Hockey Hips

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No stranger to hip problems,  Tyler Seguin is currently healthy.

I was watching the Dallas Stars play the Calgary Flames tonight and my eyes drifted to the news ticker at the bottom. I saw that yet another NHL player was out with a bum hip. I have some pretty unique hip issues from playing hockey so I wanted to see how many other pros are dealing with the same thing this season. This is a short google search:

Groin

Jaromir Jagr, Kris Versteeg, Jeff Zatkoff, Jonathan Quick, Joonas Korpisalo, Tyler Ennis, Hudson Fasching, Blake Comeau

Hip

Jason Dickinson, Ales Hemsky, Thomas Vanek, Andrew Ference, Luke Opilka, Jared Cowen, Aaron Rome

This was one of the shortest searches I could do, but I did go to page two. I put Aaron Rome in italics because he’s the reason I wanted to talk about this. He’s been out for a couple of seasons and he’s the first name that pops up when you search “NHL hip injury.”  Aaron Rome played for the Dallas Stars towards the end of his career and in 2014 had to leave a game versus the St. Louis Blues because he threw a hip check that put him out of order. That was the beginning of the end for him, and now his lawyers assert that the hit was “career ending.” He is now suing the NHL and his insurance company because he is no longer able to play. It’s all in the hips.

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This is a Getty image, obviously. Is this the hit that did it?  I’m not sure, but even though it looks like a “light” hit, its still enough to destroy an ailing hip.

So why the emphasis on hockey players’ hips? I just turned 30 and I already have osteoarthritis in my right hip.It started slowly as inflexibility from hockey and was reinforced by weight training. Hip pain sucks, and I’ve only recently started to experience some relief, but we’ll get to that in a bit.

Hockey players, specifically, suffer hip injuries at a much higher rate than does the rest of the sporting population (except the NFL). A 2011 study of NCAA Division 1 and Professional hockey players found that 77% of them had hip and groin MRI’s that were indicative of pathology even if they were experiencing zero symptoms. Another published study that looked at younger players found high incidences of hip angles that were correlated with labral tears and cartilage damage in the joint. 93% of the midget hockey players that participated had hip angles greater than 55° — again, indicative of labral tears and cartilage damage. Midgets are 16-18 years old. The news is better for the 13-15 year olds, only 63% of them are at risk. The 10-12 year olds are better yet at 37%.

Higher hip angles leads to an increased chance of forming bony over growths as a result of compression. They call it Femoral Acetabular Impingement and it sucks. Imagine a ball and socket joint, but instead of being nice and smooth, the ball has an asymmetrical lump on it. Sometimes this causes pain, sometimes it doesn’t. Before moving on, I’ll mention that the study also said that this problem is often misdiagnosed as a hip or groin strain. How many NHL players on that list above are dealing with hip or groin pain?  Trick question, all of them.

Remember the problem is called Femoral Acetabular Impingement. The first two words just mean hip joint, Latin just sounds cooler. Impingement means “to strike or dash especially with a sharp collision,” which is a pretty vivid way of getting the point across. Collision, or rapidly coming together, should not be happening in a joint that is meant to be relatively friction-less. How do we fix that?

Add space. You have to add space.

The pelvis has multiple axes that move synergistically with every motion. It rotates in a number of directions with a given movement. Repeat a movement long enough and your body gets strong for that movement. If you don’t work to de-train that movement, your body can get more and more frozen in that position. The muscles that are meant to move around and with one another become a unit of glued-together, poorly functioning muscles. Since hockey players rarely or never quit, they just work around these imbalances and further reinforce them.

Enough about the problem though, I’m a solutions guy. Back to the space.

Foam rolling crushes a space (squish a sponge), bad stretching compresses a space (wring a towel), but ELDOA and myofascial stretching for the hips and pelvis can open the space and pull water back into the crushed, spongy joint space, or normalize and hydrate that tightly wrung muscle. There are several NHL players from several different teams that currently swear by these exercises, which I can say with certainty is the only reason the above list isn’t longer.

Coaches used to tell me to stretch and I can remember laughing them off, and doing it half-heartedly when I did. For a while, I thought I was the exception, but the research is starting to show that I’m a little bit closer to the rule. Since rules rarely change, I know youth hockey players rarely stretch.

The only way to stop FAI is to keep the joint space open and normalized, and the only way to do that is with a properly written exercise program that includes ELDOA, myofascial stretching, and segmental strengthening.

Waiting will only make the condition worse, so call me to get started today (281) 803-9930.

 

**EDIT 11/30**

My good friend Dan Hellman, of Hellman Holistic Health in Ft. Lauderdale, has put out a video on why you should NOT foam roll. It’s an hour long, but well worth the watch. You can find it here.

Flu/Treat-your-body-like-crap Season

Daylight savings time is here this weekend and I’m happy to be getting an “extra hour” of sleep. For some reason our little nation of farmers has decided this process is essential to the optimal functioning of our society, so the habit remains.

Unfortunately, this time of year is also the beginning of flu season. With daylight savings time and day-shortening causing circadian stress, the body’s natural wake/sleep cycles are disrupted. The average American is bombarded with stressors every day in the form of a poor diet, sedentary lifestyle, emotional stress, etc, and that wears on the natural defenses. The immune system can only work so hard and when the load gets too great, you get sick.

There are several things you can do to help boost your immunity this flu season and they contribute significantly to the reason I haven’t needed a flu shot in years.  I could go into the science behind all of these but we both have things to do so I won’t waste your time.  Just reach out if you have any questions.

  1. Drink lots of water. Water helps to flush out the bad stuff and strengthens the good stuff. You’re going to pee more frequently so practice holding it and you can train the muscles of your pelvic floor as a bonus. Also, you’re not hydrated when you can pee clear, you’re hydrated when you can do that for 60+ days in a row.
  2. Get enough sleep. People tend to argue with me on this one but studies consistently show that getting more sleep is good for you. Turn off the lights and TV at night and try to read a book. If you fall asleep quickly, you need it, and waking up early to work out only makes sense if you’re getting enough rest. Sometimes it is much more beneficial to skip the lift.
  3. Eat for your needs. It’s nearly the holiday season, I get it. Cookies, pies, cakes, candies, alcoholic everything. It’s hard not to get excited until you realize that stuff can have some pretty negative effects for up to 3 days after consumption, or life if you decide to push it. The “bug I get every [Nov/Dec/Jan]” is probably due to the life disrupting schedule changes or the food you’re hoovering every holiday season. Sugar decimates the immune system. See option #1 should you decide do skip this suggestion.
  4. Move, and move differently. Exercise is a funny thing. It’s good for you until it’s bad for you, and vice versa. The same goes with stretching, yoga, you name it—even too many ELDOA in the same position can be unnecessary. If you’ve been doing something regularly, mix it up. If the underlying theme is that you want “a good burn” or something that “kills you” then try something that makes you feel alive, or something chill.
  5. Be quiet. I prefer the sauna as my quiet place, and it seems to go with the cold weather in places that aren’t Texas, but anywhere will do. Turning off the noise, especially the holiday noise, can significantly lower stress levels. The research is beginning to prove what the anecdotal evidence has shown all along, mindfulness, meditation, deep-breathing and the like has directly positive effects on the immune system. The harder time you have quieting your mind, the more you need it.

It sounds pretty easy but it takes focused effort to do it, but it’s not the kind of effort that takes a significant change in your daily schedule. You’re already doing most if not all of these things. Good for you! You’re the best!

Now do just a liiiittle bit better.

These habits done well all contribute to the most important factor in regulating the immune system. Happiness. Find some happiness this holiday season, if we can all turn off our screens for just a few more minutes a day, we’ll see that it’s all around us.

Contact Antidote for more information about coaching, ELDOA, myofascial stretching, and more at (281) 803-9930.

Rotator Cuff Recommendations

I came across an article a few days back on triathlete.com while scrolling through my phone in an airport (listed here: http://www.triathlete.com/2016/10/training/importance-strengthening-rotator-cuff_295647).

Ironically enough, that habit —craning over a smartphone/tablet/keyboard – is what is contributing to the increase in shoulder and neck problems for most Americans. The article describes a bit about shoulder pain and what causes it in a broad sense, but in my opinion it didn’t give you, the athlete, enough information to act upon.

“The rotator cuff is a collection of muscles that surround the shoulder joint and help hold the humerus bone of your upper arm in the shoulder socket.”

Yes, and no. That’s like saying a car is made of wheels. You get partial credit at best. Tendons, ligaments, bones and muscles all play a synchronous part in holding the shoulder together. The shoulder is a collection of 5 joints and the quality of movement between all of the tissues of the respective joints need to be managed in order to correct or strengthen the joint complex. Each of the tissues that surround the shoulder play an important role in its overall function. Living tissue is always communicating with the brain, giving feedback in real-time as it moves through space. Without understanding this, you can’t go on to correct an impingement or frozen shoulder by the standard stretch/strengthen model alone.

The point that irked me and made me want to write my first blog post in 6 months is the fact that they pass off the cortisone injection as effective treatment. It doesn’t take much effort to find that cortisone reduces swelling, but it has a dark side. Swelling is an important part of the healing process, and while we don’t want it to persist, we certainly need it. Cortisone causes weak tissue to stay weak longer. It can’t respond as well to the given movement, so another part of the joint or body takes over. This is the root cause of the repetitive injury cycle and keeps a revolving door policy at injection-happy clinics.

In keeping with today’s trends, the article has bullet-points and basic exercises at the end. We’re all lazy when it comes to reading, I get it, so I’ll do the same, but modify theirs a bit.

See a doctor. Definitely do that. I’m not one. They can take images of the shoulder and that can be useful. Surgery and injections are overrated. You need to know that there are in many cases other options that utilize your body’s healing processes much more effectively than going on the chopping block.

Take it easy. They say lay off the upper-body work. I say do better upper body work and quit being stupid about it. See more below.

Ice it. Nope. Only immediately after an injury. Otherwise you need to know how to move to get those healing fluids to the joint—that’s where I come in.

Try an NSAID. Again, I’m not a doctor. I know how to read though, and there is plenty of research that shows that NSAID’s definitely damage your gut lining. When the gut lining is damaged, the inflammatory processes that take place can cause joint pain. So, if you’re having joint pain and you want more joint pain, do that NSAID thing.

Start rehabbing. Finally a solid recommendation, but then they miss the mark. The exercises they list can help you, unless they don’t. The body and postural issues are based on the model of complexity. If multiple different areas of the body can’t work together, then neither of the parts can work correctly. Trying, for example, the “seated dumbbell external rotation” can help you if you have awareness in your shoulders and can put the shoulder blade in the right position. If you’ve been injected with cortisone, iced too much, or have rested too long, this movement suddenly becomes dangerous.

It’s best to find someone trained in how to deal with the body as a complex system. By focusing on the complication, you miss what is causing the problem. You need to know what ranges of motion and what parts of the muscle are compromised and focus on strengthening them, or else your problem will persist. I use ELDOA, Myofascial Stretching, Analytical and Segmental Strengthening, and Pumping exercises to normalize the body and remove the causes of pain. After a long and painful battle trying to find a solution for my subacromial impingement, I found that I was my own best therapist.

I can show you how to be yours. Contact me today at (281) 803-9930.