PRORehab Library

Hip Adductor Strains in Hockey Players

The sport of hockey has grown throughout all of North America. Traditionally the sport was enjoyed by Canadians and Americans residing in northern states where colder climates dictated cultural habits. However in recent years this trend has declined due to the popularity of in-line hockey and the expansion of the National Hockey League into southern regions. Also, the gold medal won by the U.S. women's team in the 1998 Olympic Games in Nagano fueled the interest in women’s hockey further increasing the sports popularity. More and more individuals are discovering the fast paced sport and enjoying the rewards of competition and involvement. Not unlike other sports, participation can lead to injuries. This article will describe one of the most common injuries suffered by hockey players, the mechanics behind this injury, and methods of prevention.

"Groin pulls," or "groin strains," are familiar injuries to most athletes. This injury specifically affects the adductor muscles of the hip. In the human body five muscles that attach to the pelvis and the inner part of the leg bone called the femur collectively make up the hip adductors. One of the most frequent injuries seen in ice hockey players are adductor muscle strains.1,4 Recently a study was performed on the New York Islanders to determine the causes of this phenomenon. The researchers who worked with the professional team wanted to determine if this common injury resulted from the traditional theory of muscle "tightness" or rather weakness of the muscle when compared to its antagonistic hip abductors.5 Hip adductor muscles are antagonists to the hip abductors meaning the muscle groups work in opposition to each other. The results of their study showed that if a player’s hip adductor muscles were considerably weaker than the hip abductors, the player was more likely to suffer a groin strain than those players where strength differences were not significant.5 Furthermore, adductor flexibility was not related to these injuries.5

So what does this all mean for the everyday hockey enthusiast? Due to the mechanics of skating, hip abductor muscles are typically very strong in most professional, amateur, and recreational players. As a player strides the hockey blade edge digs deep into the ice surface and the hip abductors are employed to propel the player forward. The hip adductors must work as well to stabilize the hip and decelerate the limb.4 If muscle imbalances are present hip adductors may become strained due to tissue overload during the muscles' attempt to counteract the opposing forces.4 Based on the information from the study it makes sense that integration of specific adductor strengthening exercises into players' conditioning programs to balance overall hip strength would be beneficial.

Several other studies have shown that hockey injuries are correlated to overall fatigue. Many injuries are suffered at the end of a period or game when strength and reaction times are diminished.2 Poor training, inadequate nutrition, and lack of sleep can all lead to fatigue. Hockey is a vigorous sport and those participating should prepare their bodies to handle high intensive work. Preparation should consist of both aerobic and anaerobic training since both forms of respiration are utilized by the body during game play. Diets should include well balanced regimens consisting of foods rich in quality carbohydrates such as fresh vegetables and whole grains. Also participants should always practice good sleeping habits and avoid overtraining which can lead to chronic fatigue.

Several easy dry-land exercises can be performed to strengthen the hip adductors and balance overall hip strength. A player can target the desired muscles by lying on his or her side and raising the lower extremity against gravity as shown in fig 1. Ankle weights may be added to increase the resistance if repetitions become too easy. Players may also perform this exercise in standing with the use of tubing or elastic exercise bands as shown in fig 2. Inflated exercise balls of various sizes can be squeezed between the knees and held for several seconds as shown in fig 3. Repetitions, sets and frequency can vary. Generally the technique of progressive resistive exercise or PRE can be used to formulate an exercise regime. This is achieved through obtaining a 1 or 10 rep maximum for a given resistance and then creating a program to continually overload muscle tissues to provoke increases in muscular strength. A traditional PRE program would include 3 sets of 10 repetitions of a given exercise with resistance based on a 10 rep maximum. The trainee would perform the first set with 50% of the resistance of the 10 rep max, the second set with 75% of the max, and the third set with 100% of the max. Other PRE programs exist and one should recalculate his or her rep max periodically to account for increases in strength. With a PRE program, training with a variety of exercises 2 to 4 times a week is optimal. Muscles do require rest to grow and daily training may prevent sufficient recuperation. Are these exercises safe for children? The available evidence indicates that supervised resistance training emphasizing high repetitions and low resistance can considerably improve the muscle strength of children with no adverse effect on bone, muscle, or connective tissue.3

If a player happens to suffer a groin strain injury, treatment guidelines can be prescribed by a physician, athletic trainer, and/or physical therapist. Stretching, icing, rest and wrapping techniques can all be used to treat an acute injury. A medical doctor should always be consulted when an injury is serious or when a seemingly minor injury does not improve after several days of rest.

Unfortunately injuries are inevitable in a sport like hockey where the action is rapid and contact is frequent. Preparing one’s self physically and seeking knowledge about injury prevention can decrease incidents and make the sport more enjoyable for everyone.

Ray Bauer MS PT



1. Lorentzon R, Wedren H, Pietila T. Incidences, nature, and causes of ice hockey injuries: a three year prospective study of a Swedish elite ice hockey team. Am J Sports Med 1988;16:392-396.

2. Molsa J, Airaksinen O, Nasman O, Torstila I. Ice hockey injuries in Finland. A prospective epidemiologic study. Am J Sports Med 1997;25(4):495-499.

3. Sewall, L., and Michelli, L.J.: Strength training for children. J. Pediatr. Orthop., 6:143, 1986.

4. Sim FH, Chao EY. Injury potential in modern ice hockey. Am J Sports Med 1978;6(6):378-384.

5. Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility on the incidence of groin strains in professional ice hockey players. Am J Sports Med 2001;29(2):124-128.

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