Medically reviewed by Misty Seidenburg
It’s not surprising that ice hockey is increasingly becoming one of this country’s most popular team sports. This fast-paced, high-impact sport is exhilarating to watch and play. Last year, the U.S. had the most registered hockey players in the world—over half a million! As players of all ages discover a love for the sport, it’s crucial to be mindful of the risk of sports injuries. From direct trauma to the body to overuse conditions, your safety equipment may not be enough to protect against all common hockey injuries. However, you can significantly reduce these risks and stay in the game with the right injury prevention strategies.
When it comes to ice hockey, speed and physicality increase the risk of injuries. Ice hockey players skate at an average of 25 miles per hour, and pucks move even faster—upwards of 100 miles per hour!
In hockey, collisions are not just common; they are expected. Players collide with each other, pucks, sticks, and boards. This forceful impact can cause internal and external traumatic injuries. In a recent study of male ice hockey players, researchers found trauma to be a factor in up to 96% of reported injuries.
The repetitive pivoting motions of skating place added stress on the hips, pelvis, knees, and ankles. Stickhandling and shooting can also lead to overuse injuries of the shoulders and elbows. Yet, with proper conditioning, these risks can be significantly reduced, making you more prepared and proactive in your approach to the game. Let’s touch on some of the most common hockey injuries affecting players.
Concussions: Ice hockey is among the top 10 sports with the highest concussion rates. A blow to the face, head, or neck or a hit to the body can cause a concussion. Hockey helmets are beneficial but cannot control the brain’s acceleration within the skull.
Bursitis: Repetitive motions, trauma, and poor technique can also cause painful inflammation of the small, fluid-filled sacs that cushion the bones and soft tissue. Hockey players’ knees, shoulders, and hip joints are most frequently affected.
Ankle Sprains: Contact with the puck can damage the bands of tissue (ligaments) that connect ankle bones at the joints. High-ankle sprains (syndesmosis) are especially common in ice hockey due to the foot elevation off the ground and the quick directional changes that leave the lower leg vulnerable to injury. The boot also acts as a natural brace that locks out the lower part of the ankle and forces strain higher up the leg.
Groin Strains: Skating’s powerful forward and cross-over movement patterns require strong contraction of the adductor muscles. These muscles stabilize the pelvis and femur and rotate the thigh. Without proper conditioning, they can overstretch or tear.
Knee Injuries: The medial collateral ligament (MCL) runs from the thighbone to the shin bone and is the knee’s most common injured ligament. The MCL is vulnerable to sprains due to the position of the leg position when the player pushes off the skate’s inside blade.
Shoulder Injuries: A direct hit with another player, the wall, or the ice can cause a painful shoulder injury. The collarbone can fracture, or the shoulder joint can be forced out of position (dislocation.) The most common shoulder injury in hockey is an acromioclavicular (AC) joint separation, where the shoulder becomes dislocated from the joint where the collarbone and shoulder blade meet.
Fractures: As with most full-body contact sports, broken bones are relatively common. Running into other players, sticks, and boards can lead to broken shoulders, ribs, wrists, and fingers. A forceful stick or puck to the skate can fracture the delicate bones of the feet.
Spine Injuries: Ice hockey also has the highest incidence of cervical spine injuries of any sport, even more than football. If the neck is flexed, a check from behind that causes a player to collide with the wall can cause a severe cervical fracture.
Hip Injuries: The rapid rotation needed to change position during hockey, combined with the repetitive movement of skating, can increase stress on the hips. Goaltenders are in a constant state of demanding hip rotation, which can lead to labrum injuries.
Sports hernias: The muscles of the lower abdomen and groin can become injured during the repetitive twisting and frequent changes in direction required in ice hockey.
Now, let’s focus on practical strategies ice hockey players, coaches, and parents can use to help prevent common sports injuries.
Waiting until winter to train for ice hockey season can leave your body unprepared for the sport’s demands. Year-round training enhances motor skills, increases strength and flexibility, and lays a solid foundation for proper movements, making you a better athlete.
Physical therapy helps athletes improve balance and coordination through various exercises to improve strength and stability in the core and lower extremities. This is particularly important for hockey players to increase power in the lower body, which helps them skate faster and shoot more accurately. It also allows players to become more flexible and reactive to keep up with the game’s fast pace.
Before every practice and game, hockey players should spend a few minutes warming up their bodies. A dynamic warmup and stretching routine begins with basic movements, like arm circles and high knees, that target range of motion and flexibility in the large muscle groups. Follow that up with sports-specific movements to activate the most-used muscles. Lateral shuffles, quick pivots, and stickhandling drills are ideal for hockey players.
Always wear the proper safety equipment for your position every time you hit the ice. Refrain from using outdated, ill-fitting, or broken gear. Your helmet is the most critical piece of equipment. It should fit snugly just above the eyebrows. Helmets should be fitted at a pro shop to ensure they fit and are worn correctly. Keeping a small equipment repair bag with you is a good idea in case you need to replace any loose screws.
Players should also wear neck guards, shin guards, gloves, shoulder pads, elbow pads, and mouth guards. Some gender-specific differences exist when considering the fit of gear. Specific men’s items include jocks and protective cups. The female-labeled gear comprises a ‘cup’ covering the pubic bone, hockey pants with built-in sacroiliac stability belts, and specific chest pads to accommodate breast tissue.
Skates, of course, are also an important piece of gear that needs to be addressed. Blade masters are people who sharpen skates with specific training to profile skates to your specific position and style of play, making them more efficient for what you do on the ice.
Correct technique is essential for injury prevention for hockey players and other athletes. Proper form helps you maintain good posture and balance, which enables you to stay on your skates and play with greater strength and power. It also keeps you from placing excessive pressure on joints and muscles, which can lead to injuries.
Proper form also distributes the load evenly across the body so you can more safely and efficiently. Physical therapists who work with athletes help hockey players correct imbalances and technique problems to lower their injury risk and improve their performance.
After hockey practice and games, cool the body down with static stretching. With a static stretch, you move a muscle as far as possible without pain and hold it for 15-45 seconds. Players should focus primarily on the lower body muscles, so hockey stretches for the groin, glute, hip flexor, hamstring, and calves are recommended.
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Because of the high risk of injuries, it is important to pay attention if something doesn’t feel right. Obvious signs of injury, like severe pain or visible deformity, should be treated immediately. However, sports injuries do not always cause immediate and obvious symptoms.
If you have pain or stiffness, problems with function or range of motion, or other symptoms that worsen or do not improve within a day or two, see your provider and follow up with a physical therapist. If left untreated, sprains, strains, head injuries, and other hockey injuries can worsen and lead to more severe complications.
Hockey players may find physical therapy is the best tool for injury prevention and recovery. Physical therapists who work with athletes are trained to identify potential issues before they become serious. Injury prevention for athletes primarily involves exercises and stretches to improve strength, endurance, coordination, and flexibility.
Physical therapy also helps hockey players recover from intense activity and injuries. Therapists use evidence-based techniques and manual therapies to reduce pain and inflammation and promote tissue healing. Athletes also depend on physical therapy to gradually and safely recover from surgery and return to pre-injury performance.
If you have any existing injuries or want a personalized sports injury prevention plan, it’s important to seek professional help. Find a physical therapy clinic near you to get the support you need to elevate your performance and stay safe and healthy in the game.
