Does Percutaneous Neuromodulation Promote Recovery in Hockey Players With Grade 0 Adductor Injuries?

Summary

Ice hockey is a widely practiced sport, particularly in North America and Europe, with over 2,500 professional players in North America and approximately 2,000 in Europe. Its global expansion has extended participation to regions such as Africa and Australia. This sport demands high physical performance, speed, strategy, and specific preparation to prevent injuries. The most common injuries include muscular and joint trauma, especially in the knees, shoulders, and groin region, where "groin pain" is a frequent issue.

Injuries to the hip joint, such as femoroacetabular impingement (FAI), acetabular labrum and cartilage lesions, and intra-articular loose bodies, are prevalent. Extra-articular injuries primarily involve the adductor and abdominal muscles. The biomechanics of ice skating require repetitive and forceful hip movements, increasing eccentric load on the adductors, particularly at higher skating speeds, thereby raising the risk of strains.

Studies have shown that the adductor muscles, particularly the adductor longus, are the most frequently injured. Risk factors include a history of previous injury, high training intensity, strength imbalances between adductors and abductors, and inadequate preseason preparation. A critical threshold is the adductor/abductor strength ratio: if it falls below 80%, the risk of injury increases 17-fold.

Invasive physiotherapy has gained prominence as an effective option for the treatment and prevention of such injuries. Ultrasound-guided invasive techniques, such as ultrasound-guided percutaneous neuromodulation (US-guided PNM), have demonstrated the ability to reduce muscle stiffness, improve intra- and intermuscular coordination, and enhance endurance. These techniques have shown greater efficacy than conventional methods, contributing to improved athletic performance and reduced injury risk.

US-guided PNM is a minimally invasive technique that delivers electrical stimulation via needles placed under ultrasound guidance near peripheral nerves or motor points. The stimulation is adjusted according to therapeutic goals, whether to reduce pain, improve neuromuscular function, or modulate muscle tone. Its efficacy has been documented in studies showing improvements in flexibility, strength, and post-exertion recovery, with effects observed even in the contralateral limb, attributed to the crossover phenomenon.

Given the high incidence of adductor injuries among hockey players and the associated risk factors, this clinical study aimed to evaluate the effectiveness of a single session of US-guided PNM in players with grade 0 (muscle contracture) injuries of the adductor muscles. Three primary variables were assessed: muscle strength (Adductor Squeeze Test), hip mobility (Bent Knee Fall Out Test), and subjective pain (VAS scale), both in daily activities and during on- and off-ice training.

Conditions

• Grade 0 Adductor Injurie

Interventions

OTHER

US-guided PNM

Stimulation will be applied for 15 minutes at 4 Hz, using a 250 ms pulse duration.

Sponsors & Collaborators

• Universidad de Zaragoza

  lead OTHER

Principal Investigators

• Pablo Herrero, Physiotherapist · Universidad de Zaragoza

Study Design

Allocation

NA

Purpose

OTHER

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

MALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-06-27

Primary Completion

2025-09-01

Completion

2025-10-01

Countries

• Spain

Study Locations