Groin and abdominal strain injuries in the National Hockey League

Objective: To analyze groin and abdominal strain injuries retrospectively a mong elite male hockey players in the National Hockey League (NHL) over six seasons of play (1991/92, to 1996/57). Design: Retrospective case series design. Setting: The NHL. Participants: The NHL participants were an inclusive sample of 7,050 NHL ho ckey players who played in the NHL from the 1991/92 to the 1996/97 seasons. A subset of 2,600 NHL hockey players who played from the 1995/96 to the 19 96/97 seasons was further analyzed. Main Outcome Measures: The injury definition for groin/abdominal strain inj ury included any injury recorded as a muscle strain injury involving a musc le in any of the abdominal, hip flexor, or hip adductor muscle groups. Femo ral, abdominal, and inguinal hernias were also included. Cumulative inciden ce rates over six seasons of play in the NHL and incidence densities over t wo seasons of play in the NHL are reported. Specific injury parameters exam ined included muscle region, time in season, type of session, reinjury, tim e period in session, position of play, player's experience, mechanism of in jury, and time loss. Results: A total of 617 groin/abdominal strain injuries were reported in th e NHL over six seasons of play. The cumulative incidence rate in the NHL in creased over 6 years of play from 12.99 injuries/100 players/year in the 19 91/92 season to 19.87 injuries/100 players/year in the 1996/97 season. The rate of increase was 1.32 (95% confidence interval -0.58, 3.21) injuries/10 0 players/year. The incidence density of groin/abdominal injury during NHL training camp was five times that during the regular season and 20 times th at during the postseason. The incidence density in the NHL during games was six times that during practice. The majority of injuries reported were add uctor groin muscle strains. The proportion of injuries reported that were r ecurrent was 23.5%. There was no significant difference in proportion of in juries reported by time period within a session. The mechanism of injury re corded was noncontact in nature in >90% of injuries reported. Mean time los s due to injury was significantly greater for abdominal injuries (10.59 ses sions) than for groin injuries (6.59 sessions). A con servative estimate of the impact of groin/abdominal injury on each NHL team is a game loss of 25 player games/year. Conclusion: The impact of goin and abdominal strain injury at an elite leve l of play in hockey is significant and increasing. Future research in this area is needed to identify risk factors and potentially implement preventio n strategies to reduce groin and abdominal strain injury at all levels of p lay.