In part 1 of this “Training Around Hockey Injuries” series we discussed some very important components towards injury, inflammation and the cost/benefit analysis between various methods athletes utilize to enhance their recovery process. Within this blog post, I want to stay inside the injury perspective but shed some light on active recovery and training around both upper and lower body injuries.
I first want to make something very clear here though for everybody. I am not a physiotherapist or rehab geek of any sort. My expertise lie within strength + conditioning and nutrition for optimal performance. I know what I’m best at and what I am not. What you will be reading here today is an informed opinion on the topic (as I have done much research in this area, just not to the level any of movement expert of course) from a guy who has also been messing himself up in the gym for the past 10+ years straight.
I will be talking about things that I have done that have worked for me, this is for educational purposes only and I always recommend that if any of you have injuries that it should be something you discuss with a medical specialist first.
When it comes to injuries, if you have been playing hockey and lifting long enough, it’s going to happen. The degree of which you get injured will vary greatly, everything from broken bones to just the normal wear and tear. Some athletes get lucky and go a whole professional career with only the general wear and tear. No matter what though everyone seems to get a little banged up here and there.
Having done this many times myself plus coaching so many athletes through it as well, I feel I have a lot of both theory and experience to offer on this subject. Let’s starter’ up with some active recovery talk.
Active recovery is one of the best things you can do for both injury recovery and even Delayed Onset Muscle Soreness (DOMS) in my experience. A steady, low-intensity effort can create a “pumping effect”. This pumping effect generates repetitive mechanical squeezing by the muscles during contraction and relaxation which will increase blood flow and improve range of motion. Due to this increased blood flow, you will also be increasing the removal of inflammatory causing agents as well as residual fatigue producing by-products (such as lactate) from the muscle and/or injury site.
Active recovery from a training perspective is typically used either on off days or during periods where you are training 2x per day and you have several hours in between workouts. Anaerobic training sessions increase lactate concentration within working muscles, leading to fatigue and a reduction in force and power output. Therefore, our ability to remove lactate and hydrogen ions from the muscle after anaerobic exercise will set us up for better perform within our PM training session by simultaneously removing fatigue by-products and re-stocking phosphocreatine (for more discussion on low-intensity effort work’s role in anaerobic power output, see this blog). Research has even demonstrated that as little as 20mins of low-intensity active recovery produced better recovery measures several days later.
Why is active recovery so important for injuries?
• It improves blood flow and range of motion
• It gives you something to do to continue burning calories while you’re injured
• It removes fatigue producing by-products
• It is very effective at managing inflammation which is the main source of pain during injury
• It enhances recovery through both the removal of cellular debris (dead, injured cells) and the remodeling of new tissue
Two more things worth mentioning here on the subject of active recovery.
1. Active recovery is also hard training, it’s not just low intensity stuff. Meaning, if you injured your lower body but you still put in a hard arm workout today, that’s still a great form of active recovery.
2. The advice “just listen to your body” is normally stupid. Obese people listen to their body all the time, that’s why they are overweight. If I listened to my body it would tell me that beers are awesome for simultaneous muscle building and fat loss. But, the “listen to you body” advice actual does play a good role in active recovery. As mentioned in part 1, whatever you do has to be pain-free. If it’s not pain-free, you are not helping anything. Listen to your body and pay attention to what you can and can’t do.
Training Around Injuries
It’s very easy to come across knee pain at some point in a hockey career. Hockey players are notorious for having under developed vastus medialis muscles and over developed vastus lateralis muscles. This structural imbalance within the quadriceps (often in combination with weaker hamstrings) can lead to additional stress on the knee.
Compiling on top of this, sprints, squats, single leg squats, skating and just lots of leg work in general is a must in hockey strength training and can overtime lead to some knee pain. This is actually the most common form of knee pain, inflammation of the tendons due to overuse.
Some tips on training through / healing up knee pain include:
• Trying to not allow the knee to pass the toes during squats and other leg movements. This actually isn’t an issue for those with healthy knees, but can be for those with inflammation. The further the knee tracks forward, the greater torque you are placing on the knee. This means keeping your knee behind the toes during leg movements, this also means don’t lift in a shoe with an elevated heel. We want to limit ankle flexion as much as possible here.
• Emphasize exercise in where your feet don’t move (leg press, hamstring curls, etc) compared to those where your feet do move (lunges, sprints, etc). A controlled motion = controlled pain.
• Knee sleeves are great for knee pain and are also recommended to wear even outside the gym. Not really tight ones though.
• Cho-pat straps are also fantastic here, but only wear them if it begins to ache, don’t wear them all day.
• Leg pressing and box squatting seems to be 100% ok for almost everybody who has knee pain but I’m speaking entirely from experience with myself and all my clientele so take from that what you will.
For prevention, make sure you are structurally balanced in the lower body. I have wrote articles on this in the past as it’s a big issue for hockey players due to skating mechanics. An easy recommendation to make here without going into the great detail that structural balance deserves is just to simply make sure you are always incorporating unilateral lower body work in your training and not just always doing bilateral work.
Elbow pain is something that is much less common in those who have good technique in the gym. From what I have seen, if you have good technique for all your upper body work, elbow pain is a pretty rare thing. It’s primarily the ego-lifters using weights they can’t handle with good technique with lots of momentum and bouncing it around that run into these issues.
But for those of you who do legitimately have good technique and can honestly say that to yourself and still have elbow pain it’s generally due to inflammation and overuse, just like the knee joint. Similar issues across the board between the elbow joint and the knee joint primarily because they both have a hinge structure and function the same.
Some tips on training through / healing up elbow pain include:
• Wearing elbow sleeves in and out of the gym, but especially during all your pressing movements.
• Slowly working your way up from lower weights to heavier weights for all your pressing movements. Take a while to warm up and get in the groove here.
• Skull crushers should be eliminated entirely.
• Sleeping on a good quality mattress (yes I’m serious, this helps).
• Make sure your wrist stays in line with your elbow during pressing and pulling. Not doing this puts extra stress on the forearm muscles and tendons which then adds additional stress to your elbow.
• Grip the bar very hard during any and all movements. This keeps much more of the tension on your muscles and not your connective tissue, distributing more tension away from your elbows. This will also improve the strength of your lifts through the law of innervation, discussed in length in my most recent Lighting the Lamp training system.
• Use exercises that allow a more natural movement / rotation of the arm such as doing your chin ups on rings or swapping out barbell work for dumbbell work. When you force the wrist in a fixed position (like with chin up bars and barbells) the tension on the elbow is higher. The elbow is designed for stability, not mobility.
For prevention, make sure you are performing everything with very solid technique. This should really be the rule for all pain but it just bears emphasizing for elbow pain because very often it’s simply a technical flaw that is causing their pain and not actual overuse or inflammation. Beyond this, keeping the biceps work up, don’t be afraid to use sleeves more often than not and just leave skull crushers out of the game entirely. I find even when done with great technique, those who do skull crushers year round still run into problems. It might not happen now, but it will happen down the road. There’s a reason all the old guys at the gym will tell you skull crushers are rough on the elbows, they just are.
Groin pain is common during skating, but even more common for goalies who in a split second have to drop down and shoot a leg out. Lots of guys also run into some groin pain here and there during squat movements, but I would definitely say that it’s more of an on-the-ice injury than in the gym.
Groin strains can be a killer, depending on the severity of the groin issue I would even recommend avoiding lower body work all together. Yes even body weight stuff, just eliminate it all. There is really not a lot of stuff you can do that doesn’t involve stretching the adductors/abductors in some way or another.
Some tips on training through / healing up groin pain include:
• A very good warm up. The groin is almost never stretched in everyday life, so an insufficient warm up of these muscles leaves them more prone than other muscles to injury in a stretched position (Ex. Skating, squatting, toe saves, etc)
• The adductor machine is actually really great at helping fix this issue, despite whatever functional training idiot told you to bounce around on a ball until it doesn’t hurt anymore.
• The adductor machine (AKA the good girl machine) is great for warming up the groin, stretching the groin and strengthening the groin, it doesn’t get much more functional than that.
For prevention, keep your adductors/abductors strong and always warm before activity. Good exercises for strength include lunging, split squats and Cossack squats. Also since it is more susceptible than other muscles for pulls and strains, keeping up with your hydration and electrolyte balance is key here. Dehydrated guys pull muscles more often, especially the groin.
For those who know their anatomy, you know that the shoulder in infinitely complex and that I absolutely cannot cover everything that can happen within the shoulder in this small section here. The injuries for this area of the body vary considerably due to the wide range of motion, wide range of functions and just simply how many muscles connect within that region.
Here’s my experience speaking again, most shoulder pain is a result of poor technique in the gym and is most often associated with external rotation pain. Beyond this, another reason for shoulder issues is actually genetically based by how your parents decided best to shape your acromion. Long story short, the shape of your acromion determines how much space your shoulder has to function and your overall susceptibility to shoulder impingement issues.
You can test for this genetic susceptibility right now.
1. Stand up
2. Straighten your arms on your sides
3. See how far you can raise your hands laterally in the stretch position with your thumbs pointing down (as if you are emptying a can).
4. Now, try again with your thumbs pointing towards the ceiling (like you are not spilling a can).
5. If you feel any pain or if you are significantly weaker with your thumbs down but not with your thumbs up, this suggest impingement issues.
6. This is called the Jobe’s test, I did not invent this. You can look it up for more information if you’re interested.
Some tips on training through / healing up shoulder pain include:
• Avoiding impingement issues during training is effectively accomplished through pinching your shoulder blades together and arching your upper back. This increases how much room your shoulder has to function internally and prevents pain / injuries from turning up.
• You should be bench pressing like a power lifter for the above reason.
• Don’t neglect rotator cuff work in your plan, most people have wildly weak external rotation. This is something that should always be in your plan and can be trained 1-3x per week. How many times have you ever heard somebody say “Hey man, ease up on the rotator cuff work, your rotators are looking jackedddd”. Never.
• Shoulder pressing with dumbbells is generally easier on the shoulders than a barbell. Additionally, dumbbell shoulder press utilizing a neutral grip is by far your safest overhead press for the shoulders.
For prevention, pick the right parents next time you get born so that you have less impingement issues. But in all seriousness, a good warm up (once again) goes a long way here. Warming up the rotators before heavy overhead pressing is a must, especially if you’re prone to shoulder pain. Additionally, incorporate actual strength work with your rotators 1-3x per week, avoid wide grip bench pressing and do lots of face pulls.
And that just about covers it!
I didn’t want to make this blog post too long so I went over the most common injuries hockey players have, 2 for the upper body (shoulder / elbow) and 2 for the lower body (knee / groin).
As a final note I want to say that just because something is recently pain-free, this doesn’t mean that it’s healed. You can learn this the easy way by listening to me, or you can learn it the hard way. That’s up to you. Because once that pain goes away, you start getting really happy and start pushing it again.
Then, bam! The same injury happens again. How many times have you heard of guys re-injuring the same spot again because they went back at it too soon? About a million times? Me too.
A general rule to follow here to wrap up this whole series is that once you have a training session with absolutely zero pain or tightness, continue all the above prevention and rehab techniques before you try and up the ante. That injured area of your body is still weak and is still not 100%. All that happened is it’s not hurting anymore, this is good, but doesn’t mean you’re back to your old self yet.
Keep up the rehab stuff, then make a plan for two weeks from now to start getting back into it slowly and safely. This means not going super heavy for at least 8 more weeks. You’re a hockey player, you should be building strength in the gym anyways, not demonstrating it.