It’s been 4 weeks since the hockey seasons started at the youth level, and already 3 players on the U18 team I train came up with shoulder injuries.  One of them suffered a grade 2 separation from a contact during a game.  Another one dislocated his shoulder pretty severely during a senior trip (what a bad luck), and will most likely require surgery.  And the last one mysteriously woke up with an AC joint pain, that “magically” went away after some daily soft tissue work.

At this point I still think hip injuries are the most common ones in hockey players, but shoulders might not be far behind, along with concussions.  The thing with shoulder injuries is that most of them are contact injuries due to the nature of the sport; especially at the U18 level, guys are bigger, stronger, faster and they hit hard.  Even though most non-contact injuries are preventable, there isn’t a whole lot you can do about traumatic injuries.

The fact that contact-based injuries are hard to prevent, doesn’t mean there is nothing you can do to minimize the incidental damage from a hard hit.  Here are a couple strategies that might be worth applying to avoid another dislocated shoulder because of a hard hit.

1. Improve posture.  The chance of the humeral head popping out after a hard hit is much higher if the player has a poor resting posture.  Think about the direction the force is absorbed with a hit from the side if the scapula is anteriorly tilted and the humerus internally rotated.

The chances of the shoulder dislocating is much higher because of the alignment of the shoulder.  If you spend enough time working on posture with your athletes, and more importantly educating them on the importance of having good posture throughout the day, it may reduce the risk of dislocating a shoulder after a big hit.  When the alignment of the shoulder is optimal, the humeral head will be pressed in the shoulder joint following a hard hit, and the risk of dislocation will be reduced.

2. Shoulder and rotator cuff stability and strength.  In line with the previous point, along with good posture goes good stability.  If you don’t have good posture, you can’t have optimal stability.  That means all the muscles surrounding the shoulder structures (scapula, clavicle, humerus) must be strong and stable.  The rotator cuff in particular has to be very efficient in its role of stabilizing the humeral head in the glenoid fossa to prevent it from moving.  A strong rotator cuff can also be very effective in keeping the shoulder properly aligned.

Great exercise to improve the stability and strength of the rotator cuff

3. Muscle mass.  This might seem too broad of a strategy to be specific in helping shoulder injury, but I feel it’s an important one.  When you get hit against an immovable board at high velocity, if you don’t have a lot of “meat” to absorb the impact, the chances of getting structural damage increases.  The bigger and the stronger the muscles around the shoulders are, the better the capacity of the body at absorbing impacts.  So make sure your athletes eat enough!  It’s always a struggle for me with some of my smallest players to get them to understand that they need to eat more in order to gain muscle mass, but the higher the level they play, the more important it becomes.

Again, traumatic shoulder injuries are usually pretty hard to avoid in hockey, just like in other sports, but with the few tips above you will at least put all the chances on your side of limiting the risks and the damage of some of these contact injuries.

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