Well, it certainly isn’t idea for a hockey goalie, but how bad is it?
You know that I am in the process of writing the most comprehensive article I have ever written on any topic (since writing my Master’s Thesis of course) and it is all about hip impingement and that has me with a little case of “impingement on the brain”.
Before I finish up that huge article, let’s just look at answering the question “how bad is it?”
No goalie wants to hear that they have hip impingement. Just like no pitcher wants to hear that they have a torn labrum or a rotator cuff tear. And I see goalies do the same things that pitchers do when they have joint pain; they try to ignore it or downplay it. They basically bury their head in the sand and hope it goes away.
If I don’t KNOW for sure that I have hip impingement, then logically, I DON’T have hip impingement. I just have a sore hip – – YAY; all good!
And this is hand’s down the WORST strategy you could adopt.
For starters, you only know you have hip pain. You don’t KNOW it’s impingement at all. Or maybe it is impingement but it’s not a true bony impingement that is caused by a mis-shaped ball or socket in the joint.
You could be getting that impingement because your pelvis is out of alignment, or because the ball is sitting too far back or too far forward in the socket or maybe the connective tissue capsule which surrounds our articular joints has become too restrictive and it is compressing the ball in the socket.
All of those can be solved with some good manual therapy from a good sport physiotherapist or sport chiropractor. I specifically say a “good” practitioner because I have worked with so many goalies who go to get their hip assessed and the treatment provider only spends time looking at their hip joint – not their pelvis, their back or even their ankle which can all impact how you use your hip.
Also notice that I did not suggest a trip to your doctor right off the hop and that is for two reasons…
- The initial treatment is often to rest and take some anti-inflammatories. Well, pretty much ANYTHING will feel better with rest and anti-inflammatories, but it does nothing at all to solve this specific problem.
- They might want to treat you based on the imaging. Here’s what I mean. They might do X-rays or even MRI and those might show hip impingement, which may lead to a referral to an orthopaedic surgeon… who (depending on where you live) might lead to a booking for surgery.
But don’t you need surgery to fix it?
Well, yes.
If the cause of your pain is a true bony impingement (cam, pincer or mixed), then you will likely need surgery at some point to correct that.
But what if your imaging shows evidence of a cam impingement, but your pain is really the result of capsular tightness?
There are a lot of goalies out there playing pain free who would show evidence of hip impingement on imaging. They may need surgery for it at some point, but not when they are symptom free.
So is it Bad or Not So Bad?
It’s not great; but it isn’t the worst thing ever and here’s what I think you should do.
Do a good course of physiotherapy first (plan on giving it 8-12 weeks of dedicated physiotherapy), ideally that would be with someone who has experience working with hip impingement (soccer players, hockey players, field hockey players, etc).
They will address any soft tissue restrictions (like that capsular restriction), they will help you regain neutral pelvis and take you through a progressing teaching you how to maintain that position while you play.
You will learn your boundaries and what you just need to avoid in your off-ice goalie training – you will never be a deep squatter, so stop trying to get four-inches lower when you lift. Just go with what you have.
You will also pay more attention to where your restrictions lie on the ice, so you can work on different techniques that will work for your body. Basically, you will (hopefully) stop trying to smash a square peg into a round hole which creates more trauma and makes your impingement worse over time.
But what if I DO need surgery?
Again, not ideal, but not career ending at all.
In fact, of 24 NHL hockey players who participated in the research study by Marc Phillipon et al that was published in the Journal of Knee Surgery, Sports Traumatology & Arthroscopy in 2017, all but one of them returned to professional play.
The one who did not return to play, had significant joint osteoarthritis at the time of the surgery which complicates things.
Here is the Bottom Line…
Hip impingement is not good.
Hip impingement is not the end of the world.
Active treatment with an experienced physiotherapist can resolve your symptoms without surgery.
That doesn’t mean you might not require surgery down the road.
If you do require surgery at some point, don’t let your pain get worse and worse because you ‘don’t want to have surgery’. If you continue to force yourself through your goalie training and play through pain season after season, you are accelerating the damage to your joint and making it harder to have a successful outcome following surgery.
Now I will also remind you that I am not a physiotherapist, primary care doctor nor surgeon. Trust your health care providers to help you make the best decision for you based on their assessment. My purpose for writing this article is to explain some of your options and hopefully inspire you to look after any hip pain. I would much rather you get an assessment and be told that you are totally fine and you just need to stretch more than to have you suffer on for months and do permanent damage to your hips.
I am also working on a new episode of GTP TV walking you through what hockey goalies should expect following surgery for hip FAI – you can watch it HERE
And if you want to do something that could reduce your risk of FAI and at least take some load off your hips, knees, ankles and pelvis, then you should definitely be doing the Butterfly Challenge. It’s free. It only takes about 8 minutes to complete and not only will it help your mobility, but it will help you stop more pucks – – BONUS. Most of you are already doing it, but if you are new to GTP.com, then you can go grab it now RIGHT HERE.
Catch you later!
Maria
