The achilles tendon is located at the back of the heel. It attaches the muscles located at the back of the lower leg to the heel bone.
An individual who has suffered with achilles tendinopathies (problems to the tendon) is more susceptible to an achilles rupture. An achilles tendon rupture can either be complete or partial.

The achilles can rupture if an individual:
  • Makes a forceful push off with the foot whilst the knee is straightened. For example jumping, landing then pushing off to run
  • A sudden trip or fall and the foot is put in front to break the fall, stretching the tendon
  • Falling from a significant height or suddenly falling into a hole or off a curb 


Signs & Symptoms
An individual may notice the symptoms come on suddenly during a sporting activity. A snap may be heard or the sensation of being kicked in the back of the leg when the tendon is torn. The sharp pain usually settles quickly, although there may be aching at the back of the lower leg. After the injury, the usual symptoms are:
  • A flat footed type of walk. The individual can walk and bear weight, but cannot push of the ground properly on the side where the tendon is ruptured.
  • If the tendon is completely torn, you may feel a gap just above the back of the heel. However, if there is bruising then the swelling may disguise the gap.

Treatment
An achilles rupture should be diagnosed and treated as soon as possible. The individual may need to be referred on to see a doctor. If a ruptured Achilles tendon is suspected, you should not put any weight on that foot, so DO NOT walk on it at all.
There are 2 options for treatment. One being an operation to surgically repair the tendon. The two torn ends of the Achilles tendon are sewn back together, and perhaps may also use another tendon or a tendon graft to help with the repair. A plaster cast or brace is needed after the operation.

The second option is to allow time for the tendon to heal naturally, resting it in a brace or plaster cast. This is called conservative treatment. However, If the tendon does not heal on its own, a surgical repair can then be done later.

Both options will involve having a plaster cast or brace for about eight weeks, to protect the tendon while it heals. The plaster or brace is positioned so that the foot is pointing slightly downwards, this is done to take the strain off the tendon.
There is a trend towards early mobilisation rather than using crutches was traditionally done. This involves fitting a plaster or brace which you can walk on.

The tendon does take time to heal, usually about six to eight weeks. More time will be needed after this to allow the muscles to regain their strength from before the injury and from being in a brace/cast. The time taken to return to sport is between 4 and 12 months.


Hannah Schofield
HS Injury Rehab 
 
Hockey is sport which requires skill, fitness and the ability to make changes in direction quickly.
As a result of this hockey has a high percentage of injuries. 

Some common hockey injuries include:

ACL (anterior cruciate ligament) rupture
The ACL is an important ligament as its funtion is to help stabilise the knee. ACL ruptures are a common hockey injuries, especially in women. The injury occurs when the knee is twisted during a change in direction. The signs of this injury include knee pain, swelling, instability and difficulty walking. A loud pop may also be heard at the time of the injury. Play should be stopped immediately, and apply the RICE principle (Rest, Ice, Compression and Elevation) and seek medical attention as soon as possible.
Rehabilitation with Sports Therapy or Physiotherapy is needed to help return to the hockey field.

Meniscus tears
The menisci are made up of two rings of cartilage located in the knee - the medial meniscus and the lateral meniscus. Their function is to absorb shock. However with constant twisting of the knee pain, swelling, difficulty bearing weight and inability to bend the knee can begin. 
When this happens play should stop the RICE principle should be again be applied and medical help seeked. Again Sports Therapy or Physiotherapy will be needed to help return back to play, but in severe cases surgery may be necessary to correct the issue then continuing onto rehabilitation.

Ankle sprain
This is a very common hockey injury which occurs when the ankle turns over causing the sole of the foot to turn inward. Damage is usually to the ligaments located on the outside of the ankle. Symptoms of an ankle sprain include ankle pain, swelling, stiffness, bruising and an inability to bear weight. Using the RICE principle followed by rehabilitation with a Sports Therapist or Physiotherapist is the best form of treatment.

Hamstring strain
A sudden, sharp pain at the back of the leg while sprinting or quickly changing direction can signal a hamstring strain. Other symptoms include pain while stretching the muscle, swelling and bruising to the area. There are different grades of hamstring strains, the symptoms ranging from mild to severe. In more severe cases, walking is greatly limited and crutches may be used.
The RICE primciple followed by rehabilitation is the best course of treatment.

Groin strain
A tear or rupture to any of the muscles lacated on the inside of the thigh constitutes a groin strain. This type of hockey injury results in groin pain ranging from mild to severe, grade 1 being mild, 2 moderate and 3 severe. Tightness may be felt in the groin area as well as pain when squeezing the legs together. 
In a grade 3 strain, a lump or a gap in the muscle may be felt. Rest and ice along with rehabilitation are whats needed to help return to the sport.


These are just a number of the ways that players can be injured while playing hockey. In many cases, injury can be prevented by warming up properly for the sport. 
Wearing the correct protective equipment help avoiding some of the contusions and fractures that occur in hockey.

Hannah Schofield 
HS Injury Rehab