Back To Hockey

Hockey season is back, and as we prepare to witness the awe-inspiring goals and breathtaking saves from the NHL, it's important to recognize the remarkable physical toughness and resilience that this sport demands. Hockey players are not only masters of their craft but also warriors who face a myriad of injuries head-on. Closer to home, youth in our communities have also hit the ice, ready to emulate some of their favourite professional hockey players. However, while the young players strive to imitate the greatness they see on television, it is important to help them understand the importance of avoiding injuries that can come with the game. They dream of replicating the exhilarating goals and breathtaking saves but hope to do so without the same physical toll. Minor hockey is not just about mirroring the pros; it’s about learning the lessons of hard work, sportsmanship and resilience while staying safe and healthy on their journey toward their own unique hockey dreams.

It is important to recognize that despite our best efforts to prevent injuries from occurring in minor hockey, they will still happen. Proactive injury prevention measures not only reduce the risk but also empower young athletes with knowledge about proper training, conditioning, and self-care, equipping them to enjoy the game they love while minimizing the potential for harm. In this blog, we delve into some of the most common injuries encountered in hockey, signs, and symptoms of these injuries and how to help protect your child in hopes of preventing them. Concussions: Concussions in youth hockey are a significant concern, highlighting the importance of player safety at all levels of the sport. According to a 2020 Smith et al. (1) study, concussions are relatively common in youth hockey due to the fast-paced, physical nature of the game. Identifying the signs and symptoms of a concussion is essential for early diagnosis and proper management. Common signs and symptoms include: - Headache - Dizziness - Confusion - Sensitivity to light and noise It is important to note that symptoms may not always be immediately apparent, making it crucial for coaches, parents, and players to be vigilant in monitoring for any unusual behavior or physical complaints following a hit or collision on the ice. Preventing concussions in youth hockey is a multifaceted endeavor. Fortunately, governing bodies and minor hockey leagues have stepped up to prioritize safety by emphasizing and mandating safer equipment, enforcing rules that protect players and raising awareness about concussions. One effective strategy is emphasizing proper technique and safe play during practices and games. Coaches should aim to teach players how to control their sticks and appropriate times to engage in body contact. Players are also required to wear well-fitted, CSA approved helmets with a full cage or clear shield at all times when on the ice. Today’s helmets have extra padding for more cushion and are adjustable which allow for a more customizable fit. Rules against dangerous plays have been heavily enforced in recent years to try and prevent checking from behind or hits to the head; both of which can carry higher risks of concussions. Furthermore, educating parents, coaches, medical staff, and the athletes themselves about the signs and symptoms of concussions and the importance of reporting any suspected head injuries is paramount to ensure timely and appropriate care. By combining these prevention methods with a culture of safety and responsible play, youth hockey can reduce the incidence of concussions and prioritize the well-being of its young participants (1). A word about mouthguards. Many parents often ask about the role of mouthguards in the prevention of concussions for their kids while playing hockey and/or any other sport for that matter. While mouthguards are a vital piece of protective equipment in youth hockey, it is important to note that they primarily serve as dental protection rather than concussion prevention. According to one study, mouthguards play a significant roll in preventing dental injuries, such as broken teeth and lacerations to the lips and tongue, by cushioning and shielding the teeth during impacts (2). However, while they offer essential dental protection, it’s important to note that mouthguards are not designed to prevent concussions. As has been discussed, the prevention of concussions in hockey requires a comprehensive approach to address the complex issue of head injuries in sport. Sprains and Strains: In minor hockey, sprains and strains are among the most common injuries, often arising due to the sport’s fast-paced and physically demanding nature. Sprains are injuries to ligaments, while strains are injuries to muscles, with each of the two injuries having varying degrees of severity. These types of injuries can significantly impact young players, potentially sidelining them for extended periods (3). As young athletes grow at a rapid pace, their musculoskeletal system is more susceptible to these types of injuries, because of this, recognizing the signs and symptoms of sprains and strains is crucial for early interventions. Common indicators include: - Pain - Swelling - Bruising - Difficulty moving the affected limb - Muscle spasms - Weakness of the injured area Prior to games and practices, a proper warm-up routine can help reduce the risk of these injuries. Adequate strength and conditioning programs tailored to young athletes can improve their physical resilience and reduce the likelihood of strains and sprains. Furthermore, coaches should emphasize safe playing techniques and discourage reckless behaviour that may lead to collisions and falls. As with concussion prevention, proper fitting protective gear such as shin, elbow and shoulder pads can provide an additional layer of protection against impacts and falls on the ice. These injuries may be part of the learning curve, but they are also teaching invaluable lessons about resilience and the importance of proper training and conditioning. By implementing these strategies, minor hockey can take significant steps towards minimizing the incidence of sprains and strains and safeguarding the well-being of its participants (3). Fractures: Fractures are a sobering reality in minor hockey, where the combination of speed, physical contact and puck impacts can lead to significant injuries. An article by Emery et al. (4), underscores the prevalence of fractures among young players, highlighting the importance of both early detection and robust prevention measures. Signs and symptoms of fractures can be more obvious if is severe, but they can also be more subtle. Things to look out for include: - Severe pain - Swelling - Deformity - Inability to weight bear - Inability to move the injured limb - Mild to severe bruising in the area - An audible cracking sound upon impact As with all prevention methods, it started with players having access to well-fitted, protective equipment like helmets, shoulder pads and elbow pads that can help to reduce the severity of impacts and the risk of fractures. Furthermore, emphasizing proper body-checking techniques such as how to throw a body check and even more importantly how to receive a body check, can help to reduce the risk. Coaches can teach players how to recognize when a body check is coming their way, how to prepare themselves for it and how to keep themselves safe when it does inevitably happen. As mentioned, minor hockey organizations will continue to enforce rules against dangerous plays and help promote respect for opponents to further mitigate the incidence of high-velocity collisions that often lead to fractures. Coaches and trainers should also educate young athletes about the risks associated with reckless behavior on the ice and the significance of reports any suspected injuries. By integrating these preventative measures into youth hockey programs, the sport can prioritize safety of its participants and minimize the occurrence of fractures (4). Lacerations: In minor hockey, one of the most concerning injuries for most parents are lacerations. Due to sharp blades of skates and the high-speed action on the ice, minor to severe cuts can cause damage to blood vessels and other parts of the musculoskeletal system. It is important to bring about the awareness to players of this risk and introduce preventive measures when it comes to dealing with lacerations among young players (5). Recognizing the signs and symptoms of lacerations is essential for prompt and effective first aid. Lacerations typically present with bleeding, pain, and visible wounds. The severity can range from minor cuts to deeper, more extensive injuries that may require immediate medical attention. The main area of concern for lacerations would be to the neck and wrists, as these areas can be exposed by ill-fitting equipment or natural spaces where 2 pieces of equipment overlap. Additionally, injuries to tendons and ligaments can occur in these same spots where proper protection is lacking. There are famous examples of NHL players having wrist flexor tendons and Achilles tendons being completely severed, leading to significant loss of playing time and potentially career and life-altering changes to the function of these structures. Preventing lacerations in youth hockey involves a combination of equipment, coaching, and player education. Ensuring that players wear properly fitted jerseys, protective neck and wrist guards, and socks that cover the vulnerable areas around the neck, wrists and ankles can reduce the risk of lacerations. Equipment companies have tried to address these often-exposed areas by creating Kevlar wrist guards and socks, to help protect from lacerations to wrists and ankle. Neck guards are now mandated from minor hockey to junior hockey to help ensure the safety of our young athletes. They can be purchased in many varieties that can increase protection all the while being comfortable for the athlete to wear. Coaches should emphasize safe play techniques that minimize the likelihood of players falling on their own or others' skates. Education is key, with young athletes being taught how to use skate guards when off the ice and the importance of being mindful of blade positioning during play. Additionally, coaches and trainers should be well-equipped to provide immediate first aid in case of lacerations to minimize blood loss and prevent infection. By integrating these preventive measures into youth hockey programs, the sport can prioritize player safety and minimize the occurrence and severity of lacerations (5). Shoulder and Knee Injuries: Hockey is a sport that demands agility and resilience, but it also presents inherent risks, particularly when it comes to shoulder and knee injuries. According to a peer-reviewed source, shoulder and knee injuries are not uncommon among young players due to the sport's physical nature and frequent abrupt stops and changes in direction (6). Detecting the signs and symptoms of these injuries is critical for early intervention. Common indicators of these types of injuries include:

Shoulder Injuries Pain Swelling Limited range of motion Knee Injuries Minimal pain Instability Difficulty weight bearing

Young athletes should engage in comprehensive strength and conditioning programs designed to enhance their physical resilience and improve joint mobility and stability to help reduce the risk of such injuries. Coaches should educate players on safe play techniques, emphasizing proper body positioning and control to reduce the risk of collisions and awkward falls. Ensuring that players wear well-fitted protective gear, including shoulder pads and knee braces, can offer additional support and protection. Moreover, injury prevention should be an ongoing conversation among coaches, parents, and players, with an emphasis on reporting any signs of discomfort or pain early to address potential issues before they escalate (6).

There is always a risk of injuries in sport, but that does not mean we should prevent our young athletes from participating in the games they love. In the face of these common hockey injuries, we stand with our players, cheering not only for their goals but also for their incredible strength in the face of adversity. They are the embodiment of what it means to be "hockey tough," and we salute them for their unwavering dedication to the sport.

If you have any questions about the information in this blog post or would like an assessment of your or your child’s hockey injury, please book in with one of our chiropractors today!

Dr. Jared Borosch, BSc., DC.

Resources:

1. Smith, J., et al. Concussions in youth hockey: a scoping review of the literature and multidisciplinary expert consensus on rehabilitation and return to play. [Internet]. The physician and sportsmedicine journal, 2020 [cited 2023 Oct 5]. 49(4), 392-403

2. Emery, C., et al. The association of mouthguard use and the risk of orofacial injuries in ice hockey [Internet]. Clin J Sport Med, 2015 [cited 2023 Oct 6]; 25(5): 417-422.

3. Hanson, A., et al. Youth ice hoceky injuries: a comparison of body checking and non-checking states. [Internet]. The American Journal of Sports Medicine, 2019 [cited 2023, Oct. 5]; 47(9), 2186-2192.

4. Emery, C., et al. A systematic review of risk factors for injury in youth ice hockey. [Internet]. Archives of Pediatrics & Adolescent Medicine, 2017 [cited 2023 Oct 6]; 171(1), 1-10.

5. Mrazik, M. et al. Ice hockey injuries in the western hockey league: the impact of two-line offsides. [Internet]. Clinical Journal of Sport Medicine, 2015 [cited 2023 Oct 6]; 25(4), 313-316

6. Caine, D. et al. Epidemiology of injury in youth ice hockey players. [Internet]. Pediatric Exercise Science, 2019 [cited 2023 Oct 6]; 31(2), 185-193)