MANAGING INJURY THROUGH MANUAL THERAPIES
The dynamic nature of hockey results in specific injury patterns, most injuries involve the soft tissues: muscle pulls (strains), ligament tears (sprains), and impact trauma (collisions). The physical hazards of playing hockey cannot be completely eliminated; but the risk of permanent and/or long term impairment can be substantially reduced through manual therapy. Understanding the mechanism of the musculoskeletal injury is critical for accurate diagnosis and treatment selection.
Treating musculoskeletal pain and injury involves more than pain elimination to regain optimal function. To understand this, you have to understand the reasons we feel pain. According to Guyton and Hall, pain serves as a protective signal for self-preservation from bodily damage. It is a signal to discontinue the insulting activity, even if it is something as simple as taking hundreds of slap shots per week. The example of taking slap shots is a common hockey overuse activity that compresses the soft tissues of the trunk, reducing blood flow, causing tissue damage and leading to pain. As a result, the body weight is shifted away from the pain, or modified technique is implemented resulting in further dysfunction. Individuals with no pain sense due to spinal cord trauma will fail to move away from the pain, resulting in complete breakdown of the anatomical region.
In a study performed at Ball State University, seven schools from the Eastern Collegiate Athletic Conference and Hockey East Conference participated in a 3 year investigation on type, nature and frequency of injuries sustained in intercollegiate hockey. There were 280 injuries reported with a total injury rate of 10.22/1000 athlete exposures. Eighty six percent of all injuries were sustained by a direct impact mechanism. There was a high rate of upper body injuries that the study attributed to the direct impact of person/ice and boards collisions being the predominant factor. The study also determined that forwards incurred the highest rate of injuries to all body areas except the groin, hip and thigh. Defense having the higher rate of injury to this region. The data from this study should make it clear that general injury management for all body parts should be in order to ensure the prevention of long term damage from traumatic tissue damage.
This study and explanation of pain, makes it clear that pain is harmful, but how can active/competitive individuals accept this and discontinue the painful activity when the activity is their sport? They don't. They go to chiropractors, physical therapists or massage practitioners for relief. What these professionals have in common is the approach of manual therapy to eliminate pain and dysfunction. What I've personally discovered, outside of the chiropractic paradigm of the spinal adjustment being the primary mode of healing, is that soft-tissue therapy is equally if not more essential along with a focus on detailed reconditioning plans and an anti-inflammatory nutrition.
Unfortunately, we are not like machines that break down and are able to have parts replaced. The human body is a much more complicated system requiring detailed solutions. So, what's the solution? The solution I have implemented with athletes and found to be very effective is the integration soft-tissue manipulation (i.e.; Fascial Manipulation, neurosensory taping and Active Release Techniques), injury reconditioning, and anti-inflammatory nutrition and supplementation. The reason for this approach is that it addresses all of the reactions that occur when an injury happens. When pain is experienced, several events are occurring in the body. Inflammation (causing the sensation of pain) is one of them. Antalgia is another. It results in postural deviations leading to muscular imbalance, causing more structural dysfunctions in the body. An integrated mode of the treatment addresses skeletal misalignments,tension in the fascia, inflammation, dysfunctional movement patterns and muscle weakness.
Here's my
integrated approach:
- Balance tension in the fascial suit through soft tissue
therapy
- Reduce inflammation through diet and
supplementation
- Rehabilitate dysfunctional movement to
strengthen movement patterns and propioception.
Would this approach provide you with the solution you've been looking for? From my experience, it should. I would recommend that you seek a professional in your area that can understand the systemic nature of your injury, understands the physical demands required of hockey athletes and can provide you with the type of comprehensive treatment I've described. Something to remember regarding musculoskeletal injuries is that given the right support and treatment, the body will heal. Remember, when an injury happens it's not just the pain that needs attention, addressing the joint restriction, soft-tissue disorder, exercise reconditioning, and nutrition are all critical to recovery.
