Sports Medicine: Just the Facts

4. Forwards have greater anaerobic activity and typ-
   ically skate faster than defensemen or goalies.


5. Despite the above differences by position, muscle
   fiber composition remains equivalent between
   positions.
   b.Flexibility (Sim et al, 1988)


6. Goalkeepers are significantly more flexible than
   forwards or defensemen.


7. Forwards and defensemen have been found to
   have equal flexibility.

• Shooting
  a. Properly coordinated acceleration and deceleration
  of motion of body segments produces maximal
  velocity (Sim et al, 1988; Alexander, Drake, and
  Reichenback, 1964).
  b.Motion is concentrated in the lower arm (Sim et al,
  1988; Alexander, Drake, and Reichenback, 1964).
  c. However, maximal velocity is produced through
  maximal use and full rotation of the trunk (Sim
  et al, 1988; Alexander, Drake, and Reichenback,
  1964; Alexander, Haddow, and Schultz, 1963).
  d. Accuracy of the shot is enhanced via trunk stabi-
  lization and restricted use of body segments (Sim
  et al, 1988; Alexander, Drake, and Reichenback,
  1964; Alexander, Haddow, and Schultz, 1963).

EPIDEMIOLOGY OF INJURIES

• Ice hockey is classified as a collision sport by
  the American Academy of Pediatrics (Anderson,
  Griesemer, and Johnson, 2000).


• There are many opportunities for injury in this aggres-
  sive, fast-paced sport.
  a.Contact/collision with the hard ice surface,
  unpadded boards, goal posts, equipment from other
  players (skate blades, sticks), the puck, and the
  bodies and at times fists of opponents.
  
  
  1. In elite hockey, the puck can travel at speeds up
     to 120 mph, producing impact forces >1250 lb
     (Sim et al, 1988).
  
  
  2. Professional players can skate at speeds up to
     30 mph (Sim et al, 1988).
  
  
  3. Sliding on the ice after a fall can occur at speeds
     up to 15 mph (Sim et al, 1988).
     b.Fatigue appears to be a risk factor for injury (Molsa
     et al, 1997; Stuart, and Smith, 1995; Mair et al,
     1996; Smith, and Reischl, 1988).
     c. Equipment that is in poor repair also places the ath-
     lete at increased risk for injury; however, even
     when adequate protection is worn, injury is still
     possible. Molsa et al. (1997) found that 58% of
     injuries were on body parts that were covered with
     protective equipment.
  
  
  
  

•Overall injury rates

a. Overall 5.6 injuries per 1000 player-hours (1.5 per

1000 hours in practice, 54 per 1000 hours in

games) (Molsa et al, 1997).

b.Injury is more common in the game setting (76%)

than in practice (23%), even though practice repre-

sents significantly more time (Molsa et al, 1997).

Injuries are thus 25 times more common in game

settings (Stuart, and Smith, 1995).

c. Acute and traumatic injures account for 85%,

while overuse injuries represent 15% of all injuries

(Tegner, and Lorentzon, 1991).

d. Approximately 16% of injures are related to rules

infractions (Molsa et al, 1997).

e. During games, Pelletier and colleagues found that

27.1% of injuries occurred during the first period,

35.6% during the second period, and 26.6% during

the third period (Pelletier, Montelpare, and Stark,

1993). In contrast, other investigators suggest that

3rd period injuries are roughly equal to 1st and 2nd

period injuries combined (Molsa et al, 1997), or are

twice as common in the 3rd period (Stuart, and

Smith, 1995).

•Age-specific injury rates: Injuries appear to increase

with increasing age with a peak in early adulthood

(rates are expressed per 1000 player hours of practice

time vs. game time) (Stuart, and Smith, 1995).

a. Youth

1. Squirt (age 9–10) ..................... 1.2 versus 0.0


2. Pee wee (age 11–12) ................ 2.2 versus 0.0


3. Bantam (age 13–14) ................. 2.5 versus 10.9
   b.Junior A (age 17–19) ..................... 3.9 versus 96.1
   c. Intercollegiate (age 18–21) ............ 2.3 versus 84.3
   d. Swedish elite (age 19–33) .............. 1.4 versus 78.4

• Mechanisms of injuries
  a. Collisions—14 to 65% of all injuries (Sim et al,
  1988; Molsa et al, 1997; Stuart, and Smith, 1995;
  Mair et al, 1996; Smith, and Reischl, 1988; Tegner,
  and Lorentzon, 1991; Pelletier, Montelpare, and
  Stark, 1993; Lorentzon et al, 1988; Sane,
  Ylipaavalniemi, and Leppanen, 1988), with one
  study showing 29% are caused by unintentional or
  accidental collisions (Pelletier, Montelpare, and
  Stark, 1993). Collisions with the boards account
  for roughly 10% of all injuries (Molsa et al, 1997;
  Stuart, and Smith, 1995; Mair et al, 1996; Smith,
  and Reischl, 1988; Tegner, and Lorentzon, 1991;
  Pelletier, Montelpare, and Stark, 1993; Lorentzon
  et al, 1988).
  b.Puck—3 to 20% of injuries (Sim et al, 1988; Molsa
  et al, 1997; Stuart, and Smith, 1995; Mair et al,
  1996; Smith, and Reischl, 1988; Tegner, and
  Lorentzon, 1991; Pelletier, Montelpare, and Stark,
  1993; Lorentzon et al, 1988; Sane, Ylipaavalniemi,

508 SECTION 6 • SPORTS-SPECIFIC CONSIDERATIONS