Sunday, March 2, 2014

Lack of mobility in hockey players: What causes it? Why does it matter? And, what can be done about it?

This post is a follow up from our Lakers Day presentation on mobility for hockey players. The Huron Perth Lakers are a AAA hockey organization and we were asked to talk about the importance of stretching, as well as injury prevention with their players.  This was a great experience, as we were able to assess and observe players from the Atom age group to Midget. It didn't take too long to see a pattern emerging; as the players got older their mobility decreased, which leads to the topic of today’s post. Lack of mobility in hockey players: What causes it? Why does it matter? And, what can be done about it? I will also talk about anterior pelvic tilt, better known as ‘hockey butt,’ and why this is not a good thing for hockey players.

*Throughout this post I use the term flexibility and mobility quite loosely. You can think of flexibility, as the ability of a muscle to go through a full range of movement. When muscles lose their flexibility they can affect the flexibility of the joint (joint range of motion) and therefore affect the overall flexibility of the athlete. As for mobility, we can think of it as the overall movement of the athlete through different movement patterns. If the athlete has poor overall flexibility, they will not move as well and as a result they will be less mobile. This will show up in the overhead squat and also in other movement patterns such as skating and running.*
We used the overhead squat as a predictor of overall flexibility and mobility, as it is a quick way to make a visual assessment of the players. Based on our observations almost 100% of the Atom players could do a full overhead squat. When we observed the Peewee players, the average was probably closer to 85% and moving on to the Bantams, fell to below 80%. When we looked at the Minor Midgets the numbers fell again. Although our numbers are estimates, it was easy to identify the aforementioned trend occurring, among the players of the Lakers organization.

Overall, the flexibility of the players on Lakers Day was better than I was expecting.  As a physical education teacher, I have also observed this lack of mobility showing up in gym class.  One of the ice breakers I use deals directly with my previous observations.  I will have the class make a circle and have all the students do multiple repetitions of body weight overhead squats. After, I will go around the circle and pick out the hockey players. Obviously, my success rate is not a 100%, but it is quite high! It is definitely high enough to make an impression on the students, which is the reason I use it to open the class. Furthermore, I own a strength and conditioning studio, which has allowed me to work one-on-one or in small groups with many different hockey players, ranging from Atom age to experienced veterans. This also includes professional hockey players. As you might guess, the trend I see is a lack of flexibility and mobility throughout the ranks. Now this is not a controlled, long-term study, based solely on quantifiable observations, it is instead my opinions, based on my experiences. It also takes into account experiences shared by my colleagues - trainers, teachers and other disciplines that also deal with hockey players and young athletes.

This begs the question, why do hockey players have worse flexibility than athletes in other sports? In my opinion, it is in the nature of the sport, as it is a very repetitive activity. The movement pattern that occurs in hockey is much different than in other sports. The following is a brief and simplified explanation:

Skating is a very quad dominant movement, the thigh muscles (quadriceps) do more work than the muscles behind the legs and hips (hamstrings and glutes), while the position of the athlete has the player in a constant state of hip flexion (bending over at the waist). As a result, the muscles that keep the body in flexion (hip flexors), that help rotate the leg out (lateral hamstring and other hip rotators) and that help pull the leg back in (adductors), get over worked in a shortened position, which leads to them becoming tight. 

We can relate this to other situations that result in a similar outcome, albeit under different circumstances. If you sit in a chair for a long period of time and get up, the front of your hips will feel tight. While you were sitting, your hip flexors were in a shortened position and were working to keep your body upright. When you stand up they are returning to their normal range and feel tight for a while until they adjust. Over time, if you don’t stretch them out, they will get used to the shortened position and eventually they will want to stay in that shortened position. Another hockey specific example would be feeling what muscles are stiff after your first skate, when returning from a prolonged absence. My personal experience confirms my outlook above. The front of my hips and inside of my legs feels tight, as do my thighs and the outside of my legs (lateral hamstring).  If you think about your own personal experience, I’m sure you have felt something similar. In response to muscles getting tight, other muscles will become elongated, which will negatively affect the balance between the opposing muscle groups. Over time, this imbalance will become more pronounced if not corrected. We call this a loss of structural balance. In hockey players this may be apparent by displaying anterior pelvic tilt. The myth of hockey players having big, strong butts, stems from this. If an athlete is well trained this is possible, but usually it results from the hips being pulled forward by tight muscles, which in turn causes the appearance of a big ‘hockey butt.’ There even is a Facebook page dedicated to hockey butts, which shows a couple examples of the phenomenon. In reality, many of the hockey players I have worked with have a lot of problems even firing their glutes, which means their hips are so tight at the front they cannot extend their hips enough to engage their strongest hip extensors, which are their gluteal muscles. Instead of having big, strong glutes, most have weak, poorly functioning glutes.

There are many reasons that flexibility and the aforementioned issue of structural balance matter. First, and foremost, is the prevention of injury. When certain muscles get stronger than others a strength imbalance occurs. As a result, weaker muscles are prone to injury, as the force production of the stronger muscles overpowers the weaker ones. An example of this would be hamstring strains. There are multiple reasons why a hamstring strain may occur, for this example we will relate it to a hamstring imbalance. If the lateral hamstring is stronger than the medial hamstring (outside in comparison to inside, which is commonly found in hockey players), the medial hamstring will be prone to injury, when the hamstrings group is put under demand. If an athlete with this imbalance begins a sprinting program (explosive in nature, a lot of demand on the hamstrings), they are at higher risk of a hamstring strain, which usually will be the medial hamstrings. Subsequently, this is a very common injury experienced by hockey players in the offseason. Another reason for injury occurs when a muscle is stretched out of its range of flexibility. As a muscle becomes more restricted or tight, it has less range before it gets taxed and therefore has a higher chance of being strained. An example would be a hockey player with tight groin muscles (adductors), if he or she clips another player there is less range or give before the muscle is strained. Once a muscle is strained it responds by laying down scar tissue, which is less flexible than the original fibres in the muscle. If the scar tissue is not addressed it can actually lead to more tightness and therefore a greater chance of re-injury. This is definitely a case of where prevention is key, rather than dealing with an injury after it occurs.

 Performance is another factor that is influenced by flexibility and mobility. A visual example that many of us have seen, is the shortening of a player’s stride. As the season goes on and the amount of time on ice increases, the structural balance of the athlete usually gets worse. Especially if flexibility and mobility are not addressed throughout the season or in some cases the offseason leading into the season. As flexibility decreases, so does stride length. Obviously, a shortened stride can negatively affect mobility and therefore speed on the ice. Earlier, I discussed the shortening of the hip flexors and how this can ‘turn off’ the glutes. In testing this shows up in different types of jumping assessment. Many strong hockey players do not do well in the vertical jump test or in the standing broad jump test. When the hip flexors are tight, it limits the hip extensors (the muscles that bring the hips forward), which leads to weaknesses in hip extension, which limits leg power in these tests. Hip extension, as well as, rotation are needed in straight-line skating, but are more crucial in stopping, starting, turning and shooting. Without strength in these muscles, these areas of the game will suffer. It might be argued that hip extension is not as important in skating as in running, but it still plays an important role. Another offshoot of the hip extension issue is the limiting of strength gains in the other muscle groups that also are needed for hockey players. If an athlete has poor flexibility and poor hip extension, it will limit his or her gains in other lifts, which will in turn negatively affect strength gain in other areas. Many strength coaches feel the front squat is the best in gym predictor for hockey performance. You need to be strong and have good structural balance to perform a front squat. It also is a great predictor of overall leg strength. The problem is if you have structural balance issues you are unable to perform this movement properly and therefore cannot get the benefit of a strong front squat. 

In order to help maintain flexibility and therefore mobility, athletes need to maintain structural balance. They need to keep overused muscles from becoming tight and they need to strengthen muscles that are underused and that have become weak. It seems very simple and logical, but it can get more complicated the longer the issue persists. The first step is to keep stretching the muscles that may get tight (adductors, hip flexors, lateral hamstring), to try to prevent muscle tightness as much as possible. On the flip side, underused muscles need to be kept strong so that muscle groups don’t get out of balance.  The hip’s many different hip extensors need to be kept strong in order for this to occur. If you observe younger children, they can all sit in a full squat. Parents should have their children sit in this position to help them keep their range and so that they don’t lose this ability. A Facebook campaign called the 30/30 Squat Challenge, could be a great way to get athlete’s to do this at home.

Playing multiple sports can also help, as it changes the movement patterns the athletes will be taking part in and will help reduce structural balance issues. As the athlete begins to specialize in one sport, more focus must be made to maintain structural balance. It begins with proper stretching routines and depending on how often the athlete is skating and how competitive they want to be, a proper strength training program. A proper strength training program will work on the athlete’s weak areas first, before progressing on to more advance exercises. An example of this would be using split squats instead of full squats, until the athlete can maintain a neutral back in the full squat. A full squat is when the hamstrings muscles cover the top of the calf muscles; if an athlete cannot do this it could lead to injury or actually worsen pre-existing structural balance issues. In a full squat there is greater activation of the hamstrings than in partial squats. The hamstrings are often weak in hockey players, so being able to do full squats will help strengthen the hamstrings. If a hockey player that has strong quadriceps muscles and weak hamstrings muscles, does partial range squats it will put more emphasis on the quadriceps, which leads to a worsened quadriceps/hamstring balance. Furthermore, if an athlete has had previous groin and hip issues it will be more of a challenge to fix. Stretching and a proper strength training program will often be enough, but if the symptoms or injuries are persistent, a practitioner that deals with soft tissue will be an asset in conjunction to their program. Chiropractors with soft tissue training such as ART (Active Release Technique), Trigenics or other credentials, massage therapists, physiotherapists, and qualified strength coaches, all can help with these issues. Soft tissue work will help get the flexibility back, but you need to strengthen the muscles once they get their range back.

 In order to get a proper strength training program, you need to find a good strength coach or trainer. Look around and ask lots of questions before committing. Make sure you ask about their training programs and what they do to help with the issues brought on by hockey. Form and proper teaching of exercises is another crucial component of a successful training program. It takes a very good trainer with a lot of patience to get athletes using proper form in their lifts. Be wary of large training groups that use complex training exercises early in the athlete’s training program, as beginner athletes should progress in a structured manner from simpler exercises to more advanced exercises.  It is also hard to teach proper lifting technique with a low trainer/coach to athlete ratio. Furthermore, talk to other athletes and parents (if applicable), so that you can get a good overall outlook of a program or the trainer before you sign up.

Hockey is a very unique sport. The movement pattern of skating is much different than running, the major movement pattern in other sports. It is enjoyed by players of all skill levels and all ages, but with its uniqueness comes the extra challenges related to flexibility and mobility. If you are regularly playing hockey make sure to be proactive in preventing structural balance issues. If you are already suffering from ‘hockey butt,’ make sure to take action to reverse it. Although having a forward tilted pelvis might make you look like a hockey player, it will eventually lead to increased chance of injury and worsened performance. If you want the butt, without the issues, get your glutes and hamstrings strong! 

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