One of the most common hockey injuries is a groin strain, also known as an adductor strain.
The adductor muscle group pulls the leg inward towards the midline of the body. During the skating stride the adductors and hip flexors help to stabilize the hip. Studies have shown that adductor strains in hockey may be a result of the adductor group attempting to decelerate the leg during a stride. They can also be related to a muscle imbalance between the propulsive and stabilizing muscle groups.
This muscle imbalance comes from the hockey stance where the hips are constantly in flexion causing the hip flexors to become very tight and pull the pelvis down. This causes the spinal erectors to also become very tight and pull the pelvis up in the back, causing the pelvis to be pulled forward or anteriorly.
The prime movers in the skating stride are the hip extensors, abductors and external rotators. When you have an anteriorly rotated pelvis, the prime movers end up in a lengthened or stretched position. This causes extra strain and load on the adductor group as they are responsible for the opposing action and are trying to counteract the abductors and external rotators as well as decelerate the leg in the skating stride.
Studies have shown that there is a relationship with groin injuries and decreased strength and decreased flexibility. Tyler et al were able to demonstrate that strengthening the adductor muscle group could be an effective method for preventing adductor strains in professional ice hockey players.
Unfortunately, even though these risk factors have been identified and strengthening protocols have been implemented, adductor strains are still very common and continue to occur in most sports, especially hockey.
Tyler et al found that recurring groin strains could be due to incomplete rehabilitation or returning to sport too early before tissue repair was complete. Hagglund et al studied 12 elite Swedish male soccer teams and determined that prior injury such as a previous hamstring, groin or knee injury were 2-3 times more likely to lead to re-occurrence of that injury the following season.
Homlich et al and Tyler et al found that an active strengthening program that consists of strengthening the abductors, adductor and core along with proprioceptive training may reduce the re-occurrence rate of groin injuries and help in treatment of chronic groin injuries.
Here are 3 exercises to help increase your adductor strength and core all in one:
1. Lunge with wood chopper
2. Side lunge with oblique twist
3. Single leg squat against the wall
1. Sim FH, Simonet WT, Melton LJ III, et al: Ice hockey injuries. Am J SportsMed 15: 30–40, 1987.
2. Arnason A, Sigurdsson SB, Gudmundsson A, Holme I, Engebretsen L, Bahr R. Risk factors for injuries in football. Am J Sports Med. 2004;32(1)(suppl):5-16 [PubMed]
3. Ekstrand J, Gillquist J. The avoidability of soccer injuries. Int J Sports Med. 1983;4(2):124-128 [PubMed]
4. Emery CA, Meeuwisse WH. Risk factors for groin injuries in hockey. Med Sci Sports Exerc. 2001;33(9):1423-1433 [PubMed]
5. Emery CA, Meeuwisse WH, Powell JW. Groin and abdominal strain injuries in the National Hockey League. Clin J Sport Med. 1999;9(3):151-156 [PubMed]
6. Knapik JJ, Bauman CL, Jones BH, Harris JM, Vaughan L. Preseason strength and flexibility imbalances associated with athletic injuries in female athletes collegiate athletes. Am J Sports Med. 1991;19(1):76-81 [PubMed]
7. Orchard J, Marsden J, Lord S, Garlick D. Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med. 1997;25(1):81-85 [PubMed]
9. Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility on the incidence of groin strains in professional ice hockey players. Am J Sports Med. 2001;29(2):124-128 [PubMed]
10. Tyler TF, Silvers HJ, Gerhardt MB, Nicholas SJ. Groin Injuries in Sports Medicine. Sports Health. 2010;2(3):231-236. doi:10.1177/1941738110366820.
11. Tyler TF, Campbell R, Nicholas SJ, Donellan S, McHugh MP. The effectiveness of a preseason exercise program on the prevention of groin strains in professional ice hockey players. Am J Sports Med. 2002;30(5):680-683 [PubMed]
12. Hagglund M, Waldén M, Ekstrand J. Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. Br J Sports Med. 2006;40(9):767-772 [PMC free article] [PubMed]
13. Holmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomized trial. Lancet. 1999;353(9151):339-443 [PubMed]