Sports Medicine: Just the Facts

86 ICE HOCKEY INJURIES

Peter H Seidenberg, MD

Tory Woodard, MD

INTRODUCTION

• Ice hockey is an extremely fast-paced, high-contact
  game that requires the mastery of many skills (USA
  Hockey website; Official Rules of Ice Hockey, 2001;
  Joyner and Snouse, 2002). Many of these skills (skat-
  ing, stick handling, body checking, shooting, and
  goal tending) are unique to the sport (Sim et al,
  1988).


• The sport dates back to 1850s, with formal rules first
  established in Canada in 1881 (USA Hockey website;
  Joyner and Snouse, 2002; Minkoff, Varoltta, and
  Simonson, 1994; Morgan, 1990).


• In the same time period, equipment specific for ice
  hockey was developed—hockey ice skates and sticks
  (USA Hockey website).
  •It is a National Collegiate Athletic Association
  (NCAA), international and Olympic sport that made
  its debut in the Antwerp Olympic Games in 1920
  (USA Hockey website).


• It is increasing in popularity yearly in the United
  States. During the 2001–2002 season, there were
  525,373 registered players, coaches, and officials in
  USA Hockey (USA Hockey website).
  a. USA Hockey is the governing body for amateur
  hockey in the United States.
  b.Membership has grown over 176% in the past
  decade (USA Hockey website).
  •Women are active participants in all roles in ice
  hockey.
  a. Females were involved in Canada as early as 1892
  (Joyner and Snouse, 2002).
  b.In the 1920s and 1930s, women’s leagues were
  formed in Canada and the United States (Joyner
  and Snouse, 2002).
  c. After World War II, there was decreased public
  interest in women’s hockey (Joyner and Snouse,
  2002).
  d. In the 1960s, women’s leagues were restarted in
  Canada and the United States (Joyner and Snouse,
  2002).
  e. The International Ice Hockey Federation coordi-
  nated women’s world ice hockey tournaments in
  1992, 1994, and 1997 (Joyner and Snouse, 2002).
  f. In the 1998 Olympic Games, women’s ice hockey
  first appeared as a medal sport (Joyner and Snouse,
  2002).

g. Today, the NCAA considers female ice hockey an

emerging sport (Joyner and Snouse, 2002).

h.The USA Hockey registrants include 42,292

female players and 1,684 exclusive women’s teams

(USA Hockey website).

i. Many women are playing on men’s teams, even up

to the minor league level.

• The physician providing medical care for ice hockey
  athletes needs to be proficient in treating a wide vari-
  ety of traumatic and atraumatic problems that range in
  severity from mild to life-threatening.

EQUIPMENT

• All leagues now require helmets (Official Rules of Ice
  Hockey, 2001), which should fit snugly, and utilize a
  four-point fit (like football helmets) (Joyner and
  Snouse, 2002).
  a. The hockey helmet must be able to withstand low
  mass, high-velocity impacts from the puck and
  high mass, low-velocity forces from running into
  the boards (Arheim and Prentice, 1996).


• USA Hockey recommends the use of Hockey
  Equipment Certification Council (HECC) approved
  helmets, full face masks, and full mouthpieces for all
  players during both practices and games (Official
  Rules of Ice Hockey, 2001; Cross and Serenelli, 2003).


• The mouthpiece is to be internal and should cover all
  the remaining teeth of one jaw. It is required to be col-
  ored (not clear) in age 19 and under leagues. A form-
  fitting mouthpiece is recommended (Official Rules of
  Ice Hockey, 2001).
  a. International play does not require mouthpieces;
  however, they are still highly encouraged (Joyner
  and Snouse, 2002).
  b.The purpose of mouthguards is to protect dentition
  (Labella, Smith, and Sigurdson, 2002).
  c. They may also prevent or decrease the severity of
  concussion (Arheim and Prentice, 1996; Labella,
  Smith, and Sigurdson, 2002; Hickey et al, 1967).


• Full facemasks are mandatory for all youth and col-
  lege leagues (Official Rules of Ice Hockey, 2001) and
  are slowly gaining popularity on the professional
  level.
  •Kevlar throat protectors are required in many leagues
  and countries (Joyner and Snouse, 2002).


• Gloves, elbow pads, shin pads, shoulder pads, hip
  pads or padded hockey pants, protective cup, and
  tendon pads are recommended (Official Rules of Ice
  Hockey, 2001).
  a. There has been a recent trend of wearing hockey
  gloves with shorter cuffs for the purpose of allowing
  increased wrist motion (Joyner and Snouse, 2002).

506 SECTION 6 • SPORTS-SPECIFIC CONSIDERATIONS