Context: The epidemiological focus on time loss may underestimate the true magnitude of hip and groin problems in male ice hockey players.

Objective: To describe the prevalence, incidence and severity of hip and groin problems (time loss and non-time-loss) in Swedish ice hockey players over the course of a season and to explore potential pre-season risk factors for these problems.

Design: Prospective one-season cohort study

Setting: Professional and semi-professional Swedish ice hockey

Patients or other participants: Twelve professional and semi-professional male ice hockey teams were invited to participate. Nine teams agreed to participate, and 163 players were included in analyses.

Main outcome measures: Hip and groin problems in the previous season (time loss; non-time-loss), isometric adduction and abduction strength, and five-second squeeze test were recorded prior to the season and served as independent variables in the risk factor analysis. Main outcome measures were cumulative incidence of hip and groin problems, average prevalence, and odds ratios for groin problems in-season

Results: Cumulative incidence for all problems was 45.4 % (95% CI 37.6–53.4) and 19% (13.3–25.9) for substantial problems. Average prevalence was 14.1% (10.8–17.5) for all and 5.7% (4.3–7.2) for substantial problems. Among reported problems, 69.2% had gradual onset; where only 17% lead to time loss. Players with non-time-loss problems in the previous season had significantly higher odds for new problems [All: OR 3.3 (1.7–6.3); Substantial: OR 3.6 (1.8–8.4)]. Pre-season strength was not significantly associated with the odds for subsequent problems.

Conclusion: Hip and groin problems are common in ice hockey and may lead to substantial impairments in performance. Only one in five problems led to time loss and 7 out of 10 had gradual onset. Non-time-loss problems in the previous season were found to be a significant risk factor for new problems whereas preseason hip adduction and abduction strength was not.

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