Hockey Injury Prevention

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by Jeffrey S. Moore, M.D.

When it comes to team sports in Alaska, hockey is king. There are many opportunities to play at various levels of competition, and we have had our share of players make it to the “big leagues” including the NHL. Fast speed and aggressive play make it one of the most popular sports, but also make these players more prone to being injured.

As the player’s speed develops — and especially when checking becomes part of the game — injuries significantly increase. Studies have also shown that game play has a higher injury rate than practice.

Common injuries among youth hockey players include concussions, shoulder injuries, knee injuries, and ankle sprains. Players are often injured by hitting the boards or striking another player.

Concussions in all collision sports have been a hot topic in sports medicine. When I was growing up getting your “bell rung” playing football was just “part of the game.” Now we know that there are different levels of concussions, and significant injuries can occur to the brain. As in other injuries, the brain needs time to heal before being subjected to repeated trauma.

Multiple concussions can have additive effects and can potentially lead to long-term disability.

Concussions should be evaluated by a health professional prior to returning to play. Helmets, especially full face shields, have helped to decrease many facial injuries including lacerations. While helmet wear may not eliminate concussions, it does decrease the risk.

Shoulder Injuries

Common shoulder injuries involve striking the top of the shoulder and sustaining a shoulder separation. This is an injury to the attachment of the collarbone to the acromion (or “shoulder cap bone”). Most of these injuries require a sling and some time to heal. Occasionally, they require more extensive treatment including surgery. Shoulder dislocations occur when the “ball” of the shoulder joint comes out of the socket. Some injuries involve the shoulder partially going out of the socket (subluxation) vs. completely dislocating where the player usually has to go to the emergency room to have it put back in. In either case, or especially when multiple episodes have occurred, the player should be evaluated by a health professional. Bracing, therapy and surgery are options to treat this condition.

Knee Injuries

Knee injuries often involve the ligaments or the meniscus (shock absorber) of the knee joint. Some knee ligament injuries (medial collateral) may just require bracing to allow the knee to heal, while others (anterior cruciate or ACL) usually require surgery to restore stability to the knee. One clue to a significant knee injury is that a large amount of swelling develops shortly after the injury. The meniscus, or cartilage, of the knee can be damaged in twisting injuries. These injuries may not heal and can be the source of persistent pain in the knee joint. If pain and/or swelling persist after a knee injury, it should be evaluated by a health professional.

Muscle Pulls & Injury Prevention

Preventing injuries is always important. Groin pulls involve an injury to the inner thigh muscle attachments. It seems to be more common in veteran players. Strengthening these muscles prior to the season getting started as well as an off-season skating regimen may decrease this injury. “Heads up hockey” and not ducking your head when going into the boards has helped to prevent catastrophic neck injuries.

Hockey is an exciting sport. With the proper equipment and coaching techniques it can be quite safe. As with any collision sport, injuries are not uncommon. Most of these “bumps and bruises” will heal without any problems, if they continue to be bothersome through the season then they should be evaluated by a health professional.