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Injuries in Men’s Ice Hockey

Craig Angle, ME.d, ME.d, ATC, CSCS
CEO of athleteproject.com
Author of "How to Raise a Successful Athlete"

Ice hockey is considered one of the fastest and most aggressive team sports. The rink is enclosed with rigid walls (“the boards”) and the competition surface is made of solid unyielding ice. The players travel at high speeds on two single small blades of steel. They constantly accelerate, decelerate, and balance their body over thin blades that are only millimeters thick. They frequently slam into walls, their opponents, and the ice. This type of enviroment and activity puts hockey players at an increased risk for injury. In addition, sticks made of wood, carbon graphite, or aluminum are used to drive a puck at speeds of up to 100 mph. The sticks are often used to hit or slash opponents and the pucks regularly strike the players. Therefore, there is an enhanced danger due to the nature of the game.

Hockey is a collision sport. Collision sports often involve high speed activity and collisions between athletes, the ground, and/or athletes and other objects. When players collide with other athletes, the ice, or the barriers around the rink, they are at an increased risk for injury. However, hockey associations have taken measures to prevent injuries but because of the aggressive physical nature of the game, there is an inherent potential for injury.

Hockey requires a combination of power, strength, agility, balance, technical skill, and controlled aggression. Specialized equipment is needed to protect players from hazards such as the ice, boards, goalposts, skates, pucks, sticks, and collisions with each other. With enhanced protection and mandatory use of helmets with facemasks, certain injuries such as facial lacerations, eye injuries, and dental injuries are diminishing. However, blunt trauma remains the most common cause of injury, followed by fatigue and overuse.

Researchers Flik, Lyman, & Marx from the Hospital for Special Surgery in New York conducted a study to describe the injury patterns in collegiate men’s ice hockey in the United States with respect to the distribution of injuries by body region, player position, type of exposure (game vs practice), timing of injuries, and the associated time lost from participation. The study analyzed all the injuries that occurred to 8 of the 12Eastern College Athletic Association Division I Men’s Ice Hockey programs during the 2001-2002 season. The researchers found a total of 74 injuries in 259 games and 39 injuries in 676 practices. Therefore, game injuries were 6.3 times more common than practice injuries. Forwards and defense-men had similar injury rates, whereas goalies had significantly lower injury rates during games. The following list breaks down the findings of the study.

  • The incidence of game injuries was slightly higher in the first half of the season (57%) than in the second half (43%).
  • Of the 74 game injuries, 27 occurred in the first period, 27 in the second period, and 20 in the third period.
  • Fifty seven percent of injuries occurred to a player who was on the visiting team, and 43% occurred to a home player.
  • A collision, either with an opponent (32.8%) or the boards (18.6%), was the cause for more than half of all injuries.
  • Skates, sticks, or pucks were directly responsible for only 11.5% of all injuries.
  • Eight percent of injuries were considered overuse injuries.
  • Injuries during games were related to collisions in 69%, whereas practice injuries were related to collisions in only 38%.
  • Nearly 40% of all injuries occurred along the boards.
  • Concussion was the single most commonly sustained injury (18.6% overall) and was responsible for nearly one quarter of all game injuries.

The researchers drew particular attention to the low number of injuries that are sustained during practices compared to during games. They reported practice injury rates in men’s ice hockey were the lowest of all winter sports included in the NCAA injury surveillance system data in 2001. Flik, Lyman, & Marx posed the thought that this is a result of the aggressive nature of the sport during competition, which would explain the higher incidence of collision-related injuries during games. Hockey players are well protected by equipment and are unlikely to be injured unless contact at high speed is involved (more common in a game scenario). In addition, checking (purposeful body contact in which 1 player attempts to disrupt the progress of an opposing player) and other potentially injurious acts, such as slashing with the hockey stick, are less common during practices than during games.

The researchers concluded that collisions are the main cause of injury in Division I Men’s Ice Hockey. One third of all injuries in this study were caused by collision with an opponent, and nearly 20% of injuries were related to collision with the boards. There was a significant difference in the injury rates suffered during games and practices. Concussions and knee MCL injuries are common and are primarily incurred during games. Stricter enforcement of rules relating to illegal blows to the head may reduce the rate of concussion injuries.

There is no way around the aggressiveness and physical nature of the game. In hockey, injuries will happen and athletes should take all precautions to ensure safe play. In addition, athletic organizations should realize the risk of injury in hockey is high and they must implement and enforce control measures to increase the games safety. More research needs to be conducted by the sports science community in order to increase the safety of this great sport.  

Reference:

American Collegiate Men's Ice Hockey: An Analysis of Injuries.; Flik, Kyle; Lyman, Stephen; Marx, Robert G.; American journal of sports medicine (Thousand Oaks, Calif.), Feb 2005: 33 (2). p. 183-187