Sources: Tyler Seguin has hip condition
BOSTON -- Forward Tyler Seguin has been arguably the Bruins' best player so far in what is shaping up to be a breakout season, but looming in the background is a question about his long-term health.
Seguin has a congenital hip condition that makes him more susceptible to a hip injury, according to league and team sources.
The condition could lead to an injury that requires surgery and potentially shorten his career, the sources said, but is not a concern for the short-term, nor is it affecting him presently.
The condition increases the likelihood that the 19-year-old Seguin suffers a type of repetitive-stress degenerative hip injury if he isn't proactive about building and maintaining his strength in that area.
"The worst-case scenario is they start to develop recurring symptoms consistent of a groin pull, hip flexor strains, difficulty getting their hips in certain positions, reduced rotation, increase in pain and reduced levels of performance," renown hip expert and surgeon Dr. Bryan Kelly, who has not examined Seguin, said in describing a worst-case scenario for a hockey player who is battling a congenital hip condition. Kelly has performed hip surgeries on Bruins Tim Thomas and David Krejci, as well as former Red Sox third baseman Mike Lowell, among many other athletes.
It's important to note that hip disorders are common among hockey players. Bruins general manager Peter Chiarelli estimated that 70 percent of his players have hip issues and that it is "nothing to be alarmed about." Chiarelli insisted Seguin's condition is not serious.
"I'm not going to comment whether it's congenital or not," Chiarelli said. "I don't want to get into details what we think it is or isn't and I don't want any alarm bells going off. Like I said, you can go through our roster and there are probably 12 or 13 guys with something similar or the same thing.
"I'm not going to comment on any of our players' medical conditions that aren't really an issue," added Chiarelli. "We have guys with sore ankles and they play through it, so it's not something I'm going to comment on."
When asked whether he was concerned about Seguin's hip, Chiarelli was clear.
"No, I'm not," he said.
Kelly has talked to the Bruins about Seguin's condition. He explained that preemptive measures can be taken in cases like Seguin's.
"With Tyler I've never seen his X-rays and I don't know the specifics of what his problem is," Kelly said. "I've talked a little bit to the team about that he may have something going on, but there are a lot of different types of problems that have some significant implications, and some that have minimal implications and some are really easy to fix.
"The one thing we've learned is if we identify that there's a structural problem early, because we have such good treatment options for these patients, we're a little bit more inclined to just treat it and not wait for it to become an issue and if you can treat it before it's an issue then that's the best-case scenario. We're trying to identify these problems before they become so far advanced that there's not much you can do and then you're in salvage mode rather than operation mode."
Krejci and Thomas both developed hip injuries that eventually required surgery, though it is unknown whether either had a pre-existing susceptibility to such a condition, as Seguin has. Both Krejci and Thomas played through the discomfort until they reached the offseason, when they opted for surgery.
Krejci had his procedure prior to the 2009-2010 season and did not miss any time. Thomas' surgery came prior to last season, after which he went on to win the Vezina and Conn Smythe trophies and the Stanley Cup.
Kelly said the types of movement involved in hockey predispose players to hip injuries as it is, especially those who have played the sport from a young age.
"So hockey players who are playing at a high level, the reason they're good is because they started when they were young," Kelly said. "They are on the ice at the age of three, subjecting probably excessive forces to their developing hip that leads to structural alterations in the joint that predispose them to injury. Then they continue on in a sport which requires motions across the joint that their structure doesn't allow for it, so their functional requirements for their sport don't match with their physiological anatomy."
Seguin would not confirm the exact nature of his congenital hip condition -- "I don't think I've really said anything to the media about a hip or anything," he said recently. "I don't have anything to say about that" -- but acknowledged he knows he needs to keep up his work in strengthening the area to avoid problems down the road.
"The biggest injuries hockey players have are hips and groins and obviously over time, if you play a lot of games, it could start to wear down and it gets more tired," he said. "Obviously during the offseason you need to keep your hips -- your whole body really, and every hockey muscle you use -- in top shape so at the start of camp and during the season you don't pull anything.
"If you have problems with your body it's about managing them," he added. "There will be games when you have to fight through some injuries and play the best that you can. When you're away from the rink and not playing you have to take care of that stuff. It's all those little things that will help you go a long way."
Even if Seguin does need surgery at some point, he only has to look at what Krejci has accomplished to understand a hip injury doesn't have to derail a career.
Krejci suffered what he first thought was a groin injury during training camp prior to the 2008-2009 season. He took a few days off but the injury kept recurring, so he finally had an MRI and the team realized it was his hip. He was able to play through the discomfort but there were some days when he could barely walk after a morning skate and had no idea how he would be able to play that night.
"I was limping going back home," he said. "But once I stepped on the ice, for some reason it didn't bother me, so that was a good thing. I just took it day by day and I remember getting ready for every game and thinking anything could happen so leave it all on the ice because it could be my last game of the season. That was the right approach but it was a long season.
"But I wanted to get the surgery because of the feeling off the ice and I'm glad I got it done," added Krejci.
After the surgery in June of 2009 he was ready in time for training camp the next September.
"I felt 100 percent, but my hip wouldn't let me do what I could do when I'm 100 percent healthy," Krejci said. "It took some time over the season and it got to a point during the second half of the season when one game I just felt like I could skate and nothing was bothering me, nothing was holding me down, it was like I had the green light."
"Some guys say it takes three or four months to get back on the ice, but it took me almost a year to feel that there was nothing wrong."
Knowing what is at stake, Seguin and the Bruins have been proactive in making sure the highly talented forward remains healthy and productive. Seguin showed up to camp in great shape and his impressive preseason showing has carried over to the start of the season. Entering Saturday's game against the Montreal Canadiens, he had three goals and six assists for nine points, including a plus-7 rating in nine games. He leads the team both in points and plus-minus.
Both Chiarelli and coach Claude Julien have been impressed with the second-year forward.
"I really like Tyler's improvement so far," Julien said. "When you look at him from the beginning of last year and how he grew through the course of last season and this year he came into camp with a lot of confidence. Sometimes that's what a year under your belt does, and not just a year but an experience of a lifetime in the playoff."
Julien explained that Seguin is showing distinct improvements in areas that a season ago were a challenge for him and now have become second nature.
"He's going and battling for pucks in the corners where last year we saw him, at times, kind of look over his shoulder and this is all a natural thing for a young player to make that jump to the NHL as an 18-year-old. He's much stronger. He's much more confident and as long as he's like that, his skills are starting to show even more."
Joe McDonald covers the Bruins and Red Sox for ESPNBoston.com.