Jun 2, 2020
Preventative Measures for High School Field Hockey Players
P.J. Gardner, contributing writer

It has been said that you are only as strong as your weakest link. In most sports, I have found that to be true. To be a complete player in any sport, you have to work on your weaknesses (both physical and mental) – and most coaches will tell you that. Complete physical development in speed, strength, flexibility, and agility will allow maximum performance in any sport. Field hockey is no different.

In field hockey, these same components are necessary for success and reduction of injuries. Speed is a deciding factor in beating opponents down the field and to the goal. Strength obviously helps in all phases of the game. Flexibility is necessary for smooth and proper movement through the full range of motion and helps in the prevention of injury. Agility helps in maintaining balance in the redirection of unilateral movement. In essence, total body development is necessary for overall sports performance. Now, let’s look at the specific demands of field hockey.

Overview

First of all, field hockey is an anaerobic sport requiring multiple starts and stops throughout the game. Proper anaerobic conditioning is the base for program success. Another factor is the field hockey stick which ranges in length from 24”- 38” depending on the player’s height and requires athletes to forward flex from the waist in order to make contact with the ball while at a standstill or running. 36.5” is the standard size for our team according to Jessica Nerkowski, head field hockey coach at Liberty High School. Girls under 5’ tall use 35” sticks and no girls would use anything above 37”.

The lower back is sometimes in a vulnerable position and is a specific area of concern for injury. Many times, in a game an athlete will lunge to a ball and attempt to lay her stick flat on the ground to block a shot. The bending and rotating of the trunk while trying to pass or shoot are required throughout the game.  

field hockey
Photo: Wesley Sykes / Great American Media Services

These actions put tremendous stress on the low back, glutes, and quads. Some coaches feel that the lower back pain originates from core and hip weakness and lack of flexibility (5). The hamstrings are involved too but are not the focus of this article. The hip flexors are also at risk for injury from tightness resulting from the forward flexed position required for playing the game.

 This article will focus on the specific training and injury prevention program as well as screening techniques that may be used to address the demands of these areas and help to prevent or reduce musculoskeletal injuries.  Now let’s examine the most vulnerable muscle groups beginning with the lower back area.

 Lower Back

It is important to understand that you have to be strong in all muscle groups and no one group is more important than another – generally speaking. Remember the “weakest link” statement.  Specifically, in field hockey lower back strength, flexibility, and stability as-well-as core and hip strength are a high priority throughout the season to avoid strains and sprains and remain an active player all season – which is the goal. Teryn Galloway, who played collegiately at UNC and has coached all levels of field hockey and is a current coach for Liberty High School believes that hip strengthening is even a higher priority than lower back strengthening because of the specific demands of the sport. Regardless of your belief in which group deserves the most attention, one thing is clear – adequate core and hip strength, flexibility, and stability are necessary in field hockey.

To start with, let’s look at a 2015 study in the Journal of Back and Musculoskeletal Rehabilitation by Hilst, J.V. et al points out the prevalence of low back pain (LBP) in adolescents is about 30% and the (LBP) decreases performance and increases the risk for recurrence. Bending and twisting at the trunk – common in field hockey – are noted risk factors. In this same study, specifically “female hockey players reported the highest prevalence of LBP (67%) and they felt the most hampered in their performance by their LBP (22%)”. 

In addition, it is the slight forward flexed position along with dribbling that was seen as precipitating factors for LBP in training and competition (2). For the aforementioned reasons, core stability, hip, abdominal and back strength training exercises need to be focused on in an attempt to prevent – or at least drastically reduce low back injuries. 

Jessica Nerkowski also agrees that the lower back is vulnerable and states” from my experience and observations, often the lower back injury is a result of muscles not firing correctly or a symptom of hamstrings, quads, glutes and core weakness”.

Glutes, Quads, and Hamstrings

The gluteus maximus/minimus and hamstrings (bicep femoris, semitendinosus, semimembranosus) are major and powerful hip extenders in backside mechanics needing full development in field hockey for the multiple stops and starts with the trunk in various degrees of flexion while running and shooting. Teryn Galloway says “We typically focus on quads and glutes as they are the powerhouse of what drives field hockey athletes and rarely receive the proper attention necessary”.  Glute and quad strength seem to be a point of emphasis for many field hockey coaches. Lauren Penny is a performance coach for elite field hockey players and she says tight hip flexors, overworked quads, and weak glutes are the most common thing she sees when working with hockey players at all levels. (4).

The hamstrings also assist with speed deceleration and the quadriceps (rectus femoris, vastus intermedius, lateralis and medialis oblique) also play an important role in running, stopping, and starting – but do not appear to be at high risk for injury in field hockey.

*Hip adductors and abductors provide needed stability for lateral movement and an important side note is the importance of proper landing mechanics for the prevention of ACL injuries – especially in adolescent female athletes. 

Another specific muscle often overlooked in back pain is the psoas. Weak abdominals and glutes can cause tightness of the psoas and can lead to multiple lower-body injuries (4). 

Hip Flexors

The hip flexors are susceptible to excessive tightness because of the forward flexed position required to play the game. Daily stretching – pre and post-game and practice should be done to keep the hip flexors from shortening and becoming tight. “The hip flexors are the worst for injury” (5). Teryn suggests pre and post daily stretching, foam rolling and Graston IASTM to reduce pain and improve the function of the hip flexors and as an Athletic Trainer, I often use these techniques on many of our injured athletes.   

Pre/Post-Season Screening

Through a functional movement screen or other assessment techniques, the athletic trainer and/or strength coach can do a pre or post – season musculoskeletal evaluation to check for any muscle group or flexibility deficits. This will identify the weakest and least flexible areas that need to be addressed in the off-season strength and conditioning program. 

In this author’s opinion, it is ideal to do a post-season evaluation because this gives the athlete the entire off-season to do the program designed specifically for the deficits. A complete injury risk and health history profile would be optimal – but not all teams are able to do this. If time and resources allow, an individualized program is best – at least in the off-season to correct any physical deficits.  With incoming freshman and new athletes, you may have no choice but to test them in the pre-season.

A certified strength and conditioning coach should design a specific year-round field hockey program for the entire team. As with any program, adherence is the key to success. There are Apps (Team Buildr) that we use that can help track program compliance that are very useful to coaches to see if players are following their designed program – especially in the off-season. 

Following is an explanation of the strength program specifically for low back, glutes, and hip flexors for Liberty High School field hockey team designed by our strength and conditioning coach KC Bonnin. He states:

At Liberty High School (LHS), our programming, regardless of whether they are in-season, pre-season, or postseason, will always cover the following movements: power movement, squat, hinge, push, pull and accessory work. These movements may be performed in any given session and may be horizontal, vertical, lateral, unilateral, or bilateral. 

When it pertains to field hockey athletes, our focus will weigh heavily on improving the lower back, glutes, hamstrings, quads, and hip flexors. For off/preseason training, our acute variables are high volume and high intensity with a set/rep range of 4 x 12+. For the lower back, I like to implement reverse hyperextensions, superman’s and anti-rotational core work to ensure the athlete can create a neutral spine while stabilizing. 

Glutes, hamstring, and quads will see a lot of unilateral and bilateral work. The glutes and hamstrings are the powerhouse for athletic performance, so I prefer to program Nordic hamstring curl and single leg RDL which also provides the athlete with stabilization work. 

The quadriceps will see work with eccentric goblet squats, tempo front squats, or Bulgarian split lunges. I like to program lateral work for hip flexors and that could be lateral banded steps, lateral lunges or banded goblet squats, and deadlifts. Below is just an example of a way I may program some of the above exercises.

A1- Eccentric Goblet squat (6 sec.) 4 x 8

A2- Nordic Hamstring curls 4×12

B1- Reverse Hyper extensions (bodyweight) 4 x 20

B2- Palof press 4 x 10 (each 3 sec. in/out)

Summary

Field hockey – like any sport – requires total body development. Speed, strength, flexibility, and agility all play an important role in athletic performance. In field hockey, the low back, glutes, and hip flexors are specific areas of concern for injury and need specific exercises for deficits.

Functional movement screens and other techniques can be used to determine a player’s physical movement needs in order to be addressed in the off-season when more time is allowed for the program to be utilized. A certified strength coach should set up the year-round strength and conditioning program and work with the individual athletes on their specific weaknesses. 

The forward flexed position while running, shooting, twisting, and turning can be very challenging on muscles of the low back, glutes, and quads. The best preventive measures can be the proper strength and conditioning of these muscle groups to decrease injury and stay on the active roster all season. 

Understand that low back and other lower extremity injuries in female adolescents – and particularly field hockey players – can be avoided or at least decreased through early recognition of deficits and proper strength, stabilization, and flexibility training. Take the time and make the effort to properly address the exact causes of LBP in field hockey players and take the necessary steps to correct them and keep your players in the game all season long. Train to win!

References

  1. Engel, Heather, Line It Up. Train. & Cond., Nov. 2017
  2. Hilst, Jony van, et al.. Low back pain in young elite field hockey players, football players, and speed skaters: Prevalence and risk factors. Journal of Back and Musculoskeletal Rehabilitation 28 (2015) 67-73. 
  3. NASM Essentials of Corrective Exercise Training. Ed. By Michael A. Clark, Scott C. Lucett 1st ed., 2011.
  4. Penny, Lauren. Train your posterior to kick butt on the hockey field! Hockey performance academy. Internet article. OptimizePress.com, 2013. 
  5. Personal Interview with Jessica Nerkowski and Teryn Brill Galloway, Field Hockey coaches for Liberty High School. 1/26/2020.

Growing up in Culpeper, Va. Jessie Nerkowski began playing field hockey in ninth grade. She played varsity and club field hockey as well as basketball, softball, and track & field throughout high school. She continued her athletic pursuits at the University of North Carolina at Chapel Hill as a walk-on to UNC’s Varsity Rowing team. After completing one season with the team, she returned to field hockey as a member of UNC’s Club Team. Her senior year, she captained her team to its first NFHL National Championship.

Jessie has coached field hockey for four years at the middle school, club, and high school levels. She became the head field hockey coach for Liberty High School in Colorado Springs, Colo. in 2017, only one year after the program’s inception. 

Jessie is currently the business strategy analyst for the United States Olympic & Paralympic Committee’s Athlete Career and Education program. In her role, she serves and empowers active and retired Team USA athletes in their pursuit of personal, educational, and professional success.


P.J. Gardner, MS, ATC, CSCS is the athletic trainer at Liberty High School in Colorado Springs, CO


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