Ice Hockey Goaltender Rehabilitation, Including On-Ice Progression, After Arthroscopic Hip Surgery for Femoroacetabular Impingement

SYNOPSIS: Ice hockey goaltenders, especially those who employ the butterfly technique, are a specialized population of athletes because of the unique physical demands that the position places on their lower extremities, specifically at the hip. It is no surprise that hip injuries are a common occurrence among goalies. A review of the biomechanical literature has demonstrated that stresses on the hip while in flexion and end-range internal rotation, the position goaltenders commonly use, put the hip at risk for injury and are likely a major contributing factor to overuse hip injuries. The stress on a goaltender's hip can potentially be further intensified by the presence of bony deformities, such as cam- or pincer-type femoroacetabular impingement, which can lead to chondrolabral junction and articular cartilage injuries. There have been few published reports of goaltenders' functional outcomes following femoroacetabular impingement surgery, and, to our knowledge, no studies have yet identified the specific challenges presented in the rehabilitation of goaltenders following femoroacetabular impingement surgery. The present clinical commentary describes a 6-phase return-to-skating program developed as part of a rehabilitation protocol to aid hockey goaltenders recovering from surgery.