Preventing hockey injuries from head to toe

Concussion, Foot Pain, Neck and Back, Safety, Hip Pain, Injury Prevention, Fractures, Foot and Ankle Pain, Sports Medicine, Knee Pain, Elbow Pain, Hand and Wrist

Three periods of blades, sticks, and pucks
traveling across the ice at high speed.Hockey players in red and white unifroms

It's exciting. It's physical. It's hockey.

Hockey is not just a contact sport; it is a collision sport. Players race forward and backward on the ice, digging sharpened skates in the ice to execute abrupt stops and direction changes. Players take shots, fake shots, and block shots while skating swiftly down the ice toward the goal.

With one eye on the puck and the other on the goal, it is no wonder that players are injured by swinging sticks, flying pucks, or collisions with other players or the boards lining the ice arena.

According to American Academy of Orthopaedic Surgeons, there are 63,000 hockey-related injuries each year. Most of those are bruises, cuts, pulled muscles, and torn ligaments.

Hockey players are at risk for more severe injuries such as broken teeth, broken bones, dislocations, concussions, and serious spinal injuries. With a little care, most common hockey injuries can be prevented.

While it is impossible to eliminate all risk of injury in such a physical sport, some preventative measures can reduce injuries on the ice.

Wear a helmet to prevent concussion. A concussion is more than getting "knocked out." It is a traumatic brain injury caused when a blow to the head or whiplash-type movement disrupts brain function.

Concussions change how the brain works, but does not alter the brain's appearance on an MRI or CT scan.

When collisions occur, it's crucial for the player to remember to keep his or her head up. Don't duck; don't lead with your head.

Hockey helmetIf a player experiences a blow to the head due to a fall, a wayward puck, or a wildly swung stick, it's important to watch for signs of a concussion. Symptoms may appear hours, days, or weeks after the initial trauma. These include:

  • Not feeling right
  • Behavioral changes
  • Sensitivity to light and sound
  • Headache
  • Double vision
  • Balance problems
  • Confusion
  • Vomiting

Any player who has sustained a blow to the head or who displays symptoms of concussion should seek medical treatment. Any player experiencing symptoms or showing signs of a concussion should not return to play and should be evaluated by the medical team.

It takes time to heal from a concussion. Players who have had a concussive injury should not return to the ice until a medical professional has cleared them. A player who has had a concussion is at higher risk of experiencing another one. Multiple concussions can impair future health.

Proper fitting shoulder pads offer protection from separated shoulders and broken collarbones. When a hockey player slams his or her shoulder into the wall, floor, or another player, the impact can be enough to stretch the ligaments surrounding the collarbone and cause a separation or a break.

The collarbone or clavicle is the long thin bone that attaches the arm to the rib cage. If the collarbone breaks but remains in place, treatment usually consists of slings, splints, and rest. If the bone needs to be set, surgery may be required.

Players may be able to prevent shoulder injuries if they keep their shoulders up when colliding with the boards.

Elbow pads can prevent elbow injuries. Since the elbow is often exposed in hockey, it is frequently a point of contact. The repetitive impact could lead to bursitis. The bursae are thin, slippery sacs that act as cushions between bones and soft tissues. When they are injured, they swell and become inflamed causing pain. Treatment will often mean a change in activity, extra elbow protection, or drawing off the excess fluid.

To prevent elbow injuries, wear elbow pads that are soft on the inside with a hard plastic exterior. The pads should have a hole that allows for the olecranon, the point of the elbow.

Hockey gloves can provide some protection from wrist and hand injuries. Since people tend to protect themselves by putting their hands out, wrist fractures and sprains are common in the ice arena. To minimize the risks of wrist and hand injury, players should learn to brace a fall or spin into the wall with their forearms, rather than their hands.

Thumbs that are bent away from the hand during play may cause injury to the ulnar collateral ligament at the thumb's base. If there is a partial tear of the ligament, it may be splinted and taped; a complete tear may need surgery.

Players should make sure that their hockey gloves fit well and are in excellent condition. High-quality equipment will provide the best protection.

Hockey injuriesOff-season conditioning and proper training can reduce back injuries. There is a risk of low-back pain when people play hockey. The forward-flexed position needed for skating and the quick movements necessary to chase the puck can injure the structures in the low back.

Since the back is a complex structure of bones, joints, and ligaments, it's important to strengthen the back muscles from the hip flexors to the neck muscles. Developing a strong core will help prevent low-back pain and spinal injuries.

Well-fitting hockey pants with thick pads protect the hips. Hip joint and groin muscles are especially vulnerable during hockey. Blows to the hip can cause bursitis if it is not appropriately protected. The painful pull of the groin or strain of the hip flexor can be avoided by practicing a stretching regimen before and after play. Leg strengthening exercises should also be a part of the preseason conditioning and training program.

To minimize the injury risk from a blow to the hip, which can cause bursitis, it's important to wear hockey pants with reinforced pads to cushion the hip.

The thigh area, which is not covered by hockey pants, is vulnerable to injury. If a player receives a hard blow to the thigh, it can cause a deep bruise that bleeds into the muscle. If this occurs, it is important to seek medical treatment. A deep bruise will take time to heal. The assistance of crutches and gentle exercises can get players back on the ice sooner. Left untreated it can result in calcification within the muscle.

Shin guards with extensions can protect the knees. While ACL tears are more common in basketball, football, and soccer, it is the MCL or medial collateral ligament that is most vulnerable to injury in hockey. Pushing off from the inside edge of the skate puts the leg in a position to stress this ligament, especially if there is outside contact on the knee.

Tuck your skate tongue under your shin guard to protect your ankle. A hockey player's ankle is more susceptible to cuts than to sprains or breaks. Hockey skates provide great support for players' ankles.

Hockey gameAggressive plays with sharpened skates can put players on the sidelines for the season. Sharp blades do pose a risk of cuts deep enough to sever ligaments and tendons. High-quality shin guards and skates can take the edge off this hazard.

To prevent hockey injuries, players should:

  • Have a pre-season screening by a sports medicine provider to identify pre-existing injuries and determine areas of potential weakness.
  • Use the information from the preseason screening to create a conditioning program that builds strength and endurance.
  • Take part in a pre-season conditioning program.
  • Never play or practice without high-quality safety equipment that fits and protects well.
  • Develop stick-handling skills.
  • Learn how to shoot the puck accurately.
  • Practice basic and advanced skating skills.
  • Play by the rules and demonstrate sportsmanship and respect at all times during events and practices.
  • Follow the advice of a certified athletic trainer or sports medicine specialist if an injury occurs.

Serious injuries can be avoided if players avoid dangerous tactics or overly aggressive play. Play safe. Play hard. Play fair. Be a good sport.

 For information about the most common upper body injuries, check out the infographic from ProStockHockey. 

Click arrows in the bottom right corner to expand full screen

Upper Body Injuries by Pro Stock Hockey, an online resource for authentic pro stock hockey gear

 

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