The Epidemiology of Hip/Groin Injuries in National Collegiate Athletic Association Men’s and Women’s Ice Hockey

Abstract

Background:There is limited research regarding the epidemiology of hip/groin injuries in ice hockey, the majority of which is restricted to time-loss injuries only.Purpose:To describe the epidemiology of hip/groin injuries in collegiate men’s and women’s ice hockey from 2009-2010 through 2014-2015.Study Design:Descriptive epidemiology study.Methods:Hip/groin injury data from the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) during the 2009-2010 through 2014-2015 seasons were analyzed. Injury rates, rate ratios (RRs), and injury proportion ratios (IPRs) were reported with 95% confidence intervals (CIs).Results:During the 2009-2010 through 2014-2015 seasons, 421 and 114 hip/groin injuries were reported in men’s and women’s ice hockey, respectively, leading to injury rates of 1.03 and 0.78 per 1000 athlete-exposures (AEs), respectively. The hip/groin injury rate was greater in men than in women (RR, 1.32; 95% CI, 1.08-1.63). In addition, 55.6% and 71.1% of hip/groin injuries in men’s and women’s ice hockey, respectively, were non–time loss (NTL) injuries (ie, resulted in participation restriction time <24 hours); 7.6% and 0.9%, respectively, were severe (ie, resulted in participation restriction time >3 weeks). The proportion of hip/groin injuries that were NTL injuries was greater in women than in men (IPR, 1.28; 95% CI, 1.11-1.48). Conversely, the proportion of hip/groin injuries that were severe was greater in men than in women (IPR, 8.67; 95% CI, 1.20-62.73). The most common hip/groin injury diagnosis was strain (men, 67.2%; women, 76.3%). Also, 12 (2.9%) and 3 (2.6%) cases of hip impingement were noted in men’s and women’s ice hockey, respectively.Conclusion:Hip/groin injury rates were greater in men’s than in women’s ice hockey. Time loss varied between sexes, with men sustaining more injuries with time loss over 3 weeks. Despite increasing concerns of femoroacetabular impingement in ice hockey players, few cases of hip impingement were reported in this dataset.

Early Sport Specialization and Subjective Hip and Groin Dysfunction in Collegiate Ice Hockey Athletes

“…Our findings are consistent with the theory that early ice hockey specialization, which combines the unique biomechanical stresses of ice hockey skating with year-round, intensive training and skeletally immature joint tissues, could contribute to the high rates of overuse and noncontact hip and groin injuries that have been reported in collegiate ice hockey athletes. 2,4 Ice hockey skating requires excessive hip flexion, abduction, and rotation, which can lead to impingement and excessive stress on tissues such as the femur, acetabulum, labrum, articular cartilage, and adductor and iliopsoas muscle groups. 4,21 Cumulative stress on these tissues over !8 months of training per year combined with minimal rest and movement diversity may lead to chronic inflammation, tissue degeneration, or malformation of developing musculoskeletal tissues (or all of these).…”

“…Injuries to the hip and groin are considered a greater concern for ice hockey players due to the unique biomechanics of ice hockey skating combined with the anatomical complexity of the hip and groin region. 2 Evidence 3 indicates that the hip and groin region is the most frequently injured body region during NCAA women's and men's ice hockey practices and the second most frequently injured body region during high school boy's ice hockey practices after injuries to the head and face. Among NCAA women's and men's ice hockey athletes, overuse and noncontact mechanisms accounted for 77% and 67% of all hip and groins injuries, respectively.…”

“…Among NCAA women's and men's ice hockey athletes, overuse and noncontact mechanisms accounted for 77% and 67% of all hip and groins injuries, respectively. 2 Interestingly, among overuse hip and groin injuries in collegiate ice hockey players, 46% to 71% were considered non-time-loss injuries 2 ; thus, hip and groin injuries in collegiate ice hockey may affect patients more off the ice than on the ice. Some researchers 2,4 have theorized that the unique biomechanical stresses of ice hockey skating combined with early sport specialization in the sport may explain the higher rates of overuse and noncontact hip and groin injuries in ice hockey athletes.…”

“…2 Interestingly, among overuse hip and groin injuries in collegiate ice hockey players, 46% to 71% were considered non-time-loss injuries 2 ; thus, hip and groin injuries in collegiate ice hockey may affect patients more off the ice than on the ice. Some researchers 2,4 have theorized that the unique biomechanical stresses of ice hockey skating combined with early sport specialization in the sport may explain the higher rates of overuse and noncontact hip and groin injuries in ice hockey athletes. During ice hockey skating, the hip joint and musculature are exposed to repetitive, high-magnitude sagittal-, frontal-, and horizontal-plane motions that may place abnormal stresses on musculoskeletal tissues.…”

“…7 However, concern is growing among numerous youth health advocate organizations that early sport specialization may expose youth athletes to injuries. [8][9][10][11] Previous authors 12 have defined a high level of sport specialization as (1) considering 1 sport more important than others, (2) quitting other sports to focus on 1 sport, and (3) training in 1 sport for greater than 8 months of the year. This highvolume sport training with minimal diversity in movement patterns and activities during adolescence may expose musculoskeletal tissues to specific and repetitive mechanical stresses and minimal rest and may limit the development of appropriate neuromuscular skills for injury prevention.…”