with the groin and hip flexor muscles that act to turn the leg inwards.  Working together they dynamically stabilize your hip in the socket, but when hockey players develop the inevitable imbalance of tension in the external rotators, the groin loses the tug-of-war and the hip gets levered forward in the socket.  The labrum sits in the front of the hip socket as a passive structure to help with stability, but when the muscles don’t dynamically stabilize the hip properly, the labrum gets beat up on.

 

                           Deep hip rotators                                              Groin Muscles

Watch Video: Why Hips Hurt
Watch Video: Basic Hip Anatomy

 
Falls on Bum

If you’ve ever watched a hockey game before, you will know that players get knocked down a lot and that ice is hard.  The players are obviously wearing hip pads, but the jarring force created by landing hard on your butt every other night can take its toll on anyone’s body.  There are many falls that don’t injure the players, but instead result in more subtle tension and irritation around the hips and low back.  The players can still play, but they will lose some mobility in their hips because their nervous system is annoyed.  Your nerves are the electrical wiring to your muscles and your spinal cord is the fuse box.  The input from the nerves dictates the resting tone or tension in the muscles.  If the nerve is annoyed it will send an altered signal to the muscles and create bands of tension that restrict mobility to a joint and usually create pain.

         Healthy state muscle/nerve                         Irritated state muscle/nerve


Rehab & Recovery

If a player is playing with muscles in a banded/tension state, it is way easier to tear muscles and tendons because the muscles cannot contract or stretch as well as they normally should.  Muscle strains are a part of a physical game like hockey and initially they need some ice and rest, but after that they need some treatment to address the muscle tone.  Most teams use athletic therapists to help the players with massage and rehab, which is absolutely necessary to keep them moving through an 82 game schedule, but the underlying irritation to the nervous system cannot be helped effectively enough with the hands alone.  That is where IMS acupuncture comes in.  It is an anatomy specific form of acupuncture performed by physiotherapists and physicians to address the root cause of chronic pains and tensions.  It is a technique that is created here in Vancouver and should be used to help the best athletes in our city.  As a physiotherapist, I have trained in movement therapy and manual therapy (adjustments and muscle release techniques), but nothing has touched the effectiveness of IMS acupuncture in releasing taut muscles and restoring hip, back and pelvis movement.


Strength & Conditioning

I believe that Roger Takahashi is a great strength and conditioning coach for the Canucks, but I also believe that some players would gain more physically by working on movement training than strength training.  Hockey players are world class athletes and it is the slight tweaks physically and mentally that can separate them from the thousands below them.  Adding strength is important, but helping them refine the movement skills they need while addressing the compensations and imbalances they have developed over the years is the key to injury prevention and recurrence.

My hope is that the Vancouver Canucks have already found someone to help the players with IMS, but if they haven’t yet, they should.  As a Canucks fan and a physiotherapist I want to see our best players on the ice all the way into June again next year! 

You can learn a lot more about your body here on WhyThingsHurt.com or come visit me in Vancouver at Envision Physiotherapy.

Related articles:
What is IMS Acupuncture? Intramuscular Stimulation vs. Traditional Acupuncture
Why Things Hurt: Explain Pain
Basic hip Anatomy
Basic low back anatomy

Related Videos (requires membership: $65/year)
Why hips hurt
Why low backs hurt
Why mid backs hurt

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