The Association of Hip Strength and Range of Motion with Hip and Groin Pain in Collegiate Ice Hockey Players Original Research
Main Article Content
Keywords
hip adductor, injury prevention, injury screening
Abstract
Introduction: Hip and groin pain is common in male ice hockey players. The relationship between physical examination findings and hip and groin pain in collegiate male hockey players is not well established. The purpose of this study was to explore associations between hip strength and hip range of motion (ROM) and hip and groin pain in male collegiate ice hockey players.
Methods: This was a cross-sectional study of 59 male ice hockey players. The Sport subscale of the Copenhagen Hip and Groin Outcome Score (HAGOS) were collected to identify those with hip and groin pain. Measurements of hip ROM and strength were obtained at the beginning of the season. Between group comparisons were made and logistic regression was used to determine the strength of the association.
Results: Compared to those without, male ice hockey players with hip and groin pain (n=17) had a lower amount of hip internal rotation ROM (-6.21; 95% CI 2.29, 10.14; p<0.01) and a lower ratio of hip adductor to abductor strength (-0.16; 95% CI -0.27, -0.05; p<0.01). These two variables explained 37% of the difference between groups (R2=0.37; p<0.01). There was no significant difference in hip external rotation ROM between groups.
Conclusions: Hip internal rotation ROM and the ratio of hip adductor to abductor strength were lower in male collegiate ice hockey players with hip and groin pain compared to those without. These findings may help inform secondary prevention and rehabilitation strategies in this population.
References
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7. Langner JL, Black MS, MacKay JW, et al. The prevalence of femoroacetabular impingement anatomy in Division 1 aquatic athletes who tread water. J Hip Preserv Surg. 2020;7(2):233-241. doi:10.1093/jhps/hnaa009
8. Baugh CM, Kerr ZY, Kroshus E, Lanser BL, Lindley TR, Meehan WP. Sports Medicine Staffing Patterns and Incidence of Injury in Collegiate Men’s Ice Hockey. J Athl Train. 2020;55(6):587-593. doi:10.4085/1062-6050-0464.19
9. Whalan M, Lovell R, Sampson JA. Do Niggles Matter? - Increased injury risk following physical complaints in football (soccer). Science and Medicine in Football. 2020;4(3):216-224. doi:10.1080/24733938.2019.1705996
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12. Short SM, MacDonald CW, Strack D. Hip and Groin Injury Prevention in Elite Athletes and Team Sport - Current Challenges and Opportunities. Int J Sports Phys Ther. 2021;16(1):270-281. doi:10.26603/001c.18705
13. Mosler AB, Agricola R, Weir A, Hölmich P, Crossley KM. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med. 2015; doi:10.1136/bjsports-2015-094602
14. Nielsen MF, Thorborg K, Krommes K, et al. Hip adduction strength and provoked groin pain: A comparison of long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test. Phys Ther Sport. 2022; doi:10.1016/j.ptsp.2022.02.002
15. Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB, Hölmich P. Eccentric and Isometric Hip Adduction Strength in Male Soccer Players With and Without Adductor-Related Groin Pain: An Assessor-Blinded Comparison. Orthop J Sports Med. 2014; doi:10.1177/2325967114521778
16. Bonello C, King MG, Crossley KM, et al. The association between hip/groin pain and hip strength in football players: An exploratory analysis of the FORCe cohort. J Sci Med Sport. 2023; doi:10.1016/j.jsams.2023.07.008
17. Beddows TPA, Weir A, Agricola R, et al. Hip and groin pain in male field hockey players: Prevalence, incidence and associations with patient reported outcome scores and hip muscle strength. Phys Ther Sport. 2023; doi:10.1016/j.ptsp.2023.02.010
18. Oliveras R, Bizzini M, Brunner R, Maffiuletti NA. Field-based evaluation of hip adductor and abductor strength in professional male ice hockey players: Reference values and influencing factors. Phys Ther Sport. 2020; doi:10.1016/j.ptsp.2020.03.006
19. Nevin F, Delahunt E. Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain. J Sci Med Sport. 2014; doi:10.1016/j.jsams.2013.04.008
20. Tak I, Glasgow P, Langhout R, Weir A, Kerkhoffs G, Agricola R. Hip Range of Motion Is Lower in Professional Soccer Players With Hip and Groin Symptoms or Previous Injuries, Independent of Cam Deformities. Am J Sports Med. 2016; doi:10.1177/0363546515617747
21. Delahunt E, Fitzpatrick H, Blake C. Pre-season adductor squeeze test and HAGOS function sport and recreation subscale scores predict groin injury in Gaelic football players. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2016.07.002
22. Drew MK, Lovell G, Palsson TS, Chiarelli PE, Osmotherly PG. Australian football players experiencing groin pain exhibit reduced subscale scores of Activities of Daily Living and Sport and Recreation on the HAGOS questionnaire: A case-control study. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2017.04.004
23. Wörner T, Thorborg K, Eek F. Five-Second Squeeze Testing in 333 Professional and Semiprofessional Male Ice Hockey Players: How Are Hip and Groin Symptoms, Strength, and Sporting Function Related? Orthop J Sports Med. 2019; doi:10.1177/2325967119825858
24. Quintana-Cepedal M, de la Calle O, Medina-Sánchez M, Crespo I, Del Valle M, Olmedillas H. Characterising groin pain in rink hockey: Function and five-second squeeze in Spanish players. Phys Ther Sport. 2022; doi:10.1016/j.ptsp.2022.10.004
25. Nussbaumer S, Leunig M, Glatthorn JF, Stauffacher S, Gerber H, Maffiuletti NA. Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients. BMC Musculoskelet Disord. 2010; doi:10.1186/1471-2474-11-194
26. Mentiplay BF, Perraton LG, Bower KJ, et al. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study. PLoS One. 2015; doi:10.1371/journal.pone.0140822
27. Stull JD, Philippon MJ, LaPrade RF. “At-risk” positioning and hip biomechanics of the Peewee ice hockey sprint start. Am J Sports Med. 2011; doi:10.1177/0363546511414012
28. Tak IJR, Langhout RFH, Groters S, Weir A, Stubbe JH, Kerkhoffs GMMJ. A new clinical test for measurement of lower limb specific range of motion in football players: Design, reliability and reference findings in non-injured players and those with long-standing adductor-related groin pain. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2016.07.007
29. Larson CM, Ross JR, Kuhn AW, et al. Radiographic Hip Anatomy Correlates With Range of Motion and Symptoms in National Hockey League Players. Am J Sports Med. 2017; doi:10.1177/0363546517692542
30. Eckard TG, Padua DA, Dompier TP, Dalton SL, Thorborg K, Kerr ZY. Epidemiology of Hip Flexor and Hip Adductor Strains in National Collegiate Athletic Association Athletes, 2009/2010-2014/2015. Am J Sports Med. 2017; doi:10.1177/0363546517716179
31. Mumbleau AM, Schilaty ND, Hewett TE. Hip muscle inhibition after hip arthroscopy: a role for neuromuscular electrical stimulation. Int J Sports Phys Ther. 2020; doi:10.26603/ijspt20201222
32. Rice DA, Graven-Nielsen T, Lewis GN, McNair PJ, Dalbeth N. The effects of experimental knee pain on lower limb corticospinal and motor cortex excitability. Arthritis Res Ther. 2015; doi:10.1186/s13075-015-0724-0
2. Dalton SL, Zupon AB, Gardner EC, Djoko A, Dompier TP, Kerr ZY. The Epidemiology of Hip/Groin Injuries in National Collegiate Athletic Association Men’s and Women’s Ice Hockey: 2009-2010 Through 2014-2015 Academic Years. Orthop J Sports Med. 2016;4(3):2325967116632692. doi:10.1177/2325967116632692
3. Lynall RC, Mihalik JP, Pierpoint LA, et al. The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys’ Ice Hockey (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Men’s and Women’s Ice Hockey (2004-2005 Through 2013-2014). J Athl Train. 2018;53(12):1129-1142. doi:10.4085/1062-6050-176-17
4. Anderson GR, Melugin HP, Stuart MJ. Epidemiology of Injuries in Ice Hockey. Sports Health. 2019;11(6):514-519. doi:10.1177/1941738119849105
5. Vigdorchik JM, Nepple JJ, Eftekhary N, Leunig M, Clohisy JC. What Is the Association of Elite Sporting Activities With the Development of Hip Osteoarthritis? Am J Sports Med. 2017;45(4):961-964. doi:10.1177/0363546516656359
6. Wörner T, Thorborg K, Eek F. High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position. Knee Surg Sports Traumatol Arthrosc. 2020;28(7):2302-2308. doi:10.1007/s00167-019-05787-7
7. Langner JL, Black MS, MacKay JW, et al. The prevalence of femoroacetabular impingement anatomy in Division 1 aquatic athletes who tread water. J Hip Preserv Surg. 2020;7(2):233-241. doi:10.1093/jhps/hnaa009
8. Baugh CM, Kerr ZY, Kroshus E, Lanser BL, Lindley TR, Meehan WP. Sports Medicine Staffing Patterns and Incidence of Injury in Collegiate Men’s Ice Hockey. J Athl Train. 2020;55(6):587-593. doi:10.4085/1062-6050-0464.19
9. Whalan M, Lovell R, Sampson JA. Do Niggles Matter? - Increased injury risk following physical complaints in football (soccer). Science and Medicine in Football. 2020;4(3):216-224. doi:10.1080/24733938.2019.1705996
10. Mendonça LD, Ley C, Schuermans J, Wezenbeek E, Ifspt, Witvrouw E. How injury prevention programs are being structured and implemented worldwide: An international survey of sports physical therapists. Phys Ther Sport. 2022;53:143-150. doi:10.1016/j.ptsp.2021.06.002
11. Vergani L, Cuniberti M, Zanovello M, Maffei D, Farooq A, Eirale C. Return to Play in Long-Standing Adductor-Related Groin Pain: A Delphi Study Among Experts. Sports Med Open. 2022;8(1):11. doi:10.1186/s40798-021-00400-z
12. Short SM, MacDonald CW, Strack D. Hip and Groin Injury Prevention in Elite Athletes and Team Sport - Current Challenges and Opportunities. Int J Sports Phys Ther. 2021;16(1):270-281. doi:10.26603/001c.18705
13. Mosler AB, Agricola R, Weir A, Hölmich P, Crossley KM. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med. 2015; doi:10.1136/bjsports-2015-094602
14. Nielsen MF, Thorborg K, Krommes K, et al. Hip adduction strength and provoked groin pain: A comparison of long-lever squeeze testing using the ForceFrame and the Copenhagen 5-Second-Squeeze test. Phys Ther Sport. 2022; doi:10.1016/j.ptsp.2022.02.002
15. Thorborg K, Branci S, Nielsen MP, Tang L, Nielsen MB, Hölmich P. Eccentric and Isometric Hip Adduction Strength in Male Soccer Players With and Without Adductor-Related Groin Pain: An Assessor-Blinded Comparison. Orthop J Sports Med. 2014; doi:10.1177/2325967114521778
16. Bonello C, King MG, Crossley KM, et al. The association between hip/groin pain and hip strength in football players: An exploratory analysis of the FORCe cohort. J Sci Med Sport. 2023; doi:10.1016/j.jsams.2023.07.008
17. Beddows TPA, Weir A, Agricola R, et al. Hip and groin pain in male field hockey players: Prevalence, incidence and associations with patient reported outcome scores and hip muscle strength. Phys Ther Sport. 2023; doi:10.1016/j.ptsp.2023.02.010
18. Oliveras R, Bizzini M, Brunner R, Maffiuletti NA. Field-based evaluation of hip adductor and abductor strength in professional male ice hockey players: Reference values and influencing factors. Phys Ther Sport. 2020; doi:10.1016/j.ptsp.2020.03.006
19. Nevin F, Delahunt E. Adductor squeeze test values and hip joint range of motion in Gaelic football athletes with longstanding groin pain. J Sci Med Sport. 2014; doi:10.1016/j.jsams.2013.04.008
20. Tak I, Glasgow P, Langhout R, Weir A, Kerkhoffs G, Agricola R. Hip Range of Motion Is Lower in Professional Soccer Players With Hip and Groin Symptoms or Previous Injuries, Independent of Cam Deformities. Am J Sports Med. 2016; doi:10.1177/0363546515617747
21. Delahunt E, Fitzpatrick H, Blake C. Pre-season adductor squeeze test and HAGOS function sport and recreation subscale scores predict groin injury in Gaelic football players. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2016.07.002
22. Drew MK, Lovell G, Palsson TS, Chiarelli PE, Osmotherly PG. Australian football players experiencing groin pain exhibit reduced subscale scores of Activities of Daily Living and Sport and Recreation on the HAGOS questionnaire: A case-control study. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2017.04.004
23. Wörner T, Thorborg K, Eek F. Five-Second Squeeze Testing in 333 Professional and Semiprofessional Male Ice Hockey Players: How Are Hip and Groin Symptoms, Strength, and Sporting Function Related? Orthop J Sports Med. 2019; doi:10.1177/2325967119825858
24. Quintana-Cepedal M, de la Calle O, Medina-Sánchez M, Crespo I, Del Valle M, Olmedillas H. Characterising groin pain in rink hockey: Function and five-second squeeze in Spanish players. Phys Ther Sport. 2022; doi:10.1016/j.ptsp.2022.10.004
25. Nussbaumer S, Leunig M, Glatthorn JF, Stauffacher S, Gerber H, Maffiuletti NA. Validity and test-retest reliability of manual goniometers for measuring passive hip range of motion in femoroacetabular impingement patients. BMC Musculoskelet Disord. 2010; doi:10.1186/1471-2474-11-194
26. Mentiplay BF, Perraton LG, Bower KJ, et al. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study. PLoS One. 2015; doi:10.1371/journal.pone.0140822
27. Stull JD, Philippon MJ, LaPrade RF. “At-risk” positioning and hip biomechanics of the Peewee ice hockey sprint start. Am J Sports Med. 2011; doi:10.1177/0363546511414012
28. Tak IJR, Langhout RFH, Groters S, Weir A, Stubbe JH, Kerkhoffs GMMJ. A new clinical test for measurement of lower limb specific range of motion in football players: Design, reliability and reference findings in non-injured players and those with long-standing adductor-related groin pain. Phys Ther Sport. 2017; doi:10.1016/j.ptsp.2016.07.007
29. Larson CM, Ross JR, Kuhn AW, et al. Radiographic Hip Anatomy Correlates With Range of Motion and Symptoms in National Hockey League Players. Am J Sports Med. 2017; doi:10.1177/0363546517692542
30. Eckard TG, Padua DA, Dompier TP, Dalton SL, Thorborg K, Kerr ZY. Epidemiology of Hip Flexor and Hip Adductor Strains in National Collegiate Athletic Association Athletes, 2009/2010-2014/2015. Am J Sports Med. 2017; doi:10.1177/0363546517716179
31. Mumbleau AM, Schilaty ND, Hewett TE. Hip muscle inhibition after hip arthroscopy: a role for neuromuscular electrical stimulation. Int J Sports Phys Ther. 2020; doi:10.26603/ijspt20201222
32. Rice DA, Graven-Nielsen T, Lewis GN, McNair PJ, Dalbeth N. The effects of experimental knee pain on lower limb corticospinal and motor cortex excitability. Arthritis Res Ther. 2015; doi:10.1186/s13075-015-0724-0
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Aug 30, 2024
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The Association of Hip Strength and Range of Motion with Hip and Groin Pain in Collegiate Ice Hockey Players: Original Research. (2024). Research in Health and Medicine, 4(1). https://doi.org/10.53520/rdhs2024.104125
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Copyright, 2025 by the authors. This work is licensed under the Creative Commons Attribution 4.0 International License.