Overcoming Lateral Wrist Pain in Hockey: Brandon's Journey to Peak Performance

Brandon, an 18-year-old Junior B hockey player, came to us with a pressing concern. For the past 2-3 months, he had been experiencing persistent lateral wrist pain that severely impacted his shooting skills on the ice. With an important showcase for NCAA teams just three weeks away, Brandon was worried he wouldn't be able to perform at his best. Here's how we used physiotherapy to help him overcome his pain and get back to playing his best hockey.

Client Profile: Brandon 

• Age: 18
• Sport: Hockey, Junior B
• Concern: Lateral wrist pain impacting performance
• Duration of Pain: 2-3 months
• Previous Treatment: Worked with another physiotherapist in the past
• Impact: Pain affecting shooting skills, worst pain rated 7/10

Our Observations

During our initial assessment, we observed several factors that were contributing to Brandon's wrist pain and overall performance issues:

• Kyphotic posture: Kyphotic posture is an excessive forward rounding of the upper back. This can lead to reduced upper body mobility and balance, impairing a hockey player's ability to maintain an effective skating posture and execute strong, controlled movements on the ice.

• Lumbar lordosis: Lumbar lordosis is an exaggerated inward curve of the lower back. This can cause lower back pain and muscle imbalances, affecting a hockey player's stability and power during skating and shooting.

• Restricted right diaphragm with apical breathing: This condition involves limited movement of the diaphragm on the right side, leading to shallow, upper chest breathing. It can reduce endurance and increase fatigue, hindering a hockey player's performance and recovery.

• Reduced and painful wrist extension and ulnar deviation: This refers to limited and painful movement when bending the wrist backwards and towards the pinky side. It directly impacts a hockey player's ability to shoot, pass, and stickhandle effectively.

• Significant muscle tone in the forearm, shoulders, and neck on the same side as the pain: Increased muscle tightness in these areas can lead to stiffness and reduced range of motion, affecting a hockey player's ability to perform precise movements and maintain control over the stick.

• Left innominate pattern: This refers to an imbalance in the pelvic alignment, where the left side of the pelvis is misaligned. It can cause uneven weight distribution and muscle strain, impacting a hockey player's skating efficiency and increasing the risk of injury.

• Forward head posture: Forward head posture is when the head is positioned in front of the body rather than aligned with the spine. It can lead to neck pain and decreased upper body strength, affecting a hockey player's ability to maintain good posture and vision on the ice.

• Reduced thoracic rotation to the left compared to the right: Limited rotation in the mid-back region can impair a hockey player's ability to twist and turn effectively, crucial for quick directional changes and shooting accuracy.

• Anterior pelvic tilt: An anterior pelvic tilt is a forward rotation of the pelvis, causing an excessive arch in the lower back. It can lead to lower back pain and reduced core stability, affecting a hockey player's balance and power during skating.

• Reduced core and glute activation: Weakness in the core and glute muscles can lead to poor posture and decreased stability. For a hockey player, this can result in less powerful strides and an increased risk of injury during dynamic movements.

• Tight left quad: Tightness in the left quadriceps can cause muscle imbalances and restrict hip movement. This can affect a hockey player's stride length and agility, making it harder to skate efficiently and perform quick movements.

Our Approach

To address Brandon's concerns, we implemented a comprehensive biomechanical assessment and treatment plan:

1. Biomechanical Assessment and Diaphragmatic Breathing

   • We conducted a thorough head-to-toe biomechanical assessment, including diaphragmatic breathing techniques. This not only enhanced Brandon's wrist range of motion and reduced his pain but also improved his stability and endurance on the ice, crucial for maintaining performance throughout games.
   • Post-assessment, Brandon’s wrist range of motion improved, and his pain decreased from a 7/10 to a 2/10.
   • As we find deficiencies, we actively treat while we assess. Yes that is what is different about us! 

2. Pelvic Tilt and Core Activation

   • We worked on improving his anterior pelvic tilt and enhancing core activation. These adjustments relieved tension contributing to his wrist pain and provided better balance and power during skating, leading to more effective and agile movements on the rink.

3. Continued Monitoring and Support

   • We followed up with Brandon two days after the initial appointment. He reported that consistently practicing the breathing exercises further reduced his wrist pain, allowing him to perform without discomfort and increasing his overall stamina and resilience during hockey games.

Results

Thanks to the tailored treatment plan and dedicated follow-up, Brandon was able to play his best hockey at the showcase. The wrist pain that once hampered his performance was no longer a concern, and he felt confident in his abilities on the ice.

Brandon's case highlights the importance of a comprehensive, biomechanical approach to treating sports injuries. By addressing underlying issues such as posture, core strength, and breathing patterns, we were able to significantly reduce his pain and enhance his performance. While the wrist was the symptom, there were underlying issues causing the pain. Keep in mind that you may feel pain somewhere in your body, it is likely something else that is causing it and we are here to help you figure out what that cause is. In Brandon's case, he was surprised to see how quickly his wrist felt better when his program was focused on other areas of his body.

If you're struggling with similar issues, consider a thorough biomechanical assessment to identify and address the root causes of your pain. At Honsberger Physio+, we're committed to helping athletes like Brandon reach their full potential.

Looking for help overcoming your performance plateaus? We can help!

Book an appointment with Dominic in Aurora

Written by: Dominic King, Registered Physiotherapist

Additional Resources

On The Blog: Client Profile: 24-Year-Old Ultimate Frisbee Player
On The Blog: Physiotherapy And Trainer Collaboration