Brad Marchand’s Injury History: At What Point Do We Start Asking Why?

Brad Marchand recently underwent another surgery likely involving his lingering hip and sports hernia issues. At 38 years old, with more than 1,000 NHL games behind him, another procedure isn’t necessarily surprising. He has played an enormous amount of hockey and placed tremendous demands on his body.

But when I started going back through Marchand’s injury history, I became less interested in the latest surgery and more interested in what came before it.

This isn’t his first problem in this area. Marchand underwent sports hernia surgery in 2020. In 2022, he had arthroscopic surgery on both hips, including labral repairs. He required further surgery involving the groin and abdominal region in 2024, and now in 2026 perhaps we’re back to the hip and sports hernia again.

It’s easy to look at that history and attribute it to the accumulated wear and tear of a long NHL career. That may ultimately explain a lot of it. But something Marchand said after his bilateral hip surgery in 2022 made me want to look further back.

He said it was the first time in six or seven years that he’d been able to play without pain through his hips, groin and legs.

That takes us back to somewhere around 2015 or 2016.

So although the major hip surgery didn’t happen until 2022, the problem appears to have been there for years before anyone was talking publicly about bilateral labral repairs.

That’s where the story becomes more interesting to me.

What happened before the hips?

When I assess someone with a longstanding or recurrent problem, I rarely begin the history with their current diagnosis. I want to know what happened before it. Sometimes I want to go back years.

In Marchand’s case, something in that earlier history caught my attention. In October 2015, he suffered a documented concussion. He missed a couple of games before returning to play. He had also sustained a documented concussion in 2013.

Now, I want to be careful with what I’m suggesting here. There is no evidence that Marchand’s concussion caused his subsequent hip problems, and I’m certainly not claiming that it did.

What interests me is the timing.

Marchand’s 2015 concussion occurred during approximately the same period that, years later, he would identify as the beginning of persistent pain through his hips, groin and legs.

That could be completely coincidental.

But it’s enough to make me ask another question.

Could something have changed following the head injury that influenced how his body organized movement and load?

A concussion involves more than symptoms

When we talk about concussion, the conversation understandably focuses on symptoms: headache, dizziness, memory, reaction time, light sensitivity and cognitive function. Return-to-play protocols then progressively expose the athlete to increasing physical and cognitive demands until they can safely return to competition.

But concussion can also affect systems involved in organizing movement. Visual and vestibular function, cervical proprioception, balance, postural control and the nervous system’s ability to understand where the body is in space can all be affected.

This becomes particularly interesting when we consider research showing an increased incidence of lower-extremity musculoskeletal injury following concussion. That doesn’t mean a concussion directly causes a future knee, ankle or hip injury. It does suggest, however, that there may be consequences of concussion that extend beyond the point when the athlete becomes symptom-free.

An athlete can feel normal and still potentially organize movement differently.

Most of those differences would probably be incredibly subtle. But professional athletes don’t repeat movements ten or twenty times. They perform them thousands upon thousands of times, season after season. A small adaptation that means very little today could potentially become more meaningful after years of repetition and load.

Why the bilateral hips interest me

Marchand didn’t ultimately require surgery on one hip. He required arthroscopic surgery and labral repair on both hips.

That matters to me.

A single injured hip can have a relatively straightforward explanation. There may have been trauma, structural anatomy, repetitive loading or a previous injury on that side. When significant problems develop bilaterally, however, I become more interested in how the athlete is organizing load through the entire system.

What’s happening at the pelvis? How is the sacrum moving? How is the trunk positioned over the pelvis? Is there a rotational strategy being repeated every time the athlete skates, accelerates or changes direction?

And then I start looking farther away.

The lumbar spine. The thorax. The diaphragm. The cervical spine. The cranial base.

That’s where my osteopathic background influences the way I look at a case like this.

The cranial-sacral connection

In osteopathy, we don’t view the cranium, spine, sacrum and pelvis as completely independent regions. There are anatomical, neurological, fascial and mechanical relationships connecting them.

The cranial and spinal membranes are continuous. The dura extends from within the cranium through the spinal canal, with attachments through the upper cervical region and connections continuing inferiorly toward the sacrum.

Does that mean a concussion in 2015 mechanically caused Marchand’s bilateral hip pathology years later?

No.

That would be an enormous leap, and there are many other factors that need to be considered.

But it does make me interested in what happens to the rest of the system following significant head trauma.

If an athlete develops altered cervical mechanics, vestibular function, proprioception or postural control following a concussion, could the body develop a slightly different strategy for organizing itself over the pelvis? Could that influence sacral or pelvic mechanics? Could that, in turn, alter how forces are distributed through the hips?

And what happens when that strategy is repeated through thousands of hours of elite-level skating?

I don’t know. But I think it’s worth asking.

What would I look at?

If Marchand walked into my clinic, I obviously wouldn’t ignore his hips. I’d want to understand their structural condition, available rotation, capsular restrictions and how each hip interacts with the pelvis.

But I wouldn’t start and finish there.

I’d want to understand exactly how his previous head injuries occurred. I’d assess the cranial base and upper cervical region and look at cervical mobility and proprioception. I’d want to understand how the thorax and diaphragm were functioning relative to the lumbar spine, pelvis and sacrum. I’d look at balance, vestibular function and how he organizes himself during movement.

Then I would start changing things and reassessing.

This is an important part of the process for me. I’m not looking at the cranium because I’ve already decided that’s where the problem is. I’m looking there because the history gives me a reason to investigate it.

If I address something at the cranial base or cervical spine and nothing changes at the pelvis or hips, that’s useful information. If I change something through the thorax and nothing changes below, that’s useful too.

But if I make a correction somewhere seemingly unrelated to the hip and suddenly hip rotation changes, pelvic mechanics improve or movement becomes easier, I’m paying attention.

The body gets a vote.

That’s one of the reasons I don’t like approaching complex cases with a predetermined protocol. You listen to the history, assess what you find, implement a corrective solution and then reassess. What changes — or doesn’t change — determines where you go next.

Looking at the whole timeline

Marchand’s hip problems could simply represent the accumulated consequences of an incredibly long hockey career. Structural anatomy may have played an important role. So might skating mechanics, training load, age, previous injuries and countless other variables we can’t see from the outside.

His concussion history may have absolutely nothing to do with his hips.

But when I put the publicly available timeline together, I still find it difficult not to be curious:

2013 — documented concussion

2015 — documented concussion

Approximately 2015–16 — period Marchand later identifies as the beginning of years of hip, groin and leg pain

2020 — sports hernia surgery

2022 — bilateral hip arthroscopy and labral repair

2024 — further groin and abdominal surgery

2026 — possible hip and sports hernia surgery again

That timeline doesn’t prove anything.

It does make me want to look further back.

And that’s really the point.

When somebody presents with a complex or recurrent injury, the diagnosis tells us what structure is currently injured. It doesn’t necessarily tell us why that structure became overloaded in the first place.

Sometimes the answer is local. Sometimes it’s load. Sometimes it’s anatomy. Sometimes it’s a previous injury. Usually there are several things interacting.

And occasionally, the event that matters happened years before anyone thought to look there.

That’s why injury history is such an important part of Reconditioning for me.

The latest injury may be where the problem finally became obvious.

It isn’t necessarily where the story began.