Hockey is hyper specific in what takes place on the ice. Injury recovery needs to meet and exceed that specificity.

When we speak of hockey injury recovery needing to be hyper specific, there are questions that arise like: What does that mean? What should it look like? Can we specifically address injury to meet the demands of the sport? Can we mitigate recurrence? Can we psychologically assist players in recovery? Our goal should always be to properly and fully prepare the player to return to play without setback, fear or concern.

Treating Injuries

Hockey injuries, physical or concussion, must be treated relative to the specific skill set in which they are obtained. This, in the simplest form, means the players must recover in relation to sport specific equipment, movements and surfaces. For elite hockey athletes this means purposely recovering on ice. Including skill specific on-ice exercises makes it possible to maximize the effects of off-ice rehabilitation, decrease time in returning to pre-injury status and prevent or minimize further recurrence of the injury.

However, a gap exists between off ice rehabilitation and a return to play. This gap, I believe, has led to many players being injured, sidelined, and has even ended careers before they should have ended. Psychologically players not only want to know they will get better, they need to know. Returning them to the ice to continue and build on the rehabilitative process allows them to gain confidence and to continue working towards a full recovery. We are talking about recovery, not rehab. I will address the difference a little later. Of key importance is the inclusion of venue (ice) and sport specific equipment. Our sport is unique in both regards. Therefore, recovery needs to address these issues. Players with confidence do not hesitate upon return to full speed practice and game play.

It is vital to invest time on the front end of the on-ice return process to give coaches the ability to play every player, reduce man games lost and maintain roster continuity for deep season runs.

The Gap

It was working as the Strength and Conditioning Coach for the Lethbridge Hurricanes in 2008-09 where the “gap” was really exposed. We had a player selected to the World Junior Championship team and he suffered a high ankle sprain at the tournament. Upon his return, we did all the required traditional off ice rehab processes and the player was given clearance to return to ice. You could see immediately that regardless of what we did off ice, the constraints of equipment, sport specific movements and playing surface were impacting his functional abilities. As could almost be predicted, he tweaked the ankle and was out for another six weeks. That event created my Interval Sport Injury Recovery Process for Hockey (ISIRPH).

I was given the go ahead by Coach and GM and developed an on-ice recovery process that we implemented. By progressively introducing the injury back to equipment and specifics of the game, on ice, the player made a full return without recurrence or compensation. He continues to play professionally today. If asked what one thing made the biggest impact from this process, I would say that it was our dictating the rate of progress from an on-ice perspective. We programmed the pace of recovery on ice by designing an injury specific program and ensured that the ankle injury did not recur or become a knee, groin or hip injury.

The video above is a good example of the specificity required to recover the hip injury. We start slow and build in intensity and volume. This intensity and speed are bi products of the return to function.

This next video shows us progressing, increasing load and intensity positionally as this player plays defense. Once we are comfortable and feel we have risked out the potential for re-injury or compensatory injury, we hand off to or engage the skills coach to keep the progressions going and prepare the player for a full confident return to game speed. 

Rehab vs. Recovery

Rehab’s primary focus is to restore health.  Recovery’s primary focus is to restore function. A player can be healthy and feeling good, but their sport specific function may be off for a number of reasons. It is at this sensitive gap between off ice rehab and RTP that an ISIRPH should be implemented. An ISIRPH re-introduces the injury, motion segment and entire body, symmetrically, in a gradual or scaled process. Employing an injury knowledgeable skating professional is beneficial as they can accurately assess the players ability to get into a good skating position. When limited by the injury, low quality movement creates opportunity for setbacks. Setbacks increase MGL and reduce the coach’s ability to play all players. That is why we want to address the injury hyper specifically through a gradual application of force to reduce incidence of setbacks.

For recovery to be optimal, it must have meaning to the player. While overlooked and often utilized too late, incorporating the player’s mental wellbeing into the recovery process is crucial. The psychological benefits from on-ice return to sport activities following injury cannot be overstated. Returning to a familiar setting, getting back on ice in equipment and performing sport-specific movements greatly improves a player’s mental outlook for recovery.

Injury is a threat. After experiencing injury, players may feel cheated, restless, isolated, a loss of trust, a loss of identity, anxious or depressed. Providing a positive on ice recovery experience that delivers progress will encourage and drive players to continue on a positive path of recovery.

Getting players back from injury takes a multidisciplinary team of professionals all performing in their area of expertise and then handing the player off to the next level of the process. Once we have restored function and the player is comfortable, Skills Coaches are engaged to increase both the intensity and volume needed to play at full speed. Positional skills and skating can be ramped up once injury risks have been mitigated.

Our goal should be to do what we can when we can to facilitate a timely return for all players. Hockey injury recovery, including concussion injury, needs to be hyper specific. Other sports like baseball, have been employing Interval Based Recovery Processes for years. Functional recovery guidelines that simulate those sports activities. The Interval Sport Injury Recovery Process for Hockey was developed to meet the demands for our game. To specifically close the gap between off ice rehab and the return to play.

Interval Sport Injury Recovery Process for Hockey

The ISIRPH is subjective. The process is developed on an individualized basis for each player depending on several factors like; injury severity, pain threshold, mental or psychological state and readiness to commit as examples. The phases are guidelines that allow us to progress at a scaled pace to ensure we are hitting key performance functions appropriately.  A player may advance through phases faster, remain at a particular phase or may return to a previous phase at any point depending on the severity of the injury and or the return of symptoms. The process would be evaluated daily by medical/training staff if that is an option.

Important: This is not an assessment tool. Prior to starting this recovery process, the player has been assessed by trained medical professionals and cleared to return to sport. Should any symptom be verbalized or demonstrated by the player during this process, they are immediately referred to the medical community for further assessment.