How do our South African Hockey players perform and thrive?
The Women’s FIH Hockey World Cup took place in Spain and Netherlands in July, and our South African team was there! Prior to the tournament, one of our players, Bernadette (Bernie) Coston stated: “Our key focus is ourselves, how we need to perform, how we need to build the base and then perform every game to the optimal level that we can”.
How do you ‘build the base and then perform’ in hockey, both as a player and as a team? Just Physio wants to empower you to not simply participate but to perform to your optimal level, and thrive in the sport you love.
Why Hockey players get injured
Hockey is a fast-paced team sport. Players need to be fit and conditioned to run while skillfully handling the ball with their hockey stick. Hockey is also a tactical game, meaning that players need to be mentally engaged during the game. You need to be alert at all times to read the game and learn to be adaptable within the team dynamics.
Because of the fast pace and physical demands of the sport, injuries are inevitable. Players are constantly on the defense or on attack to get the ball and score a goal. Injuries are part of playing sport. However, most injuries can be very successfully managed. With the proper treatment and rehabilitation, you can most definitely get back to playing and excelling in hockey after an injury. In this way, you will perform better and thrive as a hockey player.
As a hockey player, you and your team dedicate many hours of training to your sport. We understand that the last thing you want is an injury. Injuries can be frustrating and even discouraging if it means you have to sit out for a while. If you have an injury, make sure that you get it assessed by your physiotherapist as soon as possible. We can help you get back to performing and thriving in the sport that you love.
Acute injuries can happen unexpectedly when you get hit by the ball or a stick, when you fall or collide with other players.
Acute Injuries in Hockey
The most common acute injuries include:
- Ligament sprains or tears
- Muscle strains
- Bone fractures
Any area of your body can get injured in hockey because of the physical nature of the sport. Acute injuries can range from minor bruises to severe tissue damage. They happen more frequently during games but can happen during training sessions too.
Ankle sprains are probably the most frequently seen injury in sport. Fifteen per cent of all injuries that happen in field hockey are inversion-type ankle sprains [3, 6, 9]. They usually happen with quick changes of direction. Ankle sprains range from minor ligament sprains to complete tears.
Knee ligament injuries are also frequently seen in hockey players. When your knee is forcibly moved inward or outward, you can injure the ligaments on the side of your knee. You might still be able to continue playing when you’ve injured one of these ligaments. However, you can experience considerable discomfort and swelling afterward.
A more serious injury is when one of the deep cruciate ligaments of the knee tear. Cruciate ligaments typically get injured when you land awkwardly on your leg or twist your body while your leg is grounded. With cruciate ligament injuries, you will have immediate pain and swelling of your knee. Your knee will feel unstable and you will have difficulty walking on that leg.
Other Acute Injuries
Other acute injuries that are common in hockey are muscle sprains, especially of the quadriceps (thigh), hamstring, groin and calf muscles. Muscle sprains also range in severity from minor pulls to complete tears. Bruising is common but when there is significant bleeding within the muscle, a hematoma can form. Hematomas put pressure on the surrounding healthy muscle tissue, which can cause further damage. Therefore, timely treatment of muscle tears and hematomas is crucial.
Any acute injury should be assessed by a medical professional before you consider continuing to play. Sometime the injured area swells rapidly, feels unstable, or you struggle to walk or move your injured limb. In this case, we recommend going for a scan. An X-ray, sonar or MRI scan is used assess the severity of the injury.
Acute musculoskeletal injuries should be managed using the PEACE and LOVE principles:
Initial Acute Injury Management:
P – Protect
E – Elevate
A – Avoid Anti-inflammatories
C – Compress
E – Educate
Protection comes in the form of reducing load on your injured limb such as using crutches to walk, or supporting your arm in a sling. By protecting the injured tissues, you reduce your risk of further damage and bleeding. As soon as your pain allows, gently start moving your injured area. A lengthy period of rest and immobilisation is detrimental to tissues, and can delay your recovery.
Elevating the injured area will help to minimize the swelling. Support your injured limb on pillows to keep it elevated. Wrapping a compression bandage around the injured area helps to minimize the bleeding and swelling. This subsequently relieves pressure on the injured area and reduces pain. Your physiotherapist can also apply tape to provide the compression.
You can take analgesic (pain-relieving) medication but should avoid taking anti-inflammatory medication for the first 48 hours after your injury. Inflammation is a normal response of your body to get the healing process going. By suppressing this process, you can potentially delay the healing. Anti-inflammatories can be taken after 48 hours if you still see signs of redness or swelling. However, do not continue taking them in the long-term.
You can apply ice if you have significant swelling. However, constant use of ice can also delay the inflammatory, and thus the healing, process of your injury. Therefore, avoid using ice after 24-48 hours. Instead, alternate between cold and heat application.
Your physiotherapist will discuss your injury with you and provide useful information on how to manage and treat it in the best way possible. We are here to educate and guide you throughout your recovery period. Your goals on how to perform and thrive as a hockey player are important to us.
Subacute Injury Management:
After a few days, when the acute phase is over, your injured area will need some LOVE.
L – Load
O – Optimism
V – Vascularisation
E – Exercise
Musculoskeletal injuries recover better when your rehabilitation takes an active approach. Our bodies do well when they move and exercise. As soon as your pain allows, start with gentle movement of your injured area. We will guide you as to how much movement is safe to do. Optimal loading of the injured tissues in the form of early movement and exercise will encourage tissue repair and make them stronger.
You will need to be realistic about your injury and the time it will take to recover fully. However, if you stay positive and mentally visualize your best recovery, you will achieve it. Optimism can make your recovery and rehabilitation period so much easier. At Just Physio, we strive to empower our patients and be there to motivate and encourage you all the way.
Early rehabilitation should also include some form of cardiovascular training. Aerobic type exercises increase your heart rate and breathing. This not only improves the blood flow throughout your body (vascularisation) to enhance the healing of your injury, it also makes you feel great. Very often, exercise can serve as a major psychological booster. And when you feel good, you have less pain.
The benefits of exercise cannot be over-emphasized. Exercise restores your mobility, strength and overall function of your entire body. We will take you through the phases of rehabilitation, with progression of your exercises in a safe but effective way. This way, you will improve your performance once again and thrive as a hockey player.
Overuse Injuries in Hockey
The most common overuse injuries in hockey include:
- Low back pain
- Stress fractures
Overuse type injuries are ones that develop more gradually over time. You may start to notice that you have pain, discomfort, stiffness, or weakness in a specific area of your body. An overuse injury occurs when there is repetitive movement, friction or strain to an area of your body. Overtraining is a major risk for overuse injuries.
Low Back Pain
Lower back pain can be caused by repeated strain on the muscles, joints or ligaments of your back. Hockey is played in a semi-crouched position. If your back, core and hip muscles lack strength and endurance, they can get fatigued in this position. You may then experience back pain as a result. The good news is that you can get significant pain relief from regular physiotherapy treatment. We also teach you ways that you can strengthen these muscles and so prevent recurring back issues.
Tendinitis of the hip, knee or ankle usually happens with over-training. Your tendons need time to adapt to the loads they are exposed to. Tendons do not have good blood supply like muscles do. Constant pull of muscles on their tendons can cause an inflammatory or reactive response, causing pain or dysfunction.
How to Thrive in Hockey – Tips to Prevent Injuries to boost your Performance:
Commit to an appropriate strength and conditioning program
Pre-season training is a great way to improve your body’s ability to endure the demands of your sport. Your program should ideally include aerobic, strength, and mobility exercises. Practicing specific hockey skills and endurance is also vital.
Gradually increase frequency, intensity & duration of training
Your body needs time to adjust to training loads. Respect this time and only train to your own capacity. Doing too much too soon can stress your body and lead to overuse injuries.
Undergo fitness testing prior to the season
Your coach or physiotherapist can do specific fitness tests to see whether you are ready to play.
Always do a proper warm-up before training or games. Dynamic movements and stretches prepare your body for play. If you are a reserve player, stay warm until you go on-field.
Wear correct, well-fitting protective gear
Invest in well-fitting protective equipment such as shin pads, gum guards and a helmet if you are the goalkeeper.
Avoid excessive weather conditions
Avoid playing in extreme heat, humidity, rain or cold weather.
Don’t play when feeling unwell, fatigued or dehydrated
Listen to your body. When you feel unwell, inform your coach and take some time out to rest.
Good nutrition & hydration
Try to fuel your body with good-quality nutritious food. Drink enough water and replace your electrolytes during and after intense training or games.
Try to get 7 to 8 hours of sleep every night to allow your body to recover well. Also try to take some time off to focus on other things between seasons. Do things you enjoy and avoid overtraining.
Attend to injuries and do not “play through pain”
You might feel pressured to push yourself to the max, especially when you play at a high competitive level. Adrenaline and the rush of the game can sometimes make you want to continue playing even when you have pain. However, to avoid injuring yourself further, listen to your body, attend to any discomfort or pain and take the appropriate actions.
Adequate rehabilitation for all injuries
When you get injured or experience pain, see your physiotherapist as soon as possible. Getting appropriate treatment right away will ensure your best recovery and faster return to play. It is important to complete your treatment or rehabilitation course. Returning to sport too soon can put you at risk for re-injury and persistent pain.
Engage, connect, plan and strategize with your team
Hockey is a team sport, and the dynamics within your team can have a major effect on your performance. Make team training sessions fun and interactive. Become one as a team and use each team mate’s strengths to optimize your game plan.
Each one of us has the potential to thrive in whatever we do. Follow our tips or book your session with us now!
- All-Pro Physical Therapy Field Hockey Sports Tips PDF www.STOPsportsinjuries.org
- https://sptny.com/medical-tip/field-hockey-and-low-back-pain-3-ways-to-protect-your -back-2/
- Pereira, N. Burgess, TL. Corten, L. 2021. Injury Incidence and Burden during Senior Inter-Provincial Field Hockey Tournaments. SAJSM 2021;33:1-6. DOI: 10.17159/2078-516X/2021/v33i1a11832
- Ellapen, TJ. Bowyer, K. van Heerden, HJ. Common Acute and Chronic Musculoskeletal Injuries among Female Adolescent Field Hockey Players in KwaZulu-Natal, South Africa. SAJSM 2014;26(1):4-8. DOI: 10.7196/SAJSM.482