I could say that I owe a lot to the game of hockey. It gave me the ability to travel and meet amazing people. I competed with incredible athletes and had the luxury of celebrating victory as well as mourning defeat. Hockey in a sense introduced me to my wife and is one of the common threads I share with my children. My goal as a professional has been to try to leave the hockey woodpile a little higher than when I found it.
This fundamental love of the game has transitioned into a passion to help athletes realize their potential, especially after an injury that has knocked them out of competition. As a chiropractic student, I participated in a group we called the “Functional Anatomy Club” in which we would present research on musculoskeletal based topics to our peers. I chose a study that I had come across that looked at force profiling inside of a player’s skates.
What I took away from this study was that players constantly loaded the inside edge of the blade. I assumed that this would create an atmosphere in the medial muscle chain that was “postural” in nature in that it required some degree of low level muscle contraction to counteract the “zero friction surface” that the game is played on, aka the ice.
When I proposed this concept as the cause of adductor overuse injury, I was met with plenty of resistance surrounding the concept that the adductors function as the “break” for the hip extensors at the terminal aspects of the stride.
After over 12 years of treating injured athletes and spending way too much time reading about tendon health, I feel there is much more to consider when looking at chronic tendon strains in sport. In clinical practice, I have been committed to isometric exercise, but I have always followed the slow heavy eccentric loading principle for tendon remodeling. Do they fit together or can they only exist in periodized isolation? More importantly, are they even that different or is the key here the factor of “slow”?
The solution is probably somewhere in the middle. During various points in the skating stride, there are both an eccentric and isometric function happening in the muscle depending on what aspect of the stride each leg is in. For example, when the adductor is at its maximal extension (eccentric) position at the far extended portion of the stride, the opposite leg is in deep flexion which puts the adductor in a position of isometric holding.
With the speed that most athletes perform their sport tendons and muscles will have a habit of holding onto tension and, if there is a portion of the tendon that is unhealthy, the body will naturally unload that portion of the tendon known as “stress shielding.” Stress shielding seems like a smart move by the body to protect bad tissue, but this protective mechanism leads to tendon degeneration over time.
Isometric contractions for tendon health are essential. After just 30 seconds of isometric holding like in an isometric Copenhagen exercise, there will be a 60% reduction in tendon stiffness1 and then we can access load directed toward these shielded portions of the tendon. By this practice, we will prevent the natural occurrence of stress shielding and reduce the degenerative process that leads to pain and/or injury.
It seems too simple of a preventive strategy, but it could be a basic 10-minute approach to tendon health that is built into the recovery and performance program. Using the classic Copenhagen adductor isometric exercise can be a game changer in preventing the stress shielding phenomenon in this large muscle group. We will talk more about nutrition for soft tissue health next month.
- Baar K. Stress Relaxation and Targeted Nutrition to Treat Patellar Tendinopathy. Int J Sport Nutr Exerc Metab. 2019 Jul 1;29(4):453–457. doi: 10.1123/ijsnem.2018-0231. PMID: 30299199.