Out on the Ice Faster with Warm Water Therapy
In honor of the recent college hockey playoffs and impending pro playoffs, what’s more appropriate than sharing a hockey recovery story that highlights a common hockey injury with a quick and safe return to the ice?
Mark Poolman, Certified Athletic Trainer and Associate Professor at University of North Dakota, discusses the injury and rehabilitation protocol for one of his injured athletes. The athlete was a collegiate hockey player who suffered a severe groin injury during a practice. This athlete had dealt with this injury previously, the season before, but never to the extent as this particular case.
Poolman said the athlete came to him to report that he re-injured his groin, which Poolman labeled as a ‘mild strain’. They decided to wrap him and perform a few exercises but chose not to put him in the pool at this point, which Poolman says “was a bad judgment call on his part”. The athlete played in their next game, a few days later and then felt the infamous pop in his groin and could not continue playing. He could not open up his hips or stride completely out.
The next morning, one day after, Poolman had the athlete in the warm HydroWorx therapy pool starting with some range of motion exercises to work toward a fast recovery. Poolman uses the pool for just about any type of injury from shoulder separations to groin injuries to high ankle sprains and everything in between. Poolman gravitates towards the pool when his hockey players are injured because the buoyancy of the water, the hydrostatic pressure and warm water (about 90 degrees) allows for increased range of motion. As an athletic trainer, his goal is to get his athletes back on the ice or field or court as quickly and safely as possible which is why he incorporates the aquatic therapy pool into the rehabilitation program.
After just one week of therapy, very intensive therapy (aquatic therapy, land based therapy, weights, ultra sound, anti-inflammatory medication etc.) the athlete was able to play in a game at 100%.
Poolman has the athlete begin with a warm-up, where within just ten to fifteen minutes their range of motion will be increased. Additionally, Poolman emphasizes the importance of ensuring your patient or athlete performs all of these exercises pain-free in the water. As an athlete it is easy to want to begin at 50-100% in a physical therapy program, however more damage is done when you push your body beyond its limits. Poolman informs his patients that the first priority with rehabilitation is increasing range of motion and decreasing swelling. Once the mobility has increased and inflammation has gone down, resistance training can be implemented.
Warm-up Exercises include:
- Walking jogging
- Flexion and extension of hip and knee
- Flexion and extension with hip rotation
- Adduction and abduction off of the treadmill
- Lateral slide on the treadmill- in athletic stance
- Shuffle and cross over, with gradual increase in speed
- Carioca using the hip muscles
Following these warm up exercises (demonstrated in the video), Poolman works on more sport specific exercises and movements, which not only increases strength and range of motion, but allows for a natural transition back to the ice for this hockey player. And this athlete was able to get back in his skates, just one week after suffering a serve injury to his groin.
Watch the full case history and pool protocols below: