Preventing and Treating Common Field Hockey Injuries

Field hockey is a physically challenging, multi-sprint sport. It has the same number of players and a similar sized field as soccer; making the demands very similar. Power is required for acceleration and quick direction changes, along with endurance to last the entire game. Flexibility and stability are also needed to avoid injuries. Unlike soccer; field hockey does require a lot of upper body strength to shoot faster and over greater distances.

Some of the most important movements required with field hockey are:

  • explosive trunk rotation during a shot
  • first step quickness and top speed sprinting while on offense and defense
  • ability of goaltender to be explosive with clean footwork to cover both posts
  • ability to keep low center of gravity while cutting and stick handling

Strength Training:
Strength training is the basis for all sports training. Without the proper, balanced base of strength, athletic movement cannot be executed powerfully, quickly, efficiently, or safely. A proper strength program includes a periodized schedule manipulating load (resistance), volume (reps and sets), and training methods.

Flexibility Training:
Flexibility is absolutely necessary to allow the body to use the greatest range of motion required in athletic events. Improved flexibility enhances countless athletic movements including increased stride length during sprinting, hip and trunk flexibility to handle the stresses of the game, and improved ability of goalies to scramble, dive/slide, save and recover with proper positioning and speed.

Power Training:
All athletic events revolve around one thing – powerful, explosive movements that allow one athlete to prevail over the other. Power is the combination of strength and speed. All great athletes are able to use great strength at great speeds. Field hockey players exhibit this with first step explosiveness and during their shot while goalies need to have great footwork with the ability to move laterally, slide/dive, and just as importantly, clear and recover with power to defend the goal. Various training techniques such as plyometrics and band training allow athletes to tap into previously unknown stores of power.

Sprints:
Sprint training can provide immense benefit to players not accustomed to running quickly on the field. By executing repeated sprints in short bursts, players will sharpen their technique while developing the muscles needed to run faster. Short sprints also provide players with the most reasonable facsimile of the kind of running they will do in a game setting.

There are many different kinds of injuries that are associated with field hockey. The majority of them are consistent with direct blows from either the stick or the ball. The most common injuries include ankle sprains, knee injuries, meniscal tears, muscle strains, foot fractures, hand/ wrist injuries, facial injuries, and concussions.

Ankle Sprain

An ankle sprain is the result of an unnatural sideways or twisting motion of the ankle joint that results in the stretching or tearing of the ligaments supporting the ankle joint. The best way to prevent an ankle sprain is to increase strength and flexibility in the muscle groups that help to support and stabilize the ankle joint. It is also important to train the proprioceptive capabilities of the ankle so that it can respond quickly to conditions that may lead to injury.

Meniscus Tear

meniscus tear is commonly referred to as torn cartilage in the knee. There are two menisci in the knee, medial and lateral which act as a cushioning that help disperse weight across the knee joint. The most common mechanism of injury when dealing with a meniscus tear is twisting the knee in a bent position when the foot is planted on the ground. A few recommendations to avoid a meniscus tear include strengthening the surrounding musculature and learning the correct techniques when cutting, pivoting, and jumping.

Foot Fractures

Foot fractures are caused by a direct blow to the foot or a sudden pain from a force applied to the foot. There will be tenderness, pain, and a possible deformity of the foot. A pain that develops slowly and gradually gets worse could be a sign of a stress fracture.

Hand/Wrist Injuries

The hands and fingers are extremely vulnerable to injury in field hockey. One hand is placed low on the stick, and contact with the ball or an opponent’s stick makes the hand and fingers susceptible to injury. Hand and finger fractures are quite common.

Facial Injuries

An errant shot or follow through with a stick may make accidental contact with the face and cause injury. Luckily, the majority of these injuries are minor cuts and bruises, but more severe injuries such as facial fractures, eye injuries, and broken teeth can occur.

 

There are many different kinds of injuries that are associated with field hockey. Similar to soccer and other field sports, ankle sprains, knee injuries such as ligament sprains or meniscus tears, and muscle sprains are common. The injuries that are more unique to field hockey involve direct blows from either the stick or the ball, and these include foot fractures, hand fractures, facial injuries, and concussions.

Ankle Sprain

The initial treatment of an ankle sprain should include rest, ice, compression, and elevation (RICE) to control swelling and pain. Physical therapy is often useful in restoring range of motion and muscle strength to help stabilize the ankle joint. Bracing or taping may also be used to help provide support when returning to activities.  Balance or proprioception exercises are important once the initial pain goes away to help restore the function of the ankle.

Meniscus Tears

Initial treatment for a suspected meniscus tear is the RICE protocol.  If the symptoms do not resolve, then it may be necessary to see a surgeon to diagnose a tear in the meniscus.  Depending on the size of the tear, treatment may be conservative or surgical.  Often an MRI will aid in confirming the diagnosis of meniscus tear.

Foot Fractures

A foot fracture from a direct blow usually requires immobilization and limited weight bearing for several weeks to allow the bones to heal. This can be accomplished with a hard cast, a hard-soled shoe, or a walking boot, depending on the severity and location of the fracture. Crutches are generally used to limit weight bearing after a foot fracture. Toe fractures are very painful injuries that are difficult to immobilize and are generally treated with buddy taping to the adjacent toe. Occasionally, a severely displaced fracture of the foot may require surgical reduction and fixation. One such fracture that usually requires surgical management is a fracture of the base of the fifth metatarsal, called a Jones fracture. If a stress fracture is diagnosed in the foot, the treatment is a period of rest, immobilization, and limited weight bearing until the pain resolves.

Hand/Finger Fractures

Hand fractures generally require more complex management than foot fractures, especially if they involve the joints of the fingers. The motions of the hand are so intricate and diverse that it cannot tolerate very much misalignment of the bones after a fracture. Fractures around a joint in the finger have a tendency to develop significant stiffness if they are not managed closely with good therapy. It is important to get good X-rays and to see an orthopedist if a hand fracture occurs.

Facial Injuries

Minor cuts and bruises of the face from direct contact are treated with local wound care such as ice, antibiotic ointments, and sutures if necessary. More severe facial injuries such as facial fractures, eye injuries, and broken teeth should be managed emergently by the proper specialists. Any player with a severe facial injury should also be evaluated for signs and symptoms of a concussion.

[toggle name="How can I prevent traumatic injuries in field hockey?"]Proper personal protective gear is the most important measure to prevent traumatic injuries. Shin guards, mouth guards, and padded gloves can be worn by all players to help reduce injuries. Defenders may wear a facemask for short corners. Goalies have their own set of protective gear that is more extensive.
[/toggle]
[toggle name="How can I prevent overuse injuries in field hockey?"]Taking time off during the year is very important in preventing overuse injuries. Playing one sport year-round predisposes you to all types of overuse injuries including stress fractures, tendinitis, and muscle strains. [/toggle]
[toggle name="What steps can I take to minimize my risk of injury in field hockey?"]Besides proper protective equipment, an adequate warm-up is a very important part of injury prevention. Making sure the muscles that are going to be used during the game are warm and flexible before beginning play is critical. A good warm-up should mimic motions that will be performed during the game and should last approximately 20 minutes. [/toggle]

This article was written in conjunction with Amanda Carroll, MS, ATC, an employee of KORT Physical Therapy and Athletic Trainer for Louisville Male High School. Amanda is nationally certified with the Board of Certification and state certified with the Kentucky State Board of Medical Licensure. She has a Master’s Degree in Exercise Physiology from the University of Toledo and a Bachelor in Science from Indiana State University.