2011 International Coaching Symposium

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Terence Chambers
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1 2011 International Coaching Symposium Injuries in Pro Hockey Dusan Benicky

2 Specific adaptation to imposed demands Theory 1. Introduction 2. Prehabilitation - Performance - Rehabilitation Practical Concepts 3. Specificity 4. Progressive Loading 5. Proximal to Distal 6. Quality and Consistency of Movement 2

3 1. Introduction Past History Any previous problems? Unrelated or seemingly so? Altered mechanics? General Health? Any other conditions? Weight loss? Recent symptoms? Medications? NSAIDS? Steroids? Other? Investigations? X-Rays, CT scan, MRI, Bone scan, Blood etc. 3

4 1. Introduction Subjective assessment Presentation (usual history questions) Where did symptoms start? Where are they now? Severity, acute/sharp vs. dull/diffuse Activities aggravating vs. relieving. Present? Previous? Any other musculoskeletal problems related or unrelated? What exact movements cause pain? Cough, sneeze, kick, sit-up? How long does pain last? 4

5 1. Introduction Objective Assessment There are many tests, bellow are the tests we ve found useful Static: posture, pelvic alignment/musculoskeletal balance/limb alignment/ symmetry Position: standing, sitting, supine prone tests Dynamic: Skatemill gait sport specific movements 5

6 1. Introduction 1, Traumatic (external force) player or goalie, boards, stick, hockey net equipment failure, ice conditions 2, Progressive (internal) improper execution motor program virus game/practice timing (tired vs. fresh, conditioning) seasonal perspective 6

7 2. Performance Prehabilitation Rehabilitation Through careful analysis of healthy athlete s we may be able to predict: 1, potential injuries and area of tissue breakdown (due to the inefficient or disfunctional movements) 2, but also increase biomechanical efficiency and reinforce progressive levels of load, speed, reaction, proprioception and complexity of motor patterns The end result is the athlete able to attain greater training load, decreased effort and less stress on the various body systems. 7

8 Practical Concepts The pre movement contraction of inner units prior of the onset of the superficial movers creates sound foundation for performance. Resequencing of deepest layers as described by many: (Bergman, Janda, Sahrman, Hodges, Kolar etc.) Key functions: respiratory timing and postural quality Form and Force closure application of slings described by Vleeming as coupling of muscle-tendonligamentus-fascial conections that allow quality and efficiency through the production and control of movement. 8

9 3. Specificity The only specific locomotion in hockey is skating! But still we train on bikes. We test on the bikes. We create injury prone environment by bikes. (Benicky) Many world experts agree with me on: specificity principal. NHL studies (Meeuwisse) Study of 7,050 NHL player showed over 90% of all groin injuries occurred in non-contact situations Incidence of groin injuries in pre-season are 20% higher than that in playoffs and are on the rise 9

10 3. Specificity 1. 10

11 4. Progressive In all stages prehab, training or rehab there should be a progressive increase in duration, speed, reaction and complexity of movement. Note: If maintenance of quality of the movement patterns is not achieved at early stages, they must not be progressed. 11

12 4. Proximal to Distal If proximal (the starting point of movement) stability & control is not achieved distal power, speed and efficiency will be limited. Sample: low stability of the gliding leg skating. Rotational pre set for shooting. 12

13 5. Quality and Consistency of Movement Quality and maintenance of all functional movements must be reintegrated and maintained. Hard Core is defined by McKechnie and Celebriny: The recreation of controlled unpredictability, controled instability, controled loss of control. Important need to address the alternation of sequencing of muscle firing if disfunction accures.. 13

14 5. Critical Area - Core. 14

15 Practical Gym Exercises demonstrations: Improved Proprioceptive and Kinetic Feedback Sequence Training Lower body Core U Upper body 15

16 Practical - sample of tubing exercises 16

17 Practical Simulated Skating Exercises - Videos 1, Progresive overload 2, Starts vs Stride concept (Video) 3, Closed kinetic chain 4, Resequencing the fireing pattern 5, Increased complexity 17

18 Thank you players & colleagues. 18

Make the Distinction. Make-Up of a Dryland Conditioning Program

Make the Distinction. Make-Up of a Dryland Conditioning Program Hockey Dryland Training Pacific Rim Hockey Academy Youth Hockey is becoming increasingly more competitive & physically demanding. Studies have shown that a majority of hockey injuries occur without physical