Sports hernias putting strain on hockey players of all ages

Months removed from sports hernia and hip surgeries, Claude Giroux still didn't feel like himself.

The Philadelphia Flyers' captain finally got back to normal by the end of the season, roughly nine months after going under the knife.

"I thought it'd be quicker, to be honest," Giroux said. "It's harder than I thought it would've been."

Because of the unnatural motion of skating, hockey is among the most common sports for sports hernias, a catch-all term for what are also called core muscle injuries. Within the past couple of years, Jamie Benn of the Dallas Stars, Patrice Bergeron of the Boston Bruins, Jason Zucker of the Minnesota Wild, Karl Alzner of the Washington Capitals, Shayne Gostisbehere of the Flyers and goaltender Mike Smith of the Arizona Coyotes are among the NHL players to have an operation to repair a sports hernia or core muscle injury.

Dr. L. Michael Brunt, who has been a St. Louis Blues team physician since 1994, estimates that anywhere from six to 15 players each year undergo some type of sports hernia surgery — and it's on the rise across all ages. Brunt , who has performed the surgery on Michael Grabner, Joel Ward, Mike Green, Matt Cooke, Doug Weight and others, believes the increase over the past 10 to 15 years has to do with better recognition of abdominal and groin injuries that are common in hockey, soccer and football players.

While acute injuries can lead to sports hernias, Brunt believes that too much repetition among young athletes in a single sport can cause problems, something others have blamed for more Tommy John surgeries among younger and younger pitchers.

"It's because of the sudden propulsive movements: turning, cutting, etc., that occur at high rates of speed," Brunt said. "Young athletes are committed to one sport very, very early on, and so there are these repetitive movements that occur because they're not doing three or four sports year-round and mixing up their physical sports activity. They concentrate on one sport, and it's that gradual wear and tear over the years that tends to predispose them to developing something like this."

The recovery from surgery varies drastically from player to player, too. Nolan Patrick, who's expected to be a top pick in the NHL draft next week, had surgery on his right side last summer, came back too soon and missed three months of his season.

"Everybody's different so it's hard to put a blanket on it," said veteran Dallas defenceman Dan Hamhuis, who played a full 82 games and had one of the best seasons of his career after summer sports hernia surgery in 2011. "There's lots of variables: different surgeons doing it, different levels of tears. Some guys it's just a simple hernia and mesh insertion. Other guys have (adductor muscles that) could be torn and then it's a whole thing. ... I think rehab was a huge part of it, and of course everybody has different rehab programs."

Dr. William Brown , a California-based sports hernia specialist, said many different muscles, nerves and tendons can be injured — and inexperienced surgeons can miss other injuries in the area.

"Some of the athletes respond poorly because not everything's fixed appropriately at the time of surgery," Brown said. "If (other injuries) are missed, then that could be another one of those reasons why the athlete doesn't heal quickly after the operation's over."

That's one explanation for Patrick being limited to 33 games for the Western Hockey League's Brandon Wheat Kings during his draft year. The 18-year-old centre said he should have had two surgeries but isn't dwelling on the situation as he looks forward to the draft.

"There's a ton of guys that have these injuries these days and everyone bounces back from it," said Patrick, who took two full months off skating from October to December before returning in January. "It happens to a lot of hockey players and mostly comes from over-usage. ... It's a tough bounce, but you know it's the way it goes sometimes."

When he came back, Patrick put up 16 goals and 42 assists in 28 games before a leg injury ended his season. Former NHL executive Craig Button, now a draft analyst for Canadian sports network TSN, said Patrick was more careful when he came back the second time and looked like an elite prospect again.

"Initially there was a little bit of a working-in process," Button said. "But after he got right up to speed, I thought he was right back to where he was at."

Patrick's injury history is a question for the New Jersey Devils, who have the top pick, and it led the Flyers, who draft second, to bring him in to see their doctors after the scouting combine.

"I've had to take care of my hips and groins for my whole career, so I've learned how to manage that properly," Hamhuis said. "To stay around in this league, you've got to stay healthy and allow your body to be in a good position."

___

AP Hockey Writer John Wawrow in Buffalo, New York, contributed.

___

Follow Hockey Writer Stephen Whyno on Twitter at http://www.twitter.com/SWhyno

___

For more AP NHL coverage: https://apnews.com/tag/NHLhockey

Stephen Whyno, The Associated Press