The incidence of FAI in hockey players is increasing and younger players are dealing with hip and groin problems. I’ve had clients as young as 14 years old diagnosed with FAI.
In the rehab world, there’s a lot of talk about reducing injury risk. We have access to a ton of data and brilliant sport scientists building predictive injury models. But we’ve yet to identify why hockey players develop FAI. In a world where we have an abundance of information about injuries, FAI continues to grow.
This may in part be due to a lack of perspective on how FAI develops. Most hockey players aren’t diagnosed with FAI until they are well into their teens or 20’s. At that point, this problem was been brewing for the better part of a decade.
Three key risk factors for the development of FAI actually occur between the ages of 10-14. They include:
- Playing hockey > 8 months per year
- Playing hockey > 12hrs per week
- Poor movement quality
If we want to reduce the risk of FAI, we have to target the root cause.
Most injury reduction programs for FAI target hip strength and mobility.
Those qualities are vital for managing FAI. But not for reducing the incidence of FAI. Research shows evidence of early signs of cam morphology in youth players between the ages of 10-14 years old. They also found relationships between early sport specialization and early development of cam morphology.
It seems that youth athletes are at younger ages than ever before. Most of the young athletes I treat play a single sport, get 2 weeks off in the off-season and practice 4-7 days per week. Not that they aren’t busy enough, but none of them strength train. So most lack movement quality and variability.
A shift in athletic development needs to happen for youth hockey players.
Too much hockey can be a problem.
Getting off the ice for 2 months in the off-season would be beneficial for most youth hockey players. Getting involved in other sports can help develop various motor skills that can transfer to the ice (baseball – hand eye coordination, soccer – foot control, track and field – speed/anaerobic development). Spending time building physical qualities in the gym that they don’t train on the ice can also provide a huge advantage in a contact sport like hockey.
Early specialization will not last because players who do aren’t lasting.
FAI is becoming more common because of early specialization in hockey.
But something has to change because players are dropping out or retiring before they’ve even had a sniff at professional hockey. The short-term gains of being an elite 8 year old do not outweigh the potential cost of years of hip pain and surgeries. There is a better way, a way that allows youth players to play for a long time.