I hear from a lot of therapist who feel lost when it comes to late stage hip rehab with hockey players. I can’t blame them! Post-op hip rehab is a relatively new area (since the early 2000’s) and it’s not very well understood.
But, players who only do band exercises are probably not going to have great outcomes. The reason I know this is because I’ve done it. Earlier in my career, I struggled with hip rehab. Over the years, I learned from my mistakes. And I made a lot of them. Which is why i wanted to share my 5 keys to late stage hip rehab in hockey players so you don’t make the same mistakes I made.
Now, let’s dive in.
#1 – Lift Weights:
Hockey players need to be strong. There’s no arguing that. Additionally, people with hip pain tend to have atrophy of the hip flexors and glutes. Guess what? Those muscles are super important in skating. After surgery, hockey players need to build up hip flexor and glute strength. Late stage hip rehab should look more like a training session than a rehab session.
It takes ~12 weeks for muscle to grow. Muscles need load to grow. Move to heavy squats, lunges and hinge variations. Isolation exercises also work great for building muscle. Having good relationships with strength coaches in your area can be helpful for this.
Clinical pearl – some players might still get pinching in their hip at the bottom of a squat. Elevate the heels to reduce that and increase pain-free squat depth.
#2 – Motor Skill Training:
Hockey is a very frontal plane sport, yet a lot of hockey players are poor frontal plane movers. I see this as being a contributor to a lot of hip and groin pain. Particularly, this is often a big contributor to hip and groin pain after surgery.
I add frontal plane movement training in their warm up. I like using a progression of dry skaters that I stole from the speed skating community. They key focus of the dry skaters is for them to push laterally rather than pull laterally.
#3 – Plyometrics:
Athletes with hip and groin pain typically lack the ability to create stiffness. This leads to longer contact times in tasks like cutting. Longer contact times leads to more work being done by the hip and groin.
Exercises like low amplitude hops and drop jumps can help increase lower body stiffness. This can take some of the work away from the hip in a stop-and-go task on the ice by increase the demand on the ankle and knee.
#4 – Ankle mobility:
The ankle is the force transducer of the hip.
If the ankle doesn’t move well, the hip takes on more load and stress. I often see this as a cause of higher workload on the hip and groin. Even after surgery, if the root cause isn’t addressed players continue to have groin pain.
#5 – Lumbopelvic Complex function:
I see the pelvis as the scapula of the hip.
A lot of players I see with hip pain don’t know the difference between lumbar spine movement and hip movement. Most will move the pelvis and the hip as one unit, which in my mind is inefficient. I use segmental control drills, which include running mechanic drills and dissociation drills.