Physical fitness metrics and their relationship to locomotor activity profiles among female international field hockey players across an Olympic cycle

OBJECTIVES

The study explored the correlations between physical fitness metrics and match locomotor activity profiles. Furthermore exploring the transformations of both fitness tests as well as match locomotor activities over an Olympic cycle.

DESIGN

Observational descriptive study.

METHODS

Fitness testing (n = 24) and match locomotor activity (n = 102) profiles were collected. A Pearson's product-moment correlation and 95 % confidence intervals were calculated to determine relationships between metrics for each year. A mixed-effects model was used for repeated measures to identify differences in the physical fitness tests and match locomotor activity profiles between years.

RESULTS

The YoYo intermittent reocvery testest level 1 changed significantly (p < 0.0001) and accounted for 29 % of the variance in average speed (p < 0.001, rrm (59) = 0.54) Upper and lower body muscular strength, also improved, evidenced by the 3RM bench press (p < 0.0001), and a 28 % (2017-2019) increase in 3RM squat (p < 0.0001). Also pull-ups increased from 4.2 ± 2.8 pull-ups (2017) to 10.0 ± 3.1 pull-ups (2020) (p < 0.0001) and. countermovement jump height increased over the study duration (p < 0.0001). Match total distances remained unchanged, while average speed increased significantly (p < 0.0001). High-speed running distance (p < 0.0003) and sprint counts (p < 0.0001), showed significant improvements over the study period.

CONCLUSIONS

The study underscores noteworthy improvements in physical attributes and performance metrics over an Olympic cycle. Contributing valuable insights for enhancing athletic performance in hockey players competing in the Olympics.

The mechanical response to hockey-specific running gait: implications for the objective monitoring of (p)rehabilitation

Field hockey is characterized by a unique dribbling position which has been associated with a prevalence of low back pain and lumbar injury. To quantify the biomechanical response of the hockey-specific running gait, twelve field hockey players completed treadmill running at speeds of 6, 9 and 12 km·hr-1 with a normal running gait and whilst manipulating the hockey stick to replicate dribbling. Mechanical loading was quantified using tri-axial accelerometery at L4, and muscular activity was measured for biceps femoris (BF), gluteus medius (GM) and quadratus lumborum (QL) of each limb. Running with the stick elicited greater mechanical loading in the medio-lateral (p = 0.001) and antero-posterior (p = 0.003) planes, and increased peak (p = 0.004) and mean (p = 0.002) EMG response of QL (p = 0.004). The greater planar mechanical loading and QL activation in response to hockey-specific running technique support epidemiological observations of lower back pain prevalence. The sensitivity of uni-axial mechanical loading to the hockey-specific running posture provides an efficacious means of objectively monitoring mechanical loading in-vivo, whilst the QL activation response has implications for (p)rehabilitative interventions. Running posture and speed can be considered as discrete progressions when considering training load.

Mixed-methods process evaluation of the injury prevention Warming-up Hockey programme and its implementation

Warming-up Hockey (WUP) is an effective injury prevention programme to reduce acute field hockey injuries among youth. This paper describes the process evaluation of the nationwide scaling-up. We conducted a mixed-methods process evaluation from September 2019 to December 2020 according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework, focusing on the intervention and its implementation. We collected data through questionnaires, interviews and web/app analytics. Participants were trainers/coaches, technical/board members of hockey clubs (TBMs) and employees of the Royal Dutch Hockey Federation (KNHB). In total, 226 trainers/coaches (61 via WUP and 165 via training courses) and 14 TBMs filled in questionnaires. Ten individuals (four trainers/coaches, four TBMs and two KNHB employees) participated in semistructured interviews. The study showed the following results according to the RE-AIM framework. Reach: According to web/app analytics, 1492 new accounts were registered. Effectiveness: Overall, users were satisfied with WUP and the implementation strategies, and believed WUP could reduce field hockey injuries. Adoption: 63% of the trainers/coaches (enrolled via WUP) indicated they used WUP. Implementation: Most trainers/coaches did not use WUP during every training session or match. Most TBMs promoted WUP in their club. Implementation barriers included lack of integration with other training programmes, 'know-it-all' trainers, lack of supervision on WUP use and delayed start of implementation. Facilitators included perceived added value, information need on injury prevention in small clubs and tailored communication. Maintenance: Users planned to use WUP occasionally. The KNHB intended to integrate WUP in their newly developed Knowledge Platform. To conclude, WUP was evaluated as a useful programme, but adherence to WUP was challenging. Timely preparation and creating an implementation plan based on stakeholder input, including communication at key moments during the sports season and tailored communication, were found to be important during implementation. Findings can be useful for others planning to implement evidence-based injury prevention programmes on a larger scale.

Psychological characteristics of developing excellence in talented female field hockey players

Psychological Characteristics of Developing Excellence (PCDEs) are a range of psychological factors that play a key role in the realisation of potential. We examined PCDE profiles across a female national talent development field hockey programme in North America. Two-hundred-and-sixty-seven players completed the Psychological Characteristics of Developing Excellence Questionnaire version 2 (PCDEQ-2) prior to the competitive season. One-hundred-and-fourteen players were classified as juniors (under-18) and 153 as seniors (over-18). Eighty-five players were classified as non-selected (not-selected to their age-group national team), and 182 as selected (selected to their age-group national team). A MANOVA showed multivariate differences based on age, selection status and their interaction, within this already homogenous sample, suggesting that sub-groups within this sample vary depending on their overall PCDE profiles. ANOVA showed differences in imagery and active preparation, perfectionist tendencies and clinical indicators between juniors and seniors. Furthermore, differences in imagery and active preparation, and perfectionist tendencies, were observed between selected and non-selected players. Subsequently, four individual cases were identified for further analysis based on their multivariate distance to the average PCDE profile. The use of the PCDEQ-2 at group- and particularly at individual-levels seems an important tool to support athletes as they navigate their development journey.

Contact injuries in field hockey and the potential role for personal protective equipment

Field hockey is played with sticks and a hard ball. It is fast-paced, with athletes playing together in close proximity. Athletes may be at increased risk of sustaining injuries through contact. The aim of this study was to investigate the epidemiological characteristics of contact injuries in field hockey. Data were collected during the 2017/2018 and 2018/2019 Irish Hockey League seasons. This study included two methods of data collection among male athletes: self-reported injuries and via those reported by the teams' physiotherapists. Injuries were defined as any physical complaint sustained during field hockey, supplemented by medical attention and time-loss injuries. Only contact injuries were included for analysis. Overall, 107 contact injuries were incurred, giving rise to an injury incidence rate of 3.1/1000 h, and accounting for 33.1% of all injuries. Athletes had an absolute risk of 0.372 of sustaining a contact injury. Contusions (48.6%) were the most common type of contact injury, while injuries to the head/face (20.6%) were the most frequently reported location. Contact injuries represent an important proportion of all injuries. Rule changes to mandate the use of personal protective equipment in field hockey may assist in reducing the absolute risk and severity of contact injuries in field hockey.

Hip and groin pain in male field hockey players: Prevalence, incidence and associations with patient reported outcome scores and hip muscle strength

OBJECTIVES

Investigate point prevalence (second half season 2018-2019) and incidence (season 2017-2018 and first half season 2018-2019) of non-time-loss and time-loss hip/groin pain in male field hockey players. Secondary aims were to study associations between: current/previous hip/groin pain and hip muscle strength, patient reported outcome measures (PROM) and hip muscle strength, and previous hip/groin pain and PROMs. Additionally we studied normal values for the PROMs (Hip and Groin Outcome Score (HAGOS)).

DESIGN

Cross-sectional study.

SETTING

Testing at field hockey clubs.

PARTICIPANTS

100 male field hockey players (elite, sub-elite and amateur).

MAIN OUTCOME MEASURES

Point prevalence and incidence of hip/groin pain, strength: eccentric adduction and abduction, adductor squeeze, HAGOS.

RESULTS

Hip/groin pain point prevalence was 17% (time-loss: 6%) and incidence was 36% (time-loss: 12%). Presence of current or previous hip/groin and lower HAGOS-values were not associated with lower hip muscle strength. Previous hip/groin pain was associated with a significant lower HAGOS-values in all domains, except for the 'participation in physical activities' domain.

CONCLUSIONS

Hip/groin pain is common in field hockey. One fifth of players have hip/groin pain and one third had pain in the previous season. Previous hip/groin pain was associated with worse ongoing patient reported outcomes in most domains.

The knowledge and attitudes of field hockey athletes to injury, injury reporting and injury prevention: A qualitative study

OBJECTIVES

Researchers have often struggled to successfully implement injury prevention strategies in real-world practice. This is despite such strategies proving successful in reducing overall injury incidence and burden. It has been hypothesised that this may be because the behavioural and contextual factors related to sports injury are not fully understood. Such factors stem from multiple key stakeholders, including the athlete. The primary aim of this study was to investigate athletes' knowledge and attitudes towards injury, injury reporting and prevention, as well as some of the barriers that may impact the future implementation of prevention strategies.

DESIGN

Qualitative; with semi-structured interviews following an interpretivist approach.

METHODS

Twenty-two field hockey athletes, playing in the top-tier Irish Hockey League were interviewed. Data were analysed using reflexive thematic analysis, with three general dimensions containing six higher-order themes.

RESULTS

The findings highlighted that athletes have a varied understanding of injury, which tends to improve with experience. The reporting of injuries by athletes to members of the coaching staff was relatively poor. This may be due to limited resources and supports available to athletes which also cause challenges to injury prevention.

CONCLUSIONS

Future injury prevention strategies in field hockey need to account for athletes' varied understanding of what constitutes an injury. Furthermore, policy changes to influence potential barriers to injury may assist in preventing or reducing the number of injuries being sustained by athletes.

The incidence of injury in male field hockey players: A systematic review and meta-analysis

OBJECTIVE

Few studies have investigated injury incidence in field hockey. The aim of this systematic review was to determine the incidence and characteristics of injury in male field hockey athletes.

DESIGN

Prognosis systematic review with meta-analysis.

LITERATURE SEARCH

MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO; SPORTDiscus; and Web of Science were searched.

STUDY SELECTION CRITERIA

Prospective studies and retrospective studies employing video analysis, written in English and published in peer-reviewed journals, expressing the incidence of injury in male field hockey athletes were included. Studies must have been of a duration of a minimum one season or one tournament. Studies were screened by two authors, assessing the eligibility of each record. Following selection of the studies, data were extracted by the two authors.

DATA SYNTHESIS

Levels of heterogeneity were assessed in aggregate data using the I² statistic.

RESULTS

In total, 1722 records were identified. Twelve studies were included in the review. Injury incidence ranged from 4.5 to 57.9/1000h (I² = 98.5%). Nine studies were undertaken in tournament settings, with the remaining three conducted in club-based athletes in season-long settings. When a medical attention definition was used, there was a pooled incidence rate of 48.1/1000h, all in tournament studies. Contusions and muscle strains were the most frequently reported injury types, while the lower limb was the most common site of injury. Contact injuries were most common in tournament-based studies, while non-contact was more common in season-long studies.

CONCLUSION

Prospective, season-long epidemiological studies investigating injury incidence in field hockey are lacking.

Movement patterns and neuromusculoskeletal impairments observed in a female Olympic Field Hockey team: An observational cohort study

PURPOSE

The purpose of the cross-sectional observational cohort study was to quantify movement patterns and neuromuscular impairments in Olympic Female Field Hockey utilizing a standardized movement-centered assessment model.

METHODOLOGY/SAMPLE

A sample of convenience was obtained from the active roster of the 2016 USA Women's Olympic Field Hockey team. Inclusion and exclusion criteria were applied and resulted in nine participants. The study was conducted over 1 session in which each athlete was tested using the SFMA™, Y Balance Test Lower Quarter (YBT-LQ™) FMS™, and closed chain dorsiflexion range of motion (CKCDFROM). Injury risk assignment was generated based on an evidenced based algorithm. Descriptive statistics and frequency distributions were applied to the subjects.

RESULTS

Injury risk stratification was applied to the subjects with 44% being at moderate risk and 56% at slight risk. 100% of the athletes exhibited spinal extension deficits and 89% of the athletes displayed a dysfunctional single leg stance pattern. Regional impairments included the following observations: anterior hip mobility deficits (5/9 subjects) and rolling motor control dysfunction (7/9 subjects).

IMPLICATIONS

A battery of movement centered tests combined with an evidenced based algorithm can provide meaningful information informing future programming for the elite female athlete. Considering regional interdependence applications, impairments at the hip and thoracic spine, combined with poor quality of movement in extension could create undue stress in remote regions of the spine and lower quarter, thus contributing to injury risk for the spine and lower quarter.

Injury surveillance in elite field hockey: a pilot study of three different recording techniques

Objective

In field hockey, injuries are assessed by various recording techniques leading to a heterogenic collection of poorly comparable injury data.

Methods

Injury data were prospectively collected at the 2016 Men’s Hockey Junior World Cup using the match injury reports (MIRs), video injury clips provided by the Fédération Internationale de Hockey, and daily medical reports (DMRs). A pilot study comparing injury type, mechanism, location on the field, injured body part and overall injury incidence among the different injury recording techniques was performed.

Results

MIRs and video injury clips were completely available for analysis. DMRs were returned from 11 out of 16 teams (69%). In total, MIRs yielded 28, video analysis 36, and DMRs 56 injuries. Overall injury rate varied between 24.8 and 57.9 injuries per 1000 player match hours. The majority of injuries affected the lower limbs by all three methods (41.7–61.2%) and were mainly caused by having been hit by the ball (20.4–50%) or stick (11.1–28.6%). Reports of concussions during competition were incoherent between MIR (2 cases) and DMR (no cases). The DMR was the only method to record overuse injuries (16.1%), injuries in training (12.5%), and time-loss injuries of one or two days (12.5%) or of three or more days (14.3%).

Conclusion

Injury data vary substantially between the MIR, DMR and injury video recording technique. Each recording technique revealed specific strengths and limitations. To further advance injury research in field hockey, the strengths of each recording technique should be brought together for a synergistic injury assessment model.

A systematic review of injuries in recreational field hockey: From injury problem to prevention

The purpose of this study was to gather information from scientific literature related to all steps of Van Mechelen's "sequence of prevention" for injuries applied to youth and adult recreational field hockey players. A systematic review was conducted in Medline via Pubmed and in SPORTDiscus via EBSCOhost. Twenty-six original studies were included. Regarding injury incidence (step 1) results showed several overall injury incidence rates (youth: 1.47 per 1,000 Athlete Exposure (AE) time-loss (TL) injury up to 11.32 per 1,000 AE TL ánd non-time loss (NTL) injury, adults: 2.2 NTL injury per 1,000 AE, 15.2 injury per 1,000 hours of sports participation). Considering games and practices, most injuries were sustained in games (youth: 4.9, adults: 7.87 per 1,000 AE). Considering body parts, highest injury incidence rates were found in body parts in the lower extremities (youth: knee injuries in games (0.33 per 1,000 AE), adults: hamstring injuries in pre-season (0.75 per 1,000 AE)) and injuries in the head/face/eye (youth: 0.66 and adults: 0.94 head/face/eye, 0.71 head/face and 0.63 concussion per 1,000 AE). Regarding aetiology (step 2), no studies were found. Regarding the efficacy of available interventions (step 3 and 4), one study was found among youth players, describing a warm-up programme.

The inclusion of vibration therapy in rehabilitating a gastrocnemius tear: a case study in master athlete

[Purpose] The aim of this case study was to determine if VT could be included into a rehabilitation programme by monitoring the progress of muscle pain, range of motion and muscle strength. [Participant and Methods] An international male master hockey player sustained a medial gastrocnemius 5 cm tear prior to the World Cup. VT was applied early in the rehabilitation programme where 9 sessions of VT were performed during the first 16 days. Other conventional rehabilitative exercises were included. [Results] Twenty-eight days post-injury the athlete returned to full playing. Calf pain had subsided by day 8 with a change of 12° in ankle dorsi flexion range of motion. Grade 5 calf strength was attained by day 16, which was equivalent to the unaffected limb’s strength. There were no residual side effects of including VT into the rehabilitation programme and it did not compromise the athlete’s recovery. [Conclusion] To ensure optimal loading of VT, 9 sessions were implemented and progressively increased; consequently, there was no detrimental effect on the rehabilitative process. The athlete reported no side effects of using VT and its ease and time efficient application has a role to complementing soft tissue injury rehabilitation.

Quantifying acromiohumeral distance in elite male field hockey players compared to a non-athletic population

BACKGROUND

Shoulders of elite field hockey players are loaded continuously during play. Frequent high shoulder loading is known to influence certain shoulder variables, such as acromiohumeral distance. However, the influence of elite field hockey play on acromiohumeral distance is not examined yet.

OBJECTIVE

To examine the acromiohumeral distance in elite male field hockey players compared to a non-athletic control group.

DESIGN

Cross-sectional study.

METHODS

Fifty male participants were included; 25 elite field hockey players (age: 24.0±2.72 years; weight: 77.2±5.29kg; height; 180.5±5.37cm) and 25 age- and gender matched non-athletes (23.0±2.29 years; weight: 75.7±9.53kg; height: 181.8±5.52cm). A Telemed-Colormaster-128 EXT-IZ device was used to bilaterally obtain ultrasound acromiohumeral distance images at 3 different angles of shoulder abduction in the frontal plane.

RESULTS

Field hockey players showed a bilateral larger acromiohumeral distance at 45° (mean difference: 1.46mm [95% CI 0.46; 2.46]; p=0.005) and 60° (mean difference: 1.07mm [95% CI 0.21; 1.93]; p=0.016) compared to controls. In both groups, a significant but clinically less relevant, side difference was established for the acromiohumeral distance at 60° (mean difference: 0.79mm [95% CI 0.21; 1.34]; p=0.009).

CONCLUSION

With active shoulder abduction, elite field hockey players show a larger acromiohumeral distance in comparison to non-athletic participants. This may be a protective sport-specific adaptation, to better guard the shoulder from injury. Thus, acromiohumeral distance measurement may help physical therapists/coaches decide which athletes could benefit from specific, additional exercises aimed at enlarging the subacromial space.

Elite male field hockey players have symmetric isokinetic glenohumeral strength profiles, but show asymmetry in scapular muscle strength

Shoulders of elite field hockey players are loaded continuously during play. However, shoulder girdle muscle performance in this population has never been examined yet. This study aimed to compare isokinetic shoulder girdle performance in elite male field hockey players to matched controls, with respect to strength, endurance and muscle balance. The complete male national field hockey team of Belgium (n = 25) was included and matched to a gender- and age-matched control group of healthy participants (n = 25). A Biodex system-4 dynamometer was used to measure glenohumeral and scapular muscle strength at 2 velocities in a concentric/concentric mode. With the main outcome measures being isokinetic strength values, peak force (protraction-retraction), peak torque (rotations), fatigue index and agonist/antagonist ratio's. Measurement results showed that elite male field hockey players were stronger than their matched controls, for both the rotational and the protraction-retraction movement. Concerning rotational strength, symmetrical findings were established, contrary to scapular strength, where side differences were noted. At low velocity, retraction peak force was higher on the dominant side. Protraction peak force was higher on the non-dominant side when measured at high velocity. In conclusion, elite field hockey players have a symmetrical rotational strength profile, in contrast to their scapular strength profile.

Dupuytren disease is highly prevalent in male field hockey players aged over 60 years

BACKGROUND/AIM

Dupuytren disease is a fibroproliferative hand condition. The role of exposure to vibration as a risk factor has been studied with contradictory results. Since field hockey is expected to be a strong source of hand-arm vibration, we hypothesised that long-term exposure to field hockey is associated with Dupuytren disease.

METHODS

In this cross-sectional cohort study, the hands of 169 male field hockey players (IQR: 65-71 years) and 156 male controls (IQR: 59-71 years) were examined for signs of Dupuytren disease. Details about their age, lifestyle factors, medical history, employment history and leisure activities were gathered. Prior to the analyses, the groups were balanced in risk factors using propensity score matching. The association between field hockey and Dupuytren disease was determined using a subject-specific generalised linear mixed model with a binomial distribution and logit link function (matched pairs analysis).

RESULTS

Dupuytren disease was observed in 51.7% of the field hockey players, and in 13.8% of the controls. After propensity score matching, field hockey playing as dichotomous variable, was associated with Dupuytren disease (OR=9.42, 95% CI 3.01 to 29.53). A linear dose-response effect of field hockey (hours/week x years) within the field hockey players could not be demonstrated (OR=1.03, 95% CI 0.68 to 1.56).

DISCUSSION

We found that field hockey playing has a strong association with the presence of Dupuytren disease. Clinicians in sports medicine should be alert to this less common diagnosis in this sport.

Injury data of major international field hockey tournaments

BACKGROUND

Detailed injury data are not available for international tournaments in field hockey. We investigated the epidemiology of field hockey injuries during major International Hockey Federation (Fédération Internationale de Hockey, FIH) tournaments in 2013.

MATERIALS AND METHODS

FIH injury reports were used for data collection. All major FIH tournaments for women (n=5) and men (n=11) in 2013 were included. The main focus of this study was to assess the pattern, time, site on the pitch, body site and mechanism of each of the injuries. We calculated the average number of injuries per match and the number of injuries per 1000 player match hours.

RESULTS

The average number of injuries was 0.7 (95% CI 0.5 to 1.0) per match in women's tournaments and 1.2 (95% CI 0.8 to 1.7) per match in men's tournaments. The number of injuries per 1000 player match hours ranged from 23.4 to 44.2 (average 29.1; 95% CI 18.6 to 39.7) in women and 20.8 to 90.9 (average 48.3; 95% CI 30.9 to 65.8) in men. Most injuries occurred in the circle (n=25, 50%, in women, n=95, 51%, in men). The rate of injuries increased after the first quarter. Injuries to the head and face (n=20, 40%) were most common in women. The head/face (n=51, 27%) and the thigh/knee (n=52, 28%) were equally affected in men. The ball caused the most injuries, followed by the stick, collisions and tripping/falling. There were no deaths or injuries that required hospital treatment in the entire cohort.

SUMMARY

Field hockey has a low incidence of acute injuries during competition.