Incidence, Prevalence, and Severity of and Risk Factors for Hip and Groin Problems in Swedish Male Ice Hockey Players: A 1-Season Prospective Cohort Study

Abstract

Context: The epidemiological focus on time loss may underestimate the true magnitude of hip and groin problems in male ice hockey players. Objective: To describe the prevalence, incidence and severity of hip and groin problems (time loss and non-time-loss) in Swedish ice hockey players over the course of a season and to explore potential pre-season risk factors for these problems. Design: Prospective one-season cohort study Setting: Professional and semi-professional Swedish ice hockey Patients or other participants: Twelve professional and semi-professional male ice hockey teams were invited to participate. Nine teams agreed to participate, and 163 players were included in analyses. Main outcome measures: Hip and groin problems in the previous season (time loss; non-time-loss), isometric adduction and abduction strength, and five-second squeeze test were recorded prior to the season and served as independent variables in the risk factor analysis. Main outcome measures were cumulative incidence of hip and groin problems, average prevalence, and odds ratios for groin problems in-season Results: Cumulative incidence for all problems was 45.4 % (95% CI 37.6–53.4) and 19% (13.3–25.9) for substantial problems. Average prevalence was 14.1% (10.8–17.5) for all and 5.7% (4.3–7.2) for substantial problems. Among reported problems, 69.2% had gradual onset; where only 17% lead to time loss. Players with non-time-loss problems in the previous season had significantly higher odds for new problems [All: OR 3.3 (1.7–6.3); Substantial: OR 3.6 (1.8–8.4)]. Pre-season strength was not significantly associated with the odds for subsequent problems. Conclusion: Hip and groin problems are common in ice hockey and may lead to substantial impairments in performance. Only one in five problems led to time loss and 7 out of 10 had gradual onset. Non-time-loss problems in the previous season were found to be a significant risk factor for new problems whereas preseason hip adduction and abduction strength was not.

High Prevalence of Seasonal and Current Groin Problems in Rink Hockey Players

“…Along the study period, 1.3 in 10 players suffered groin problems at any given month. These findings align with those observed in football or ice hockey, where weekly prevalence of groin problems stands around 13% [1,11,28]. Some researchers have hypothesized that the odds of getting injured are higher during pre-season, mainly due to deconditioning throughout the summer break [29].…”

“…High prevalence of seasonal groin problems has been historically associated with football/soccer or ice hockey, due to their multidirectional nature [1,22]. Recent investigations have shown that groin pain is similar in elite and amateur rink hockey athletes [7,23].…”

“…Groin problems constitute a major concern in multidirectional sports, due to their high prevalence and burden [1,2]. Adductor muscles play a major role in the development of this condition, although aetiology can be influenced by other clinical entities, highlighting the intricate nature of the underlying pathology [3].…”

Why Median Severity and Ordinal Scale Severity Values should not be used for Injury Burden Results: A Critical Review

“…Unfortunately, in many of these studies, the principles associated with collecting, calculating, reporting and presenting injury burden data have not been fully understood. As a consequence, median severity values and/or ordinal scales of severity have been incorrectly employed to calculate and present injury burden values in a range of sports, including: football [20][21][22], ice hockey [23][24][25], athletics [26,27], gymnastics [28] and Paralympics [29,30].…”

Soccer players show the highest seasonal groin pain prevalence and the longest time loss from sport among 500 athletes from major team sports

“…A group of international experts on the topic [6] stated that the available literature is mainly based on heterogeneous studies with low methodological quality. As far as we know, there are few studies on groin pain in team sport athletes such as basketball [9], volleyball [4], ice hockey [53,54] and water polo [42] other than soccer [2, 10, 12, 17, 27, 28, 42-44, 46, 51]. Traditional epidemiological sports injury research on groin injuries has mainly focused on time loss injuries [51], deined as injuries resulting in a player not being able to participate fully in soccer training or match play [13].…”