STAYING FIT & ON THE PITCH

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1 STAYING FIT & ON THE PITCH For Hockey Players The nature of field hockey puts extraordinary amounts of strain on the body and as a result injury is common, particularly when you fatigue during a game or training. This factsheet has been put together to give practical information, advice on injury prevention and help yourself treatment guidance for a faster recovery of an injury. Our goal is to keep you on the field pain free and performing at your best. Facts on injuries in field hockey - did you know? General play is the most common time of injury, followed by defending, then ball handling, blocking a shot and lastly goaltending. Field hockey players are nearly twice as likely to be injured in a game than in practice. More injuries occur in the second half versus the first half of competitions. Preseason has the highest overall injury rate while the postseason has the lowest. The acute non-contact category is the most common mechanism e.g. twisted knee, rolled ankle, for all injuries, followed by contact with elevated balls, overuse and contact with a stick. The majority of practice-related injuries occur during team drills, followed by conditioning and individual drills. The most common injured body part in field hockey is the knee, followed by the thigh and the head and face rank third. Muscle strains, followed by contusions, sprains, fractures and concussions are the most common types of injuries. Quadriceps (thigh) strains, lateral ankle sprains, concussions and hamstring strains are the most common specific types of injuries. KTB have specialist sports physiotherapists at both the Dartford and Bexley Clinics. Prompt assessment and treatment of an injury or pain will speed recovery and avoid unnecessary time away from sport. KTB Rehabilitation Chartered Physiotherapy in Bexley & Dartford /

2 Common Injuries in Hockey By Type: Sprains and Strains Sprains and strains are the most common type of hockey injury. The best immediate treatment for sprains and strains is the R.I.C.E. method (Rest, Ice, Compression, Elevation). Cuts and Lacerations Muscle Cramps Delayed-Onset Muscle Soreness Cuts and scrapes to the head and face are common hockey injuries, but using helmets with a full-face shield for keepers and gum-shields for field players reduces their severity & frequency. A cramp is a sudden, intense pain caused by an involuntary and forcibly contracting muscle that does not relax. This is the sort of muscle soreness experienced from 12 to 48 hours following a tough workout or game. Getting enough rest will support recovery. Overtraining Syndrome Overtraining syndrome frequently occurs in athletes who train beyond the body s ability to recover. By Area: Back Injuries from Hockey Knee and Leg Injuries from Muscle strains of the back Hockey Low back pain Anterior and posterior cruciate Herniated disks Ligament injuries Injuries to the meniscus Groin pull Hamstring pull, tear, or strain Iliotibial band syndrome Pulled or strained calf muscle Shin splints Sprains and strains Hip pointer injury Head, Neck and Shoulder Injuries from Hockey Black Eye Concussion Fractured Clavicle Torn Rotator Cuff Shoulder Separation Shoulder Dislocation Whip Lash Stinger Of The Neck Neck Strain Foot and Ankle Injuries from Hockey Ankle sprains Achilles tendinitis Achilles tendon rupture Blisters Hand Injuries from Hockey Wrist sprains Finger fractures Wrist tendinitis

3 STAYING FIT & ON THE PITCH Pre-Season Preparation With the highest overall injury rate seen pre-season, there is a need for effective pre-season training. Stage 1 Pre-Season Rest from the Activity: This is the time to let all the stresses you ve been putting on your joints, ligaments and tendons ease off. You should rest from running, twisting, bending and sprinting, the movements that you have done during your long hockey season. Instead keep active with a low impact activity to maintain the suppleness of your muscles. Swimming, brisk walking, yoga or Pilates are perfect. Stage 2 Pre-Season Injury Identification and Body Injury identification: It is important to recognise any twinges that have not settled over the 3-4 week rest period and to have these assessed by your sports physiotherapist. Body conditioning: With any niggles addressed and the body rested you can start increasing intensity, durations and frequency of your training progressively. For hockey this should include an increase in running endurance, acceleration and deceleration training, strength and flexibility work for the lower limbs, core stability training and upper body strength training. Stage 3 Pre-Season Re-Introduction of Sports Specific After several weeks of body conditioning the body you should be ready to return to hockey training including functional drills to re-learn and fine-tune the movement patterns and skills of the game, with less stress and strains to the body. Through this phase injury rates can increase so it is important to increase intensity periodically including time for relatively low intensity work. Without this players can burn out before the season has even started. In summary: The most effective pre-season training Performance to: Reduce the risk of injury. Enable you to continue playing at higher levels or a satisfactory level. Improve knowledge of self-limitation and enable you to set specific fitness and performance goals. Personal health and fitness training to: Gradually improve aerobic capacity the ability of your heart and lungs to pump oxygen around the body efficiently to reduce muscle fatigue during prolonged activity. Gradually improve anaerobic capacity the ability for you to carry out high intensity movements for longer durations or repetitively without injury or fatiguing. Allow your body systems to regulate into a training regime. Increase joint mobility, strength, strength endurance, power & proprioception. KTB have specialist sports physiotherapists at both the Dartford and Bexley Clinics. Prompt assessment and treatment of an injury or pain will speed recovery and avoid unnecessary time away from sport. KTB Rehabilitation Chartered Physiotherapy in Bexley & Dartford /

4 Endurance & Strength Endurance Endurance is one of the key aspects in hockey as a player is expected to be able to maintain high skill level throughout the game. It is important to develop endurance both aerobically and anaerobically to ensure the nervous and muscular systems provide the correct output for the tasks at hand. Running endurance is essential for hockey players, with effective use of energy in the leg muscles. Strength Training with Body Weight Strength Endurance is the length of time you can perform an activity without a decline in strength out-put, velocity, accuracy and frequency. There is currently a lot of research arguing about the best form of endurance training and the current common theme is that a mixture between strength training with body weight. Training for endurance: longer working times + shorter rest periods Continuous Movement Training Strength and Power: Hockey is a sport requiring players to move at speed but also to control this speed, this can involve side stepping, quick changes of directions, complete 180 degree turns at speed and then acceleration off the mark. Continuously accelerating and decelerating puts huge pressure on the musculoskeletal system. Joints are put under more stress and muscles are required to work harder to control these demands. Training for strength & power: shorter working times/ low reps + higher sets + longer rest periods Strength & Power Training

5 An acute sports injury is one in which there is a specific mechanism of injury, for example being hit by ball, a plant and twist, or a collision with an opponent followed by an immediate onset of symptoms including swelling, pain, bleeding, and possible deformity. If there are signs or symptoms of a serious injury, for example deformity, severe swelling and/or pain, medical opinion should be sought from an urgent care centre or your GP. Treatment for a sports injury will depend on factors such as how severe the injury is and the part of your body affected. Below we give some general treatments and advice that may be helpful. PRICE Therapy Minor injuries, such as mild sprains and strains, can often be initially treated at home using PRICE therapy for the first hours immediately after the injury. The goal during this time frame is to control the amount of swelling to the injured area, prevent further injury, and reduce pain. Following the PRICE principles is an effective way to minimize the swelling in an injured area so that the athlete can return to play quickly. PRICE stands for protection, rest, ice, compression and elevation. Protection Rest Ice Compression Elevation Injured structures need to be protected to avoid further injury to the area. This may be by using a support such as an ace bandage, aluminium splint, sling, protective tape, or brace. Resting allows the body s own healing processes to naturally occur without being impeded by movement of the injured area. It is important to avoid exercise and reduce daily physical activity. Using crutches or a sling may help. There are a number of types of cryotherapy that can be used effectively to treat injuries. The most common is an ice pack which should ideally be made of crushed ice placed into a Ziploc bag and wrapped in a thin towel. The ice should be applied for 20 minutes every 2-3 hours. When the ice pack is removed, a compression wrap should be applied to the injured area. The compression wrap serves as a mechanical barrier so that swelling is minimized in the injured area. There are a number of compression wraps available, but the most commonly used is an elastic or ace bandage. Elevation is important immediately post-injury to reduce the amount of blood flow to the Injured area. The injured area must be held or supported above the level of the heart. This may also help to reduce swelling.

6 STAYING FIT & ON THE PITCH Pain Relief Painkillers, such as paracetamol, can be used to help ease the pain. Non-seriodal anti-inflammatory drugs (NSAIDs) tablets or creams, such as ibuprofen, can also be used to help ease any pain and help reduce any swelling. Surgery and procedures Most sports injuries don t require surgery, but very severe injuries such as badly broken bones may require corrective surgery to fix the bones with wires, plates, screws or rods. Certain other injuries may also occasionally require surgery. For example, an operation may be needed to repair a torn knee ligament. Immobilisation Immobilisation can sometimes help to prevent further damage by reducing movement. It can also reduce pain, muscle swelling and muscle spasm. For a sprain prolonged immobilisation is not usually necessary, and it is important to try gently moving the affected joint as soon you are able to do so without experiencing significant pain. Corticosteroid Injections If you have severe or persistent inflammation, a corticosteroid injection may be recommended. These can help to relieve pain caused by your injury, although for some people the pain relief is minimal or only lasts for a short period of time. Surgery and procedures Depending on the type of injury, it can take a few weeks to a few months or more to make a full recovery. It is important not to return to the previous level of activity until you have fully recovered, but you should aim to gently start moving the injured body part as soon as possible. Gentle exercises should help to improve the area s range of movement. As movement becomes easier and the pain decreases, stretching and strengthening exercises can be reintroduced. To speed recovery and to prevent recurrence it is advisable to seek the guidance of a professional. A sports physiotherapist will provide a tailored treatment programme that can involve techniques such as massage, acupuncture, manipulation and a suitable recovery programme of exercises to improve the range of motion, strengthen the surrounding muscles, and return the normal function of the injured area. KTB have specialist sports physiotherapists at both the Dartford and Bexley Clinics. Prompt assessment and treatment of an injury or pain will speed recovery and avoid unnecessary time away from sport. KTB Rehabilitation Chartered Physiotherapy in Bexley & Dartford /