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ATHLETES NEED TO BE MADE MORE AWARE OF THE IMPORTANCE OF INJURY PREVENTION
– Francis Weyts –
After graduating in 1984, Francis Weyts specialised in sports medicine, manual therapy and movement analysis. Over the years, many more specialisations and diplomas were added: Oriental medicine, osteopathy, endermology and psychosomatics. Weyts has twentyfive years of experience in gymnastics and acrobatics under his belt. In addition, he has been working with dancers and various sportsmen and women in the field of anatomical assistance for about 30 years. Today he is also the physiotherapistosteopath of Royal Victory Hockey Club Fanion Team D1/H1. The right specialist, therefore, to ask a few questions about injury prevention and treatment in hockey.
Mr Weyts, in your experience, what are the most common injuries among hockey players?
In the first place, strains in the groin or adductor muscles, whether or not in combination with an injury to the hamstrings (remarkably more on the left than on the right). Back problems are also frequent, more specifically at vertebrae D12-L1, the rotation point of the spine and the place where the blood flow to the hips starts, as well as the nerve endings of the oblique abdominal muscles and adductors at the pubis. There are also frequent problems in the lower back, with discopathy L4-5-S1 and SIG problems. This is mainly due to the hunched posture of hockey players and not always the right technique on the ball when running and dribbling. It is very important to learn this in time, so that this is mastered well during growth. Ankle distortion and sagging feet are also common among hockey players. The latter also causes problems at knee level due to torsion between the calf bone and the tibia. Finally, we are also often confronted with wrist instability due to the many wrist movements and other impacts. This leads to a strain of the ligaments of the wrist, which in time will result in a cyst, tendonitis or instability.
How are these injuries treated ?
We treat acute problems locally, often opting for ‘microcurrent’ (Bioenergetic-Stimulation or B-E-St), classic massage techniques, mobilisations or dry-needling. We also like to work with Normatec’s recovery pants, Hyperice’s massage shotgun, massage ointment or andullation therapy, an alternative healing method that uses mechanical vibrations in combination with red and infra-red light to stimulate the body’s cells and thus bring about pain relief and relaxation. Of course, everything starts with injury prevention, which includes a good recovery. We want athletes to be aware of this, because prevention is still the best cure! The specific exercises we will apply in that context are in function of the cause of the injury and individual need. The combination of agility, coordination, flexibility, strength and reaction speed is what is aimed for with this.
What is a normal rehabilitation period for this kind of injury ?
The rehabilitation period obviously depends on the type of Injury. In case of muscle tears, we talk about one week per centimetre of tear and this up to three centimetres, after that it is about five to six weeks. This period is also used to work on other ‘weaknesses’, provided that the injury is not compromised. Keeping the athlete engaged during rehabilitation optimises the healing process and creates an active process in which the athlete becomes more aware of his own body. Another important fact: the better the basic condition, the easier rehabilitation will be.
Agility, coordination, flexibility, strength and reaction speed are, so to speak, the building blocks of a healthy athletic person. At our club we have started a screening / basic check of the youth players who are in their puberty. This age group is in the danger zone when it comes to injuries. During puberty, the body is constantly changing, both in terms of growth and strength, and this can cause various injuries. The screening of these youth players gives us a kind of passport with possible weaknesses, or ‘risks’ if you want. On this basis, we can draw up a work schedule. B-Gold, the programme that prepares youth players for integration into the Senior National team, also uses this method for the selected players. In my humble opinion, it would not be bad to collect all this information, also with the cooperation of other clubs. This will allow us to identify the different injuries and gain a better understanding of the strain of this sport. And if I may give you one last tip: visiting an osteopath three to four times a year can also prevent a lot of trouble, especially in the back and pelvic area.
You mentioned that injury prevention is very important. How does this go in practice?
Do you have a standard protocol for treating hockey players ?
We use a basic SpartaNova protocol, which is a spin-off of UGent and VUB and specialised in prevention, rehabilitation and training. It is based on the following pillars: lower limb strength, hip and pelvic flexibility, core/leg stability, dynamic balance and alignment. As mentioned earlier, cooperation between the clubs and B-Gold could provide a broader platform. We could work with different physiotherapists to draw up exercise schedules that we could give to the athletes, as well as make appointments and exchange thoughts on rehabilitation and so on.
When is a player ready to play again after an injury, and who decides ?
I think a player should be able to train fully with the team for at least two training sessions. After that, if we are talking about someone who plays in the first team, he or she can play a match with the second team. A number of aspects are then monitored which may tell us whether or not they are ready. The physio, together with the rest of the medical staff, can then decide whether the player is ready for the real thing again. If there are still minimal risks or problems, a decision about the number of playing minutes can be made in consultation with the coach. The physiotherapist and the rest of the medical staff are there to make and keep the players fit to play. They identify possible risks and try to take preventive action. For example, we can help the players with taping, manipulation of the back or limbs and loosening of the muscles. We also insist on a good warm-up and cool-down, as well as dynamic stretching before the game and static stretching afterwards. As you can see, injury prevention is always the focus!
