Field-based evaluation of hip adductor and abductor strength in professional male ice hockey players: Reference values and influencing factors

Associations Between Hip Pathology, Hip and Groin Pain, and Injuries in Hockey Athletes: A Clinical Commentary

Femoroacetabular impingement (FAI), particularly cam morphology, is highly prevalent among elite hockey athletes. Moreover, hip and groin pain has become a common issue in hockey, with approximately 50% of European professional athletes reported to experience a hip or groin problem during a season. While most athletes will not miss training or competition due to this, restricted competitive performance and increased risk of reduced physical and psychological well-being are likely. Recent research suggests that the development of cam morphology is related to the repetitive shear stresses experienced at the hip joint during adolescence from skating. This condition likely increases the potential for intra-articular and extra-articular injuries in these athletes later in their careers. Research also indicates that the hip joint mechanics during forward skating substantially increase the possibility of sustaining a labral tear compared to other sports. Such an injury can increase femoral head movement within the joint, potentially causing secondary damage to the iliofemoral ligament, ligamentum teres and joint capsule. These injuries and the high density of nociceptors in the affected structures may explain the high prevalence of hip and groin pain in hockey athletes. Compensatory adaptations, such as reduced hip strength, stability, and range-of-motion (ROM) likely increase the opportunity for core muscle injuries and hip flexor and adductor injuries. Specifically, the limited hip ROM associated with cam morphology appears to exacerbate the risk of these injuries as there will be an increase in pubic symphysis stress and transverse strain during rotational movements. It is hoped that this article will assist practitioners currently working with hockey athletes to develop evidence-informed monitoring strategies and training interventions, aimed at reducing the incidence and severity of hip and groin problems, ultimately enhancing athlete performance and well-being. Therefore, the purpose of this clinical commentary was to examine current evidence on common hip pathologies in hockey athletes, exploring potential associations between hip and groin pain and the biomechanics of hockey activities.

Level of Evidence

5.

The science and art of testing in ice hockey: a systematic review of twenty years of research

Introduction

Ice hockey is a complex sport requiring multiple athletic and technical attributes. Considering the variety of tests developed, on-ice testing protocols have been created to measure the physiological and mechanical attributes associated with performance. To our knowledge, a lack of technical resources exists to help stakeholders opt for on-ice protocols from among those developed. It becomes crucial for researchers and practitioners to select relevant and context-specific procedures. This systematic review of the literature outlines an inventory of the on-ice tests that have been used in the domain of ice hockey research over the last twenty years, and summarize protocols mostly used in major athletic components.

Methods

A search was performed on three databases (PubMed, SPORTDiscus and Scopus) by following the PRISMA guidelines. Specific keywords were selected to find publications using on-ice testing protocols in the methodology. Four aspects of athletic attributes were used to categorize the protocols: aerobic capacity, acceleration-speed, agility-change of direction and ability to repeat skating sprints. Analyses were conducted regarding four categories of observations: population under study, on-ice reported test(s), outcomes measures and main findings.

Results

A total of 107 articles were included, resulting in 55 on-ice tests related to the on-ice assessments of four major athletic components: aerobic capacity (n = 7), acceleration-speed (n = 6), agility and change of direction (n = 23) and repeated skating sprint ability (n = 19). Testing in male and older cohorts (≥16 years old) predominates, with a primary focus on the competitive amateur level. The selected tests were mainly designed for assessing on-ice physiological responses and fitness (n = 38), talent identification-team selection (n = 19), efficiency of interventions (n = 17) and validation purposes (n = 16).

Conclusion

A prevalence of on-ice skating tests to assess the ability to repeat intense efforts, agility, acceleration and speed components exists, which are relevant and linked to match requirement. The wealth of on-ice tests used in the literature reflects the need to adapt the on-ice evaluation process to the population, constraints, and goals. This review is a valid toolbox and can benefit for researchers and practitioners interested in testing hockey players from different levels, with a variety of aims and needs, by helping them to select the relevant procedures to their environment and practice context.

The Relationship of Anthropometric and Physical Performance Characteristics on Competitive Success in Amateur, Elite, and Professional Rodeo Athletes

ABSTRACT

Oranchuk, DJ, Gullett, LK, Kicia, M, Thome, B, and Game, A. The relationship of anthropometric and physical performance characteristics on competitive success in amateur, elite, and professional rodeo athletes. J Strength Cond Res 37(7): 1495-1506, 2023-Reference anthropometric and physical performance qualities can improve understanding of sporting needs and streamline preparation and rehabilitation programs. However, these data and their relationships with competitive success are absent in rodeo athletes. We hypothesized that riding performance would be most correlated with hip adductor, neck, and grip strength, whereas jump, reactive strength index (RSI), and change of direction abilities would best predict bull-fighting performance. Forty-three amateur ( n = 9), professional ( n = 23), or internationally ranked ( n = 11) male rodeo athletes (bareback = 9, bull riders = 16, saddle bronc = 7, bullfighters = 11) (26.8 ± 5.6 years) volunteered for this study. Anthropometrics included body mass, height, and body fat percentage. Performance measures included isometric hip adduction and abduction, neck flexion and extension, handgrip strength, squat and countermovement jump heights, eccentric utilization ratio, reactive strength index, change of direction, bike sprints, and several pneumatic power measures. Bullfighters were taller and heavier than bull riders (effect size [ES] = 0.84-0.87, p = 0.008-0.017). Bull riders were leaner than bullfighters (ES = 0.74, p = 0.012). Fighters had greater RSI than riders (ES = 0.73-1.47, p < 0.001-0.030). Competitive level of rodeo riders ( n = 32) correlated with age, rodeo experience (ρ = 0.37-0.43, p = 0.013-0.049), bent-leg abduction (ρ = 0.43, p = 0.014), straight-leg hip adduction and abduction (ρ = 0.49-0.56, p < 0.001-0.005), neck flexion force (ρ = 0.43, p = 0.016), and rotational power (ρ = 0.50, p = 0.004). The competitive level of the fighters correlated with age (ρ = 0.64, p = 0.036) and time trial performance (ρ = -0.76, p = 0.006). This is the first study providing normative and correlational strength and power performance data in a rodeo population. These data highlight the need for more event-specific physical preparation. Riders should focus their physical preparation on hip and neck strength and rotational power. Bullfighters should prioritize stiffness and anaerobic power.

Hip Strength Profiling of Ice Hockey Athletes Across Various Joint-Specific Angles: Monitoring and Injury Implications

ABSTRACT

Secomb, JL, Kelly, M, and Dascombe, BJ. Hip strength profiling of ice hockey athletes across various joint-specific angles: monitoring and injury implications. J Strength Cond Res 37(7): e422-e429, 2023-The purpose of this research was to compare the hip adduction and abduction relative strength, adduction-to-abduction strength ratio (ADD:ABD), and interlimb asymmetries of ice hockey athletes between the typically used bilateral position and 3 unilateral positions in joint-specific angles (0°, 25°, and 50° of hip abduction) relevant to an ice hockey stride. A secondary purpose was to explore any relationships between these measures and hip and groin noncontact injuries, and self-reported pain and disability. Twenty-five semiprofessional male ice hockey athletes (26.7 ± 6.7 years) were assessed for hip abduction range of motion (ROM), hip adduction and abduction relative strength, and completed the Copenhagen Hip and Groin Outcome Score (HAGOS) questionnaire. Within-subjects repeated-measures analysis of variance revealed a significant effect for the assessment position for adduction ( F1,24 = 52.4, p < 0.01) and abduction relative strength ( F1,24 = 152.1, p < 0.01), ADD:ABD ( F1,24 = 38.9, p < 0.01), and the interlimb asymmetries for each of these variables ( F1,24 = 9.8-12.3; p < 0.01), with large strength differences observed between the bilateral assessment and all unilateral assessment positions for adduction and abduction relative strength. In addition, 4 athletes experienced a noncontact hip or groin injury within 1 month after testing, and when compared with the rest of the cohort ( n = 21) with Welch's t -tests, demonstrated significantly reduced hip abduction ROM (mean difference [MD] = -8.4 ± 2.5°; p < 0.01), sport subscale score for the HAGOS questionnaire (MD = -33.9 ± 7.1; p < 0.01), and a decline in hip adduction relative strength in the unilateral position of 50° compared with the position of 25° hip abduction (MD = -13.4 ± 3.8; p = 0.04). These results suggest that practitioners working with ice hockey athletes may benefit from profiling hip strength in these unilateral joint-specific angle positions because they provide an evidence base to determine the hip strength needs of ice hockey athletes in positions associated with skating performance and noncontact hip and groin injury mechanisms (between 25° and 50° of hip abduction).

Hip muscle strength in male and female patients with femoroacetabular impingement syndrome: Comparison to healthy controls and athletes

OBJECTIVES

To examine hip muscle strength deficits in patients with femoroacetabular impingent syndrome (FAIS), with special emphasis on potential sex- and comparison-related (between-subject vs within-subject) differences.

DESIGN

Cross-sectional comparative study.

PARTICIPANTS

Forty FAIS patients (20 women), 40 healthy controls (20 women) and 40 athletes (20 women).

MAIN OUTCOME MEASURES

Hip abduction, adduction and flexion isometric strength was tested using a commercially-available dynamometer. Two between-subject comparisons (FAIS patients vs controls and FAIS patients vs athletes) and one within-subject comparison (inter-limb asymmetry) of strength deficits were conducted, based on the calculation of respective percent differences.

RESULTS

For all hip muscle groups, women were 14-18% weaker than men (p < 0.001), but no sex-related interactions were observed. For all hip muscle groups, FAIS patients were 16-19% weaker than controls (p = 0.001) and 24-30% weaker than athletes (p < 0.001). For FAIS patients, the involved hip abductors were 8.5% weaker than the uninvolved ones (p = 0.015), while no inter-limb asymmetry was observed for the other hip muscles.

CONCLUSION

Sex had no influence on hip muscle strength deficits in FAIS patients while a major impact of comparison method/group was observed. Hip abductors showed consistent deficits for all comparison methods, suggestive of a possible greater impairment compared to hip flexors and adductors.

Reliability and validity of common hip adduction strength measures: The ForceFrame strength testing system versus the sphygmomanometer

OBJECTIVES

The criterion validity of the sphygmomanometer was evaluated, relative to the Force Frame strength testing system. Test-retest reliability was assessed for both hip adduction and abduction strength.

DESIGN

Test-retest reliability study and criterion validity study.

PARTICIPANTS

50 asymptomatic, field-sport athletes.

MAIN OUTCOME MEASURES

Maximal isometric hip adduction and abduction strength were measured. Interclass correlation coefficient(ICC_2,1) with confidence intervals were calculated to evaluate reliability of peak strength values. A Pearson product-moment correlation coefficient(r) was calculated to examine criterion validity of the sphygmomanometer as a measure of force when compared to the ForceFrame.

RESULTS

Intra-rater reliability for bilateral adduction testing using both ForceFrame and sphygmomanometer values revealed good-excellent reliability for both the 0° (ICC_2.1 = 0.87-0.90) and 45° (ICC_2.1 = 0.81-0.91) positions. ForceFrame values revealed good-excellent reliability for 0° abduction position and 45° abduction position. A good-moderate relationship (Pearson's r = 0.63) for 0° adduction position, and poor relationship (Pearson's r = 0.40) for 45° adduction position, were found between adduction squeeze values on ForceFrame and sphygmomanometer.

CONCLUSION

Excellent reliability in hip adduction squeeze strength testing for both modes. However, there exists a 'good to moderate'-'fair' relationship between the Force Frame and sphygmomanometer.

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

CONTEXT

The epidemiologic 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 explore potential preseason risk factors for these conditions.

DESIGN

Prospective 1-season cohort study.

SETTING

Professional and semiprofessional Swedish ice hockey players.

PATIENTS OR OTHER PARTICIPANTS

A total of 12 professional and semiprofessional male ice hockey teams were invited to participate. Of those, 9 teams agreed, and 163 players were included in the analyses.

MAIN OUTCOME MEASURE(S)

Hip and groin problems in the previous season (time loss, non-time loss), isometric adduction and abduction strength, and 5-second squeeze test results were recorded before 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 (ORs) for groin problems in season.

RESULTS

Cumulative incidence was 45.4% (95% CI = 37.6%, 53.4%) for all problems and 19% (95% CI = 13.3%, 25.9%) for substantial problems. Average prevalence was 14.1% (95% CI = 10.8%, 17.5%) for all and 5.7% (95% CI = 4.3%, 7.2%) for substantial problems. Among reported problems, 69.2% had a gradual onset, and only 17% led to time loss. Players with non-time-loss problems in the previous season had higher odds for new problems (all: OR = 3.3 [95% CI = 1.7, 6.3]; substantial: OR = 3.6 [95% CI = 1.8, 8.4]). Preseason strength was not significantly associated with the odds for subsequent problems.

CONCLUSION

Hip and groin problems are common in ice hockey players and may lead to substantial impairments in performance. Only 1 in 5 problems led to time loss, and 7 in 10 had a gradual onset. Non-time-loss problems in the previous season were a significant risk factor for new problems, whereas decreased preseason hip-adduction and -abduction strength was not.

Hip and groin function and strength in male ice hockey players with and without hip and groin problems in the previous season- a prospective cohort study

OBJECTIVE

To describe and compare hip and groin strength and function of male ice hockey players over one season in players with and without hip and groin problems in the previous season.

DESIGN

Prospective cohort study.

SETTING

Swedish male ice hockey.

PARTICIPANTS

We followed 193 players from 10 teams during the 2017/2018 season.

MAIN OUTCOME MEASURES

Hip adduction and abduction strength, 5 s squeeze test (5SST), and self-reported hip and groin function (Hip and Groin Outcome Score). Changes over the season and differences between players with and without problems in the previous season were analyzed by linear mixed models.

RESULTS

Adduction strength decreased slightly from pre-to mid-season and abduction strength increased slightly over the full season. However, self-reported function or pain did not change. Players with hip and groin problems in the previous season had significantly worse self-reported function, and more groin pain during the 5SST compared to players without. Strength measurments did not differ between groups.

CONCLUSIONS

Hip muscle strength, groin pain, and self-reported function appear to remain stable throughout the season in male ice hockey players. Remaining impairments in players with problems in the previous season suggest that function does not recover by ice hockey participation alone.

Exploring the Determinants of Repeated-Sprint Ability in Adult Women Soccer Players

This study aimed to explore the main determinants of repeated-sprint ability (RSA) in women soccer players considering aerobic capacity, sprinting performance, change-of-direction, vertical height jump, and hip adductor/abductor isometric strength. Twenty-two women soccer players from the same team participating in the first Portuguese league were observed. Fitness assessments were performed three times during a 22-week cohort period. The following assessments were made: (i) hip abductor and adductor strength, (ii) squat and countermovement jump (height), (iii) change-of-direction test, (iv) linear sprinting at 10- and 30-m, (v) RSA test, and (vi) Yo-Yo intermittent recovery test level 1. Positive moderate correlations were found between peak minimum RSA and adductor and abductor strength (r = 0.51, p < 0.02 and r = 0.54, p < 0.01, respectively). Positive moderate correlations were also found between peak maximum RSA and adductor and abductor strength (r = 0.55, p < 0.02 and r = 0.46, p < 0.01, respectively). Lastly, a moderate negative correlation was found between fatigue index in RSA and YYIR1 test performance (r = -0.62, p < 0.004). In conclusion, abductor and adductor isometric strength-based coadjutant training programs, together with a high degree of aerobic endurance, may be suitable for inducing RSA in female soccer players.