The Secret Causes Of A Hockey Player’s Aches & Pains
On this episode of the Unreal Results podcast, I take some inspiration from a question I got from an athletic trainer who is taking my free mini-course, The Missing Link. Her question was regarding how the SI joint may be affected in hockey players due to various reasons including skating, shooting the puck, and their general playing position. In this episode, you’ll hear me break down how I think about how a hockey player’s dynamic posture and movement affect the visceral and neurovascular structures, which could ultimately be the main driver of their pain complaints.
Resources Mentioned In This Episode
Episode 46: Using The LTAP™ With Post-Surgical Rehab
Episode 50: The Elbow Episode
Episode 60: LTAP™ Core Beliefs
Episode 61: The Lung Connection To Foot Pain You Didn't Know About
Episode 66: Ego-Free Healing: Learning A New Paradigm In Patient Care
Having FOMO and want to join the FREE mini-course: Join The Missing Link HERE
Get on the Online LTAP™ Level 1 Waitlist
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello, hello, and welcome to another episode of the Unreal Results podcast. I am home in San Diego. Uh, yesterday we kicked off the free mini course week. Uh, which is called The Missing Link. And I, it was such a great call. So we had our first live training. It's a, the mini course has two live trainings.
One on Sunday, one on Wednesday. And And I'm teaching, um, how one change to a standard assessment can get you immediate results for your PT and AT clients. And I had, I think around 900 people sign up, um, for the course. So it'll be really fun to see who all is in the course, who all participates because, you know, The internet streets are crazy.
There's a lot of peddling of free education. Which is totally fine and totally great. Um, but that just means that, you know, if 900 people show up, or 900 people sign up, 900 people don't show up. 900 people don't ever log in and do the thing. Um, This is the nature of online courses. This is the nature of free stuff is when you don't have skin in the game.
Um, it's pretty like low commitment, right? Cause you have, you have nothing to lose for not showing up. Um, except of course you don't get better, but, um, you know, that's not such a tangible thing like money or whatever. So, um, My biggest thing is like whoever wants to participate and be an active participant and, uh, like get the most out of this free course.
Like I am here for it and I am ready to support you. And, um, I just, I told the people on the live call the other day, or the live training yesterday, I was like, you all that have showed up for this call live are a special group of people because it is rare. It is rare to show up to live education online nowadays and it is rare to fully get the most out of free stuff.
And so like if you're in the course and you're one of those people, again, I applaud you because I, you know, this is the sixth time I've taught this and um, The people who have shown up and done the work have gotten great results and just like supercharged their practice for their and Helped her clients so much, you know, even whether or not they continued on to learn the rest of the LTAP or What like it this free course made the difference for them and I just like that's so exciting.
So, um I'm here for it. If you have FOMO, it's not too late to get in. Um, i'll make sure Joe still puts the link in the show notes um But you only have the week to get through all the material for free. So that's Spoiler alert That's how you get people to consume the free content is you have to put an end on it because if it's free forever It'll just sit in your inbox forever so all these things I don't do to be like Like an asshole.
Um, but everything I do is to actually get people to move through the work and get people to do, to do it because it's so powerful and I want everybody to have these tools. So anyways, I don't, I wasn't planning on doing like a salesy pitch. It's not a sales pitch. It's just telling you what I've been up to.
So super excited to be with them this week. And actually today's episode was inspired by one of the questions in our private Facebook group. So, um, a shout out Sarah, athletic therapist in Canada for your comment. Um, really her comment was just introducing herself, um, and who she works with and how she was excited to learn the material and, um, I found myself wanting to respond to her with like a super long message.
So I was like, apparently I have a lot to say on the subject. So I'm going to record a podcast and it's actually a perfect podcast episode sort of like for this week too, because it's sort of like gives a little perspective about the LTAP and um, next week. Right. Next week. Yeah. On the 30th of September, I'll be opening the doors for the online course for the fall, the fall, fall 2024 cohort of the six week online LTAP level one course, um, opens on Monday, so it'll give you a little bit more perspective of sort of like what's going on.
How it all works. I've got plenty of podcast episodes where I've talked about the LTAP that I'll have Joe link in the short show show notes. If you want to go back and listen to those two, if you're interested, um, it'd be great. Um, and obviously too, like I probably tend to talk about the LTAP on every podcast now because, um, Um, that's how I do my assessment and that's how I figure out where the body is protecting and where to start and really helps me guide my treatment.
So whenever I give perspective of like body parts and how the viscera or the nervous system might be driving pain or movement dysfunction or like weakness or tightness in the area, I have to talk about it. Ah, so anyways, um. Where do I want to go? Oh, first too, I just wanted to share a little bit else about, like, personal life update.
I was also this past weekend, um, this past week, was in Wilmington, North Carolina, which, so funny, my, my 14 year old niece informed us once we got there, like, oh yeah, it's totally a thing. But we got there and somebody at, uh, like, the first coffee shop we went to was, like Oh, are you here for the One Tree Hill convention?
And I was like, what? No. I've never even watched One Tree Hill. Like, maybe I've seen two episodes back when it first started. But it was like a little, like I was a little older than most people who like it, right? And um, probably like my younger cousins really liked it. Anyways, uh, apparently it was set in Wilmington.
Well Wilmington, North Carolina. And, um, every month on the 21st of the month, there is a like One Tree Hill convention or conference, not conference, convention or like celebration or like people come from all over the country, maybe even internationally to experience the town, and the shops, and the restaurants, and the high school that was part of the One Tree Tr One Tree Hill show.
Which is like, so funny, like, so cult. I had no idea One Tree Hill was like, such a cult thing. Um, like they do, um, they even recreate the high school, like, all star basketball game That apparently was a thing. Again, I didn't see the show. And then after the basketball game, Gavin DeGraw holds a concert, like every month.
And I didn't know the significance. I was like, I asked my sister, I was like, was he like in the show? And she's like, oh, like the theme song was like, he wrote the theme song and played the theme song. So I was like, okay. But I'm assuming he must be from that area because like, Or maybe he just goes to Wilmington once a month for a concert at a fake high school all star game, uh, basketball game.
I, I don't know. Like, but yeah, Saturday morning, all these people were walking around in like high school basketball jerseys of the One Tree Hill High School, whatever the name was it. Wow. If that is not a business lesson of like, there is something for everyone, I don't know what is. Um, it was really kind of like wild to see.
But anyways, I was in Wilmington, North Carolina for a memorial service of a family member. My second cousin's wife, so I guess she's technically my second cousin too, um, she unfortunately passed away at a young age and my aunt, so my aunt would be cousins with them. Um, she really wanted to go, but her husband couldn't go.
And I could tell she was like a little hesitant to go by herself. And so since I fly all the time and I had recently gone to North Carolina and really enjoyed it. And it was like, I would love to see the coast, which is where Wilmington is. I was like, I'll go with you. And then once I said, I'll go with you, my sister was like, I want to come too.
So my sister, And I, um, went with my aunt, one of my aunts on my dad's side. And, um, I got to meet, um, or see, again, all of my second cousins, which are all four of them. They're all men, um, between the ages of like, maybe 63 and 75. Um, the oldest, uh, he was, um, My dad, like, was a really big fan of him, like, growing up, we heard about him all the time.
Also, the family was really proud of him. He was very high up in the Navy. He was a captain of a nuclear sub. And so, um, I have, like, very vivid memories as a child visiting with him and my dad just talking about him a lot. And in fact, my dad, I remember my dad went to his commissioning down here in San Diego, actually.
When I was very young, we couldn't go, but he brought us back like souvenirs. And one of the things he brought back was pictures of my cousin and then pictures of his submarine and like autographed. And I remember T I was like, I thought that that was the coolest thing. I remember taking the submarine pictures and like doing a show and tell at school about my cousin.
So anyways, I it's probably been since I was like 12, maybe since maybe, maybe 14, maybe 14. Because I do think he came to town for my grandma's memorial service when I was 14. So, I think I was 14 the last time I saw him and his brothers. Um, and then, of course, it was all of their extended families. So, my third cousins, my fourth cousins, and then their extended families.
Which is just kind of crazy, because also I found out that my third cousins, so, The person's memorial service, her daughter. Um, she lives in San Diego. Like, literally ten minutes that way, out the window. Like, across the Coronado Bridge. And so I was like, what? Every day I go on a walk at the beach, like, I'm basically parking right next to her house, which is like a little mind blowing to me.
So I was excited to connect with her and meet her kids and um, look forward to maybe hanging out with her a little bit now that we know we're in the same town. And then yeah, I met other third cousins that I've never met before. Um, And it was just really cool to connect and we're all actually really similar in age.
So I think she's like, I'm 44, she's 46, my sister's 47, her older sister's 51. So we're all, and I think, I think the youngest of sort of our age cousins was like 35 that was there. And so 35 to 51, like we're all sort of in a similar age bracket. And so, um, that was really cool because it, in my, in my immediate family, we don't have that.
They're all a little younger than me. Anyways, you did not sign up for this whole story about my family, but it was just kind of like a really cool experience. And, um, the, the, my cousin who passed away, she was a, uh, an amazing woman, woman that was very well loved by everyone, not only in her family, but her community.
And it was just really cool to, to be amongst that and support my aunt. Um, Oh, and my, probably my favorite part, which my sister so eloquently pointed out, all of my second cousins, the four men I talked about, they all look so much like my dad. And my dad is, um, one of five kids in his family, but he's the only boy.
He was the only boy. And so Once my dad passed away, like nobody ever, nobody really like, I mean, they all kind of look similar, but these cousins, since they're all men, and they're all like 63 to 75, they look just like my dad. And it, I, it was, my mom, my sister was like, Oh, look, like, isn't it cool to see four guys with dad's sparkly eyes?
And I was like, wow, you're right. They really, like, it really is. And I didn't really realize, like, how cool that would be to see that, and how much I missed my dad, even. And, um, two, to get hugs from all of them, because they're all dads. Um, but get hugs from dads that look like my dad, and were, like, part of my dad, was very cathartic for me, and I'm sure my sister, too.
So, it was a great trip. Whew. Long conversation about, uh, Wilmington. Oh my gosh. Actually, one more thing about Wilmington because I found it extremely annoying and comical. The day we flew out, which was the day of the one tree hill convention was also a Trump Vance rally at the airport. And of course, it was at the time of the airport we were trying to leave.
And when he was there, the whole airport shut down. So everybody's flights was You had to get there early because allegedly traffic was going to be bad. And, um Okay. So, um
I looked on, I happened to look on Twitter when I got to the airport because I'm like, I'm kind of curious what they're saying is going on out here at the rally since I just drove by it. And got to see it in real time because I don't trust the media when it comes to political things. And, uh, there was like no one there.
Like, no crowds. Very few people I saw. no traffic, zero traffic. And at the time we arrived at the airport, it was reported on Twitter from someone at the rally that there was 50, 000 people there and traffic was backed up for a mile to get in. And I was like, That is so untrue. And then as we took off, you could see the hangar that the, you know, not the hangar, but the area, the airport that the rally was in.
And I'm like, I mean, maybe 2000 people, there's not a chance, not a chance that there was anywhere close to 50 K, let alone close to 5k. And so I was like, can confirm crowd size was small. And media was. Not telling the truth, and I just found that, well, annoying because it fucked up travel plans, but then also, um, comical.
Very comical. So quite an adventurous four day trip to Wilmington, North Carolina. I don't know why I have such a hard time saying that town name. Wilmington. Alright. Okay. On to the podcast. So I already said it's, um, inspired by somebody in my missing link course. So I'm just going to pull up her post because I want to make sure I read it correctly.
Uh, but basically she is, like I said, she's an athletic therapist. She works, um, for a Canadian professional hockey team. Um, so, um, she said with the SI, so, so in the missing link, I'm teaching the first test of the LTAP, um, assessment, which is the SI joint mobility locator test. And so she said with the SI
joint itself being affected on many hockey athletes due to the nature of how they skate, shoot the puck, and play their position. I can't, I can't think of a better way to start this holistic journey and approach than enhancing my assessment abilities and tools with the SI joint. So I love that, um, you know, love that she's excited, love that she You know, right out of the gate sees how applicable it will be.
Um, but I, I wanted to share a few things on it. Number one, what I am constantly like teaching everyone on this podcast, in the Missing Link, in the LTAP courses, and this is like a hard concept to wrap our head around sometimes, is that the SI joint mobility locator test, though we are assessing the SI joint.
From a mobility standpoint, it actually is a whole body assessment. It is not only an SI joint assessment. Now, can it also be an SI joint assessment? Can we look at it that way? Absolutely. Especially in the incidence of kind of what she's talking about, with like SI joint dysfunction and SI joint problems.
And I think why I really thought about, like, why I was excited about this comment from her and, like, why it sparked so many thoughts in my head is because, you know, when I worked, back when I worked at Exos, we had a handful of hockey athletes that were in the NHL that trained with us, and I loved, I loved working with them.
Um, and, um, and I often think back about clients, about athletes that I worked on in the past before I had this lens of view, a more whole organism approach to the body, and I think, man, well what? I'm like, dang, I wish I had this skill set back then because I could have really helped a lot of them better than I did or quicker than I did.
Not even or, definitely quicker than I did, probably better than I did. Um, more efficiently for sure. And so then I was kind of like thinking too, just inherently sort of what she said, the positions that is hockey, and the ways that their body either, I don't want to say their body shape changes in response to being a hockey player, or I That people with this body shape tends to gravitate towards hockey because it fits it well, who knows, right?
Chicken or the egg. Just thinking about those common postures, those common dynamic alignments, even in a hockey athlete and how they might predispose for some visceral and nervous system issues that are going to then also affect the SI joint. And I was like, you know what, I want to talk about this. This is really great.
So, you know, um, there's a few things that we can think about with a hockey athlete. Number one. They are skating and skating is like a hip extension abduction and external rotation thing. So they're going to be like really dominant posterior Like glute max people, right? So in general you would expect some external rotation of their legs More than likely lacking internal rotation I would expect some significant out flare of their innominate bones Because of all that Then you have to look at them Um Um, then also you're looking at like, okay whole outside of the leg, like probably, you know, also tight, right?
Like they're not though, I mean, they're crossing the midline, but most of the time they're working things outwards, right? So I would assume that if I tested their mobility towards the midline, they would be lacking hip adduction. And, um, then also too, we're looking at their, um, You know going up the chain another real common thing you see is that their shoulder on this side That they're dominant with the stick is lower.
So if they're a right hand shooter right there right hand Right handed with the stick their right shoulder is going to be lower and their whole trunk is going to be kind of side bent to the right And then of course you have the fact that They are
Um, do I want to add on to anything? I mean, those are the biggest, like, dynamic alignment things that I can think of is the shoulder, side bending posture, and then the external rotation and out flare position. A lot of them tend to have sort of like, um, sway back as well. Uh, well, you know. thoracic mobility issues and stuff like that.
A lot of them have just in general, like, um, I think the terms like cathedral shoulders, like both scapulas tend to be pretty depressed. So let's break all of that down from a visceral lens of view of what all that could mean to. Um, of course, um, Two, like this is why we do assessment because I'm going to share all these things that I think of When I think of a hockey player's dynamic alignment and some things that I could potentially see going on So SI joint.
Yes, more than likely One is going to be hypomobile What we'll learn with the LTAP and then the missing link is like what we're curious about is does it change with a breath hold or not. Um, if there is a visceral driver,
I would expect a lot of it, a lot of this, especially for my right handed hockey guys to be liver and kidney because even for a couple reasons. So number one, just their posture, sort of putting them in that position, right? And we, I've talked a lot on the different podcasts about how the protective pattern around the organ can change the dynamic alignment, but also our dynamic alignment from repetitive movements can affect the mobility of the organ.
So it can go the other way too. So someone who is constantly side bent. and rotating in one direction to hit the puck. I would, I would be like, Oh, poor liver. It's getting crunched on and rotated on and never really getting the other motions that the liver needs to happen in. And then the kidneys right below the liver in that area too.
And they're very much connected from a functional standpoint to the right kidney is a very like, um, digestive kidneys. So oftentimes, right, our liver and our kidney kind of dysfunctions come up together. So that's sort of like the first thing I think of is just the repetitive motion making the container that the liver is in not to be so flexible and in a odd shape that's not supportive to full mobility of the liver.
And so then what, what I see from a symptomatic standpoint. Right SI joint pain would be really common. Left sciatica would be really common. Right shoulder pain would be really common. Those are kind of the big ones and then maybe even right hip like flexor kind of stuff. Um, then I look at the fact that In their sport, they're skating very fast, and then stopping very quickly.
So, inherently, that is a very whiplash motion to our organs. If they don't stop themselves quickly on the ice, you know, with their, I don't ice skate, so, also, I might be wrong with this, but it seems like sometimes they just like, break themselves with digging the blade into the ice. Like a toe pick type scenario, going back to one of my favorite movies as a kid, The Cutting Edge.
Um, so, or, kind of like football, and basketball and soccer, sometimes what stops their acceleration is another person running into them. Also in hockey, it's often the boards, the wall, stopping them. And so, any of those scenarios, whether they're stopping themselves, the board's stopping them, or another human being is stopping them, the organs have all been accelerating at that same rate they were, and they don't have the muscles and things to stop them like the body does, and so those organs have a whiplash thing happen to them.
And our heavier organs tend to stop them. feel the effects of that whiplash more than anything, which is going to be their liver and their heart. So those are a couple visceral referrals that I would not be surprised to see on the hockey guys, as well as the brain and the cranium. Same thing happens to the brain, right?
It's accelerating forward and then they stop and it, gets whiplashed. And so the tentorium and the, and the meninges of the cranium is often going to be um, under tension too. And what we see, what happens with that is we see this concurrent side bending of the whole spine towards the side of tension. And the central nervous system extends all the way down to the tailbone.
And so oftentimes, and I, and this is why I'm like, man, I wish I knew this information when I worked with hockey guys. Cause one of the, there was two things I saw on them a lot of the times, and it was a forward sacral torsion of the sacrum. And then it was also a side bending of the sacrum. And now I know that those are very central nervous system, um, patterns as well as visceral patterns because of the relationship of the piriformis as a lateral flexor of the spine and the tendency for the whole nervous system to go into side bending when there is tension in the central nervous system.
And then even to that side bending pattern that we already talked about that they're in sort of like sets us up for this scenario. And so that type of, um, scenario, right? Whether when it's like cranial, it could be shoulder pain, neck pain. It could be any arm pain. It could be any leg pain. It could be back pain.
It could be SI joint pain. It really, it really, when it's central nervous system, it can literally be anywhere in the body. It could be jaw pain. It could be headaches. Could be eye fatigue, like so many things could be ringing in their ears. I mean. The list goes on and on of all the possibilities of what they would feel with this cranial tension.
But it could be like hamstring tightness or, or, um, sciatica or things like that. So, super interesting there though. And then when we look at the pelvis itself, right, when we started out this conversation about when they're, you know, the skaters, they get sort of like so developed in their glute max and they're sort of always in this like turned out leg position, this out flared position, which is also like a very posterior tilted position, which actually That, that bilateral posterior tilt and out flare, that destabilizes the SI joint quite a bit from a force closure standpoint, um, and a form closure standpoint.
And so inherently they're going to be like a more at risk to even injure their SI joint. But the other thing that comes to mind when I see people in this position is how much that would affect tension across the inguinal ligament. and that inguinal ligament, when we add tension to it, it starts compressing the femoral nerve, the femoral artery and vein, and the body does not like that, and so then it wants to limit hip flexion and limit hip extension to avoid extra compression and, um, tensioning of those neurovascular structures, and so we might find a pretty significant Um, issue going there too, um, not to mention from a posterior standpoint, you know, it could be entrapment of the superior gluteal nerve of the sciatic nerve itself, like so many options.
But that's sort of like the first thing I think about when I think of the hockey players from in this visceral and nervous system lens of view of like, Oh man, I When I used to work with, I mean, and this too is probably why I thought about it because like when I used to work with hockey athletes, it was, you know, 10 years into my career.
And I, I feel like I was pretty good at sacral mechanics and, and fixing things with, um, exercise and movements and manual therapy and things like that. But I remember sometimes getting so frustrated with my hockey players. It's like sacral side bending and like feeling like it was such a fight to improve it.
And now I know that I'm like, Oh, it's just a reflection of probably protective patterns and other parts of their body potentially on top of this movement. repetitive movement type of thing and also it's like that's not a problem like they should be able to be like totally functional but it's like when we get stuck in those patterns and can't move out of them there's usually a deeper reason why like a deeper protection pattern of why as opposed to just the repetitiveness
So, especially if they have pain, um, or injury. So, anyways, I hope that was interesting for you all. Um, to sort of, like, think about those kind of things. And I, and, and I want to, like, stress too that, like, I speak a lot about, like, Oh, when the liver's not really, you know, moving very well the body will go in this protective pattern of right side bending and maybe flexion and a little rotation to protect it you know kind of like hug the area of protection but it but it works the flip side too when we're constantly in these positions from a postural standpoint from an ergonomic standpoint from a repetitive motion standpoint we're also putting the organs at any place which they're not able to fully express their mobility and their function will diminish.
So this is important. If somebody's having like high liver load, having a hard time with liver stuff, but they're constantly stuck in this right side mania position because of their sport, like we need to like do some things to change that so the liver can feel better. The treatment might look the same, but it's just understanding is it the container driving the problem or the organ driving the problem?
And then also, where is our skill set? Is our skill set only in treating the container? Well, that's okay, but do we need to bring somebody else in? to help us if we need a skill set that's working on the organ itself. And that might be a manual therapist trained in it, like from the Barral Institute, visceral manipulation type thing, or that might be a functional medicine doctor, right?
And so understanding that there can be this dynamic on both sides, container and contents, both as a driver and a result, like is, is helpful picture for us. Another example of this that happened recently is I saw this meme on Instagram. Oh my gosh, I laughed so hard. It was this, I'll, I'll, I'll hold it up.
It was this frog, like, sitting on its butt, like, oh my gosh. And it says, One day, you're young. The next day, you're sitting like this at the edge of your bed with a bad shoulder, bad knee and sciatic pain. And I laughed because especially like I'm at that age where I wake up in the morning. I'm like, God damn, some things kind of hurt.
But then I was like turned it into a whole post because I'm like, actually when I read that, I'm like, Oh, bad shoulder, bad knee and sciatic pain. I think, Oh, liver. I'm, so I made this whole meme and I'll have Joe link it in the show knows, but I was like, but then you see a person that's trained in the LTAP and you find out that was your liver.
You received some manual therapy, some liver support, exercises, and then you don't have shoulder pain, sciatica, or knee pain, and you lived happily ever after. But then in the caption, I described, I talked about like all the connections to those things from the liver, but, um, it just hopefully those two examples of this hockey athlete and the frog, um, those two examples, I hope you see where my brain always goes now that it operates primarily in this area.
It's a lens of view in this paradigm of whole organism. Organs are the most important thing to the body. And when I hear aches and pains in different body parts, my first thought is what organ would refer there? What nerve is involved in that area? And how could I support that? So. A little insight into the functioning of my brain.
Hope you enjoyed my whole story about my trip to Wilmington, North Carolina. And, um, that little, uh, off the cuff sort of teaching about how this all fits in, um, an athlete profile. Have a great week, and we'll see you next week.