Hockey Injury Prevention

Ice hockey is a finesse sport that requires a unique combination of speed, power, and teamwork. As a result, players are at risk for specific injury patterns. However, the good news is that some of these injuries are avoidable.

WHAT ARE THE RISK FACTORS FOR HOCKEY INJURIES?

The risk of sustaining an injury depends on several variables, including player position, the level of participation, protective equipment, level of violence, and personal susceptibility (such as pre-existing conditions and style of play). Injuries are much more likely to occur in games and can increase with each level of participation.

WHAT ARE COMMON HOCKEY INJURIES ?

Concussion

Athletes may suffer a concussion without getting "knocked out" (loss of consciousness). Players, coaches, and parents should be aware of the typical symptoms and signs, including "not feeling right" and headache. Any player experiencing symptoms or displaying signs of a concussion should not return to play and should be medically evaluated.

Shoulder Injuries

The most common shoulder injuries in hockey are shoulder separation and broken collarbone. These injuries occur from direct contact of the shoulder with another player, the boards, or the ice. Treatment typically includes a sling, rest and, in serious cases, surgery.

Knee Injuries

Because of a hockey player's leg position when pushing off the inside edge of the skate blade, as well as contact to the outside of the knee, the medial collateral ligament is most susceptible to a sprain. Anterior cruciate ligament (ACL) disruption and meniscus tears (torn cartilage) can also occur. However, these are less common in hockey than in other sports such as football, soccer, and basketball.

Wrist Injuries

Falling on an outstretched arm or contact with the boards can force the wrist up or down and may cause a fracture. Players should try bracing themselves against the boards using their forearms instead of their hands.

Elbow Injuries

The point of the elbow is a frequent area of contact for hockey players. This can result in the development of bursitis. Thick and scarred bursal tissue (which feels like bone chips, but isn't) can be a source of recurrent inflammation. The best prevention method is wearing elbow pads that fit well and have an opening for the elbow, soft padding, and a plastic outer shell.

Back Injuries

Due to the flexed (forward) posture of skating and the frequent hyperextension (backward) stress, hockey players are at risk for low-back injuries. Low-back pain and/or a pulled muscle are the most common injuries. Stretching of the hip flexors, as well as strengthening of the back and abdominal muscles, will help avoid these injuries.

Hip Injuries

The hip joint and groin muscles are susceptible to injury due to the mechanics of the skating stride. Some of the most common soft tissue injuries in hockey players include a groin strain and a hip flexor strain. Off-season strengthening and dedicated stretching before and after practice are important to prevent these injuries. In addition, a direct blow to the outside of the hip can cause a hip pointer or trochanteric bursitis. Hockey pants with reinforced padding over these vulnerable areas may help protect them.

HOW CAN HOCKEY INJURIES BE PREVENTED?

The intrinsic hazards of playing hockey cannot be completely eliminated. However, the risk of injury can be substantially reduced with certain precautions. Fortunately, the overwhelming majority of hockey injuries are mild, and most involve soft tissues: bruises, muscle strains, ligament tears, and cuts. However, serious injuries are possible and players should avoid dangerous tactics. Here are a few tips for preventing injuries:

Obtain a preseason screening examination by an experienced athletic trainer or physician to identify existing injuries and uncover deficiencies.
Participate in a sports-specific conditioning program to avoid physical overload.
Obtain high-quality equipment that fits well and is not damaged, worn-out, or undersized.
Ensure enforcement of existing rules. Players and coaches should always demonstrate sportsmanship and mutual respect for their opponents and the officials.

Following injury and treatment, a post-injury evaluation ensures successful healing and guides safe return to play.

For questions or appointments, please call Dr. Bynum's office at 239-337-2003.

ARTICLE REFERENCES, CONTRIBUTING EXPERTS AND ADDITIONAL RESOURCES

The original version of this article may be found at www.StopSportsInjuries.org

The following expert consultants contributed to the tip sheet: Michael J. Stuart, MD

Smith AM, Stuart MJ, et al; "Predictors of Injury in Ice Hockey Players: A Multivariate, Multidisciplinary Approach". American Journal of Sports Medicine, 25(4): 500-507, 1997.

Stuart MJ, Smith AM, et al. "A comparison of facial protection and the incidence of head, neck, and facial injuries in Junior A hockey players. A function of individual playing time". American Journal of Sports Medicine, 30: 39-44, 2002. Emery CA, Hagel B, et al. "Risk factors for injury and severe injury in youth ice hockey: a systematic review of the literature". Inj Prev.16(2):113-8, 2010