The epidemiology of ice hockey injuries.

As part of the injury profylaxes in Denmark a questionnaire investigation was undertaken in 14 randomly chosen ice hockey teams--out of 266 players, 210 answered (79%). The injury incidence per player per 1000 hours was 4.7, i.e. 1.5 in training and 38.0 in match. Half of the injuries were localised to the head (28%) and lower extremities (27%), 19% to the upper extremities and 7% to the back. Of these 48% were contusions. Knee and elbow injuries were of longest duration. The necessity for increased shock absorption in helmets and barriers as well as built-in rotational and collateral stabilizers in the existing knee protectors for injury prophylaxis is stressed.     

Epidemiology of women's recreational ice hockey injuries

INTRODUCTION: Participation in ice hockey by women is increasing in many parts of North America; however, research into injuries and the patterns of injury among female players associated with this activity is limited. PURPOSE: The purpose of this research was to examine the incidence and nature of injuries suffered by female recreational ice hockey players. METHODS: This prospective study followed 314 female players from 33 teams in Edmonton, Canada, during the 1997-1998 hockey season. Injury and game attendance data were collected using monthly telephone interviews throughout the season. Diagnostic information for individuals who received medical treatment was solicited from the attending health professional. RESULTS: A total of 102 players reported a total of 125 injuries for a rate 7.5 injuries/1000 player exposures. The anatomic region most often injured was the lower extremity (31.2%), and the most common diagnosis was sprain/strain (52.0%). The predominant injury mechanism was player contact, either as a result of collision with another player or a body check (40.0%). Of all injuries, 65.6% occurred during league games, 27.2% during play-off, tournament, or exhibition games, and 7.2% during practices. Although less than 1% of injuries resulted in hospitalization, 17.6% of injuries resulted in an absence from hockey of 8 or more days. CONCLUSION: The diagnostic and anatomic distribution of injury in the women's hockey league was similar to that in leagues where full facial protection is mandatory. The observed injury rate was lower than the rates reported for male recreational and collegiate ice hockey players. Female recreational ice hockey players are at risk for injuries and further research is required to identify areas for injury prevention.     

Dental injuries in ice hockey games and training

PURPOSE: The purpose of this study was to determine the incidence, cause, and nature of maxillofacial and dental injuries in ice hockey games and training and also evaluate the use and the effect of dental or facial guards. METHODS: Maxillofacial and dental ice hockey injuries in Finland were studied during years 1991 and 1992. Material was gathered from the insurance company that had practically all the ice hockey licenses in those years. The material consisted of 479 injured ice hockey players who suffered from 650 separate injuries. The most common dental injury was a noncomplicated crown fracture, which accounted for 43.5% of all maxillofacial or dental injuries. Of these noncomplicated crown fractures, almost 70% occurred in the games. RESULTS: The most common cause of accidents was a blow from the ice hockey stick. The stick as a cause of injury was approximately 3 times as common in the games than in training. Only 10% of injured players wore some kind of protective guard. CONCLUSION: A mandatory use of mouthguards and face masks or tightened rules for protection to decrease the high number of maxillofacial and dental injuries in the ice hockey games should be considered.     

Neck injuries from skate blades in ice hockey: a report of three cases

This article describes three neck slash injuries in amateur ice hockey players, with a fatal outcome in two. One player died of asphyxation secondary to hemorrhage into the respiratory passage, but the other died of hemorrhage from the main blood vessels in the neck, severed by the skate blade. All three were not wearing any neck protecting device. Neck slash injury from skate blades, as a preventable sports-related injury, and the need for neck protective equipment in preventing such injuries are discussed.     

Incidence, nature, and causes of ice hockey injuries. A three-year prospective study of a Swedish elite ice hockey team

In this prospective study, we have investigated incidence of injuries of different severity, types of injury, and mechanisms of injury during ice hockey practice and games. One Swedish elite hockey team was closely observed during three seasons (1982 to 1985). There was a total number of 95 injuries and 29 facial lacerations. The majority of injuries were minor (73%) and only 8% were classified as major. Seventy-six percent of the injuries occurred during games and 24% during practice. The incidence of injury during practice was 1.4 per 1,000 player-practice hours and 78.4 per 1,000 player-game hours. In comparison with other sports, the incidence of injury during hockey practice is very low, while that during games is high. Eighty percent of the injuries were caused by trauma and 20% by overuse. The most common types of injury were contusions, strains, and sprains. Complete tear of the medial collateral ligament of the knee was the most common severe injury. Most injuries resulted from body contact, predominantly tackling (checking), and from puck or stick contact. A reduction of the number of minor and moderate injuries should be possible by stricter enforcement of the hockey rules, especially against stick violations, and more widespread use of visors.     

Imaging pediatric sports injuries: upper extremity

With increasing youth participation in organized sports, more injuries in this age group are being treated by primary care and sports medicine physicians. Overuse injuries are much more common now than in past decades, with Little League shoulder, Little League elbow, and gymnast wrist being particular concerns. Rotator cuff tears and glenoid labral injuries, once thought to be rare in this age group, are also more common now. Osteochondritis dissecans of the elbow is relatively common and typically fares poorly without surgery. Wrist abnormalities that occur nowadays include triangular fibrocartilage tears. Tendonitis, which is now observed frequently in clinical practice in this age group, rarely requires imaging.     

Neck injuries in ice hockey: a recent, unsolved problem with many contributing factors

Previously unrecognized, major neck injuries in hockey have become a common problem in Canada and they have increased markedly in the 1980s. At the present time, the incidence remains high and has shown no sign of diminishing. The etiology of the problem appears to be multifactorial. Several epidemiologic factors have been identified and a reporting system established so that prevention programs can be monitored. It is hoped that greater awareness of the risk factors among players, coaches, leagues, referees, and parents will be an effective prophylactic measure in itself. Prevention must involve several approaches by hockey organizations and leagues, players, equipment manufacturers, and health care professionals and researchers.     

Overuse injuries of the upper extremity in baseball

The shoulder and elbow are prone to many overuse injuries in baseball. Injury to the muscles or ligaments leads to pain and loss of effectiveness in competition. Although many of these disorders respond to conservative management, surgery is sometimes necessary to provide pain relief and restore function. Unfortunately, overuse injuries that require surgery still are career-threatening injuries. Correct diagnosis and treatment increase the probability of a throwing athlete returning to competition.     

Overuse injuries of the upper extremity in golf

Golfers are athletes, for golf is a sport. To play it well, one must have athletic ability, strength, agility, coordination, and endurance. The golf swing is physically demanding and has contributed to overuse injuries in the upper extremity. The wrist, elbow, and shoulder are the most frequently injured joints.     

Return to play issues in upper extremity injuries.

OBJECTIVE: The purpose of this paper is to outline general treatment and return to play (RTP) strategies as they pertain to athletes with various upper extremity injuries. It is not intended to be a comprehensive review of these injuries. DATA SOURCES/SYNTHESIS: A review of the literature plus expert opinion served as the basis for recommendations made regarding management strategies for returning the athlete to play after upper extremity injury. A Medline search was performed using the following key words: upper extremity injury, return to play, glenohumeral dislocation, acromioclavicular joint sprains, elbow dislocation, scaphoid fracture, metacarpal fracture, finger dislocation, tendon injury, hand, mallet finger, and jersey finger. These and other related terms were crossed using the Medline database from 1966 to 2005. RESULTS: Review of book chapters, articles generated from the Medline search, and expert opinion led to the recommendations that are presented here. There is general agreement regarding the treatment of many of the injuries discussed, but controversies do exist. RTP guidelines are largely dependent on the severity of initial injury, rates of healing, and return of strength. CONCLUSIONS: Each athlete with a particular injury to the upper extremity needs to be approached as an individual as no single set of treatment or RTP guidelines applies to all injuries or all individuals. Factors such as age, injury severity, hand dominance, type of sport participation, method of treatment, and chronicity of injury are among the many issues that must be considered when developing a treatment and RTP strategy for a particular athlete.     

Spinal cord injuries in ice hockey in Finland and Sweden from 1980 to 1996

Traumatic spinal cord injury (SCI) in the cervical or thoracic region is one of the most catastrophic types of sport injuries. This study was designed to determine incidence and mechanisms of major SCI in ice hockey in Finland and Sweden from 1980 to 1996 in order to find possibilities for prevention. Retrospective analysis of injury occurrence were carried out. Medical case records were reviewed and injured players were interviewed to complete the data. From 1980 to 1996, there were 16 accidents involving spinal cord injury with permanent disability. All players were male. The mean age was 21.1 years (range = 14 to 33 yr). In 50% of the cases the mechanism was body checking from behind and a blow to the head from the boards. In 69% of the cases the vertebral injury was fracture or/and luxation between C5 and C7. The neurological endstate was tetraplegia/paresis in 10 cases and paraplegia/paresis of the lower extremities in 6 cases. Ice hockey is one of the most popular sports in Europe, and the number of participants is still increasing. The typical mechanism in SCI is body checking from behind, falling down and a head-first blow from the boards. These serious injuries may be prevented by changing the rules (banning body checking near the boards) with strict refereeing and education of trainers and players.     

Injuries in international ice hockey. A prospective, comparative study of injury incidence and injury types in international and Swedish elite ice hockey

In this prospective study, we have investigated incidence, nature, and mechanisms of injury in the Swedish national hockey team during 40 international games. There were 19 injuries associated with absence from practice or games, and 17 facial lacerations. The incidence of injuries associated with absence was 79.2 per 1,000 player-game hours, compared to the corresponding incidence of 78.4 found for Swedish national hockey. The incidence of facial wounds was 70.8 per 1,000 player-game hours, compared to the incidence of 21.8 for Swedish national hockey. The high incidence of facial injuries in international hockey is due to a high rate of stick contact injuries. Stricter enforcement of rules and more widespread use of visors would reduce the number of facial injuries.     

The avoidability of head and neck injuries in ice hockey: an historical review

The number of minor traumatic brain injury (mTBI), cerebral concussions, is increasing and cannot be eliminated by any kind of equipment. Prevention strategies, such as the introduction of "checking from behind" rules have become effective in decreasing the number of severe spinal injuries. A new "head checking" rule should reduce mTBI in the same way in the following years. Mouthguards should be mandatory as an effective device for the prevention of dental and orofacial injuries, as well as reducing the incidence and severity of mTBI. A new internet database system, the International Sports Injury System (ISIS) should improve epidemiological analysis of head, face, and spinal injuries worldwide. ISIS should provide an internationally compatible system for continuous monitoring of risk factors, protective effects of equipment, and protective effects of equipment and effects of changes in rules through the years.     

Overuse injuries of the upper extremity in tennis players

Several overuse injuries can affect the upper extremity of tennis players. A thorough understanding of anatomy and knowledge of these common conditions and their treatment facilitates the management of these athletes.     

Imaging of sports injuries of the upper extremity in children

Competitive athletics in school-aged children has become the norm rather than the exception. The increased repetitive stresses placed on the upper extremity in a wide variety of sports result in a host of injuries unique to the skeletally immature athlete. This article focuses on a discussion of the more common upper extremity injuries encountered in the child athlete and the role of radiography and MRI in diagnosis and management.     

Gender in ice hockey: women in a male territory

This study investigates how female ice hockey players describe and explain their situation within as well as outside their sport. Information was obtained by semi-structured interviews with female ice hockey players. The results were analyzed in a gender perspective where the main starting point was the concepts of different levels of power relations in society developed by Harding and applied to sports by Kolnes (the symbolic, structural, and individual level). The study shows that the players appeared to share the traditional views of men and women. They also described gender differences in terms of financial and structural conditions as well as differences in ice hockey history. Even though the players described structural inequalities, they were quite content with their situation and the differences in conditions were not considered when they explained the gender differences in ice hockey performance. At the individual level, the players considered themselves different from other women and appeared to share the traditional views of femininity and masculinity. It has been suggested that performance of a sport traditionally associated with the other sex might alter the traditional view of men and women; however, our results lend little support to this suggestion.     

Epidemiology of boxing-related upper extremity injuries in the United States

Objective: The incidence of boxing-related upper-extremity (UE) injuries in the United States has not been well characterized. Recent rule changes have been made to make participation safer for athletes, although the consequences of such rule changes on injury rates is unclear. Therefore, we sought to determine the incidence, characteristics, and trends of boxing-related UE injuries.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for the years 2012–2016. All UE injuries related to boxing from 2012 to 2016 that occurred during organized boxing participation were selected. Examined variables included injured body party, injury diagnosis, patient age, and sex. Annual injury incidence rates by body part and diagnosis were calculated.

Results: The mean incidence of boxing-related UE injuries from 2012 to 2016 was 673 injuries (95% CI 537–809) per 100,000 person-years, with hand fractures being the most common injury (132 (95% CI 130–135) per 100,000 person-years). The incidence of UE injury significantly declined from 865 (95% CI 846–884) per 100,000 person-years in 2012 to 656 (95% CI 642–671) per 100,000 person-years in 2016 (p < 0.01). Injuries to the hand exhibited the largest decrease, declining by 33%. The majority of boxers sustaining UE injuries were male (84.4%) and between the ages of 20–39 (59.9%).

Conclusions: Injuries to the UE due to participation in boxing accounted for thousands of emergency department visits in the United States annually, with males younger than 20 years of age, most susceptible to injury. Injuries to the hand, wrist and shoulder occurred at the highest rate. Finally, following rule changes made by sanctioning organizations in 2013, a significant decline in boxing-related UE injuries were observed.