Friday, February 17, 2017

Physiomoves: You Ask, We Answer - Ball Hockey

Photo credit: White Rock Ball Hockey Association

CASE STUDY: 14 Year Old Boy
Prepping for Ball Hockey
Problem Areas: Achilles

"My son started ball hockey a couple of years ago with the White Rock Ball Hockey Association. Even though I thought we got good enough running shoes, during both seasons he had to take long breaks because of sore Achilles. I am wondering what we can do better this year"

1.) Do you have any at-home treatment advice? 
It sounds like your son has developed Sever’s disease (a full examination should be done to confirm this diagnosis). This is a condition common in active youth during their rapid growth phase, especially when there is sudden increase in running or jumping. The Achilles tendon becomes irritated at its attachment to the heel bone (calcaneus) but will settle down with modified activity and some self-management tips from your Physiotherapist.

2.) What kind of therapy would you recommend? Physio? Massage
A Physiotherapist can properly assess the area and provide treatment suggestions such as modified activity (temporarily reducing the amount of running and jumping while the Achilles tendons settle down), using heel lifts inside the shoes to reduce tension on the Achilles tendons, suggest off-the-shelf orthotics if needed, teach gentle stretching exercises or self-massage techniques using a foam roller or ball, using ice after activity, etc. This program can be used to self-manage the Achilles with some guidance from your Physiotherapist. Massage therapy would certainly be a beneficial treatment in conjunction with physio.

3.) Before ball hockey begins, do you have recommendations for how he can prepare himself for this in hopes to lessen injury potential?
A good warm-up program (including some calf raises) followed by a dynamic stretching routine will help.

4.) Do you think that this has to do with the running shoe or is it more of a physical fitness issue?
Footwear can be an issue, especially if it doesn’t provide the right support or has lost its shock absorption capability. However, this condition is usually related to tendon overload – a sudden increase in running or jumping, compounded by the tight muscles and tendons caused by the athlete’s rapid growth phase. Being generally active and fit may have some protective effect, but young athletes are at risk of tendon issues during their rapid growth phase and any sudden changes in training can cause problems.

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