Hip Impingement in Hockey Players: focus on butterfly style ...

Hip Impingement in Hockey Players: focus on butterfly style ...

Hip Impingement in Hockey Players: focus on butterfly style goalies Christopher Larson, MD Twin Cities Orthopedics, Edina MN Team Physician: Minnesota Wild David Rust, MD Orthopedic Sports Medicine Fellow Overview Anatomy What is impingement? Affect on hockey players/

goalies Treatment options Other hip problems Future of research and INJURY PREVENTION!! Hip = ball and socket joint Femur = thigh bone, head and neck are involved Acetabulum = part of the pelvic ring

Labrum = cartilage ring on rim of acetabulum, mechanical bumper, seals the hip joint (gasket) Articular cartilage = smooth gliding surface, worn out in arthritic joints What is impingement? FAI = Femoral-Acetabular Impingement

Abnormal contact between the ball and rim/socket during activity Results from a ball that is not perfectly round (CAM) or a socket that is too deep (PINCER) Labral Tear Repetitive impingement leads to pinching of the labrum between the ball and socket Labral tears are common and often do not cause pain

Important to recognize and treat the underlying impingement Signs and Symptoms Deep sharp groin pain

Worse with quick turns Limited hip rotation/flexibility/stiff Unable to sit for prolonged periods Groin / Front of the hip pain after activity Impingement test = pain with hip flexion and internal rotation Must rule out other causes of pain Muscle and tendon strains Contusions, fractures

Athletic pubalgia / SPORTS HERNIA Butterfly Effect Evolution of style Rules and regulations Increased rate of surgery Approximately 5-10 NHL goalies per year have FAI surgery: JS Giguere Tim Thomas

Niklas Backstrom Vesa Toskala Patrick Roy Josh Harding Antero Niitimaki Rick DiPietro Ray Emery Craig Anderson Butterfly Effect Skills that may place hip at risk

pad flares recovery pushes T-pushes/One foot stops One knee down on post butterfly drops Treatment Options First step should be to work with coaches and athletic trainers to identify likely cause of pain Examination (with experienced provider) and regular x-rays will confirm diagnosis

When should an MRI be considered? Recent study found positive MRI finding in 77% of asymptomatic professional and NCAA hockey players FAI X-Rays Treatment Options Anti-inflammatory meds, rest, ice Modifications in technique and equipment, decreased repetitions Therapy can work on strengthening core muscles and

hip rotators Numbing injections can assist in determining the source of pain, but cortisone is usually avoided in young patients Treatment Options When should surgery be considered? Unable to perform athletics despite non-surgical treatment Pain with daily activities In our experience, athletes that have problems at

a younger age are more likely to eventually need surgery and are at risk for more significant hip damage Hip Arthroscopy Dr Larson has published over 40 articles regarding hip injuries in athletes & has operated on over 50 US and European Hockey Goalies from high school to the professional level in the last 3 years as a result of Impingement and disabling pain.

We are currently conducting several studies looking at the anatomy of the Hockey Goalie. Before Surgery After Surgery Can we prevent impingement?

Shape of hip develops over time while the body is growing Primarily takes shape during adolescent growth spurt Ages 10-14 in girls and 12-16 in boys Depends on type of activity and number of repetitions May be similar to throwing injuries in youth baseball Possible preventive strategies core fitness program for young goalies to strengthen muscles and/or maintain flexibility Improve upright Posture in butterfly and splits

positions skill repetition limits in practice greater off-season time, cross-training equipment limitations or improvements What does the future hold? Research looking at hockey goalies and players of all ages to find trends and identify who is at risk Rules and regulations to help

protect athletes from injury Guidelines and recommendations for youth athletes, parents, and coaches Research Study: Cam Impingement in Butterfly Goalies Goal is to better understand, predict, and prevent hip injuries

Hockey goalies, hockey players, non-hockey players, with or without symptoms, ages 10-40 No cost to enroll

Participants will complete questionnaire, examination, and x-rays No personal identifying information Gain knowledge with respect to the RISK of developing HIP problems based on the Examination and Xrays

Minimal physical risk Radiation from x-ray less than the typical annual exposure for an average Minnesota resident Research Study: Cam Impingement in Butterfly Goalies Participation requires signed consent (adults and parent/guardian) and assent (adolescent)

If interested please contact: Becky Stone @ [email protected] or 952-456-7136 Dave Rust @ [email protected] Thank You Twin Cities Orthopedics, Edina

Recently Viewed Presentations

  • Science Year 11 - wollastonschool.com

    Science Year 11 - wollastonschool.com

    Triple the work. Triple the reward. This course is 100% terminal exam. There are 6 exams, each covering a different area. All are 1hr 45 minslong ( 100 marks each) Two Biology. Two Chemistry. Two Physics. Multiple choice, structured, closed...
  • In order to fully understand the significance of

    In order to fully understand the significance of

    Pammy is no more than a toy, paraded out in front of guests to be looked at and admired. Oddly she has "old yellow hair", the colour of decay and is prematurely aged. ... Tom Buchanan is an old university...
  • Parliamentary Procedures - Foothill College

    Parliamentary Procedures - Foothill College

    Debate must be limited to the merits of the immediately pending question Speakers must address their remarks to the presiding officer, be courteous in their language and deportment, and avoid all personalities, never alluding to the officers of other members...
  • The Early Development Instrument A teacher completed instrument

    The Early Development Instrument A teacher completed instrument

    A teacher completed instrument which measures children's development - Offord. Centre for Child Studies. KEY MESSAGES. The EDI is an outcome measure for the quality of children's experiences, in their family, community and province, in their early years
  • Some Thoughts About WebQuests

    Some Thoughts About WebQuests

    Some Thoughts About WebQuests by Bernie Dodge What Is A WebQuest? Analysis of Article by Steven King Want to spice up your lessons? As a teacher, do you find yourself using the same format over and over?
  • Transforming Security and Risk - Central

    Transforming Security and Risk - Central

    Organizational Power1 "Ability to get work done" Everyone has power in some capacity. Relationship Power. Disclaimer: Material for Organizational Power is taken from the Manager Tools podcast and the four-part series "Three Types of Power (and One to Rule Them)"1....
  • Unit 1: Nature Of Science

    Unit 1: Nature Of Science

    Nature of Science. Pure science aims to come to a common understanding of the universeā€¦ Scientists suspend judgment until they have a good reason to believe a claim to be true or falseā€¦
  • How do I get AO2 marks in my

    How do I get AO2 marks in my

    You may even have discussed models, such as the Bradshaw model, when teaching this key idea - although it clearly IS NOT NECESSARY to teach this model for WJEC GCSE Geography B. Reinforce, at this point of the presentation, that...