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SPORTS MEDICINE HYPERMOBILITY
BY LISA KERRY, PHYSIOTHERAPIST AND DR ZOE HUDSON, PHYSIOTHERAPIST
INTRODUCTION Hockey is one of the most popular participation team sports in school- aged children in England with 20,265 under-18 boys and 20,519 under-18 girls currently affiliated to England Hockey (1). The game is a multidirectional, repetitive sprint sport, played in a globally flexed posture, on artificial turf. Both contact and non-contact injuries are associated with playing hockey, often resulting in time missed from training and competition. Contact injuries are inevitable and unavoidable. Despite wearing protective equipment such as mouthguards and shin pads, and using skill to avoid risky situations, contact injuries are an accepted risk of the game. Overuse injuries, however, might be influenced by physiotherapy input and, if hypermobility were associated with an increased prevalence of injury, screening for it could easily be introduced in this age group.
Hypermobility is a known risk factor
for injury in adolescents, with links to conditions such as chondromalacia patellae, joint subluxation and arthralgia (2,3). An association with impaired joint proprioception of the finger and knee has been established by some studies, but none of them has investigated sporting populations (4,5). Hockey requires high levels of coordination, dexterity and agility and it is commonly reported that such skills can be affected by hypermobility (4,5). The prevalence of hypermobility in junior elite hockey players in England is unknown; thus its impact on hockey players is undetermined. The aims of this study were:
n To determine the prevalence and level of joint hypermobility in junior elite hockey players. n To examine any relationships with injury type. n To investigate the subsequent impact on hockey training and competition.
METHODS Subjects and setting Participants were recruited from the national governing body for hockey, England Hockey, at national training camps for the under-18 age group
This study aimed to investigate the prevalence of joint hypermobility in junior elite hockey players in England, and explore the relationship between hypermobility and injury in this population. Hypothesis: Hypermobile junior elite hockey players in England are more prone to injury than non-hypermobile players. Hypermobility is more prevalent in females. Design: A retrospective two-season injury audit, coupled with a physical examination of hypermobility using the Beighton–Horan score. Setting: England Hockey junior training camps at various Sport England National Sports Centres in England. Participants: 33 girls and 36 boys in the under-16 and under-18 England Hockey national training squads.
Main outcome measures: The Beighton–Horan score, a self- administered hypermobility questionnaire, and the number of days missed from training or competition through injury. Results: The prevalence of hypermobility was found to be 16% in boys and 52% in girls, using a Beighton–Horan score of ≥3. An association was found between the presence of hypermobility and injury in girls, but no such association was found in boys. Conclusions: Hypermobility is common in under-18-year-old female hockey players and may be associated with more frequent injury. Keywords: Hypermobility, hockey, injury.
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A PRELIMINARY STUDY OF THE PREVALENCE OF HYPERMOBILITY IN JUNIOR ELITE ENGLAND HOCKEY PLAYERS AND ITS POTENTIAL INFLUENCE ON INJURY