NHL Injury Analysis: Grounded Jets

Let me start by saying that it is great that we have Winnipeg back in the NHL (we need more teams back in areas that actually want hockey). But Winnipeg seems inundated with injuries at this time.

Tobias Enstrom is on IR and will be out indefinitely with a broken collarbone. I can't seem to find any information on the extent of the fracture but it appears that he will not need surgery. He will most likely be immobilized for a period of time to allow the bone to heal in good position. After that period of immobilization, they will start range of motion exercises to regain full shoulder and shoulder blade movement. After he has regained much of his motion then the process of regaining his strength and stability will start. Some of this will be slowly introduced early but too much too soon will impede regaining full motion. Strength training tends to tighten muscles and, if too much is introduced too early, regaining full motion may be slowed or made difficult. Having full functional motion is the first step in returning to full activity and maximizing performance.

Chris Mason is also on IR with a groin injury. He is considered day to day but there does not seem to be any information regarding his current training or practice status. If he is day-to-day, he should be at unrestricted status regarding what he can try. He should be focused on improving the regions activity endurance. At this stage, muscular endurance is the most important factor in predicting how well they will do in game situations. Lack of muscular endurance leads to compensatory actions that can lead to re-injury or to another injury. For example, we have seen groin injuries that seem to develop into sports hernias.

Two other Jets are not on IR but have been scratches for the last few games. Randy Jones took a puck off his foot and Nikoli Antropov took a puck off his hand. It looks like there is no worry of any broken bones but you never know because small hairline fractures may be hard to find on normal x-rays. Both have particular problems. A sore foot makes skating difficult and, if they are unable to practice, they loose some of their skating fitness. A sore foot may also cause someone to walk a little differently and they may develop a little compensatory movement. This compensatory movement may lead to another area that may become a problem. There have many patients that have had an ankle or knee problem who have reported having hip or low back pains later in their recovery process if these compensations are not dealt with properly. Similar issues arise for hand injuries. A sore hand will make holding a hockey stick difficult which will impact their ability to generate power on a shot or a pass. Compensatory actions may still develop but not as frequently as leg injuries because it is much easier not to use the hand while it is not so easy not to use a foot.

Greg Zanon of Minnesota has been rehabilitating a groin injury. He has started to skate but it's on his own. This is still a good sign because it means that the groin area is healed enough that he can start to put a little stress on it. The groin is intrinsically connected to the hip so the hip must be strong enough to support the requirements on the groin region. The groin muscles are secondary stabilizers for the hip so the primary stabilizers, the hip abductors, need to be strong so there is no added stress on the groin. The groin muscles also contract in what we call an eccentric manner and this adds stress to the muscle insertion sites so the area needs to be well healed to be able to handle this added stress.

Vancouver's Sami Salo also has a groin injury and he is hoping that a three-day rest break will assist him being back on the ice for Thursday's game against LA. He has already missed 3 games and is hoping that he will not miss anymore. His chances on playing against the Kings will depend on his current practice status. If he is able to practice or, at least skate, without any symptoms then the chances of playing on Thursday are good. But if he is experiencing any symptoms with skating, the chances of Salo playing this Thursday are unlikely due to the chance of aggravating his groin.

Steve Ott of Ottawa was struck on the hip by a skate and he has not been able to skate since that incident. It is curious that he cannot skate. If it were just a contusion to the muscle or bone, I would imagine that he should be able to do some light skating on his own. Not to be able to skate at all is a little worrisome to me. Of course, it could just be a pain issue. Depending on the type of tissue injury, the pain associated may be severe enough require him to stay off the skates to allow the tissue to heal. Time will be the true indicator as to the severity of the injury. A minor injury should get better soon and we should see him back on his skates. Any extended period of time off the blades is generally not a good sign. Light skating is always a good predictor of the stage of healing/recovery after any injury. And not being able to do any light skating even on his own is not good for any hockey player.

Michael Rupp of the NY Rangers has been troubled with a lingering knee issue this season. He is to have arthroscopic surgery next week. This surgery has 2 purposes. One, it will assist the medical staff in figuring out exactly what is wrong and how to approach his rehabilitation. Even a MRI is not always correct. On a personal note, I had arthroscopic knee surgery 2 yrs ago. The MRI of my knee did not reveal anything significant. The surgeon was surprised to see significant signs of wear in my knee that was not revealed fully by the MRI. Sadly, I have more knee surgery in my future. So the surgery will give much needed light to Rupp's situation. Two, the surgery will clean up the knee and hopefully remove any structural issues which may be causing the pain. In the end, Rupp should have a pretty clear idea as what were the problem(s) and the future prognosis of his knee.

Ales Hemsky of Edmonton has a shoulder injury. The concern is that he is into his third week and he is still not taking any contact in practice. Originally, it was thought that this should be better within two weeks. The question that needs to be asked is if there is any structural issue that may be impacting his recovery. This question does not necessarily refer to the presence of any tears. I wonder if there are any biomechanical issues that may be causing the pain. Are there mechanical issues that may causing the pain to continue and limiting his ability to use the shoulder? Or is the problem purely a tissue healing matter? Shoulder pain may be perpetuated by a poorly functioning shoulder blade. The shoulder blade may demonstrate an abnormal movement pattern that may be perpetuating stress on a weak or injured tissue. Or if there an underlying pathological tissue that may not be supporting the shoulder during activity so that the pain is being perpetuated. He may require further examination to determine the reason for the slow recovery.