Here in the Old Pueblo, buzz around hockey is back by way of the Roadrunners AHL (American Hockey League) team. The team was founded in the summer of 2016, and it appears to have gotten a rather warm welcome from Tucson hockey fans. Although the University of Arizona Icecats have been playing at the TCC, this AHL team brings a different level of play and enthusiasm to town. This will undoubtedly bring attention to the Wildcats Youth Hockey league here in Tucson. An overview of common hockey injuries would be beneficial in providing newcomers to the sport as well as parents information about injuries including prevention.
Because of the mechanics of the sport including skating upwards of 30 mph and hockey pucks flying near 100 mph, injuries seem to be synonymous with the nature of the sport. Injuries in hockey range from concussions to common musculoskeletal injuries to the acromioclavicular joint (AC joint), clavicle, and medial collateral ligament (MCL). Of these, the most common injuries to hockey players are concussions, followed by MCL injuries. The injury patterns are consistent with the hard collisions of the game- whether it’s colliding with another player or boards.
Looking at the NHL or the AHL, one can see that injuries and collisions seem to be a concern, and that the concern might be translated to the youth level as well. To prevent concussion, USA Hockey has been using “Heads Up, Don’t Duck” campaign to remind players and coaches alike to keep your head up during collisions with other players or the boards.
This greatly reduces the strain put on the head and may prevent forces on the head that may increase the risk of getting a concussion. Other important preventative measures include ensuring proper helmet fitting, doing neck strengthening exercises, encouraging safe play to players. Another important aspect is to do baseline testing for concussion prior to play so that in the event of a concussion, the patient will have a prior non-concussed test to compare to for the continuing evaluation of symptoms and cognitive function. Knowing what to look for is critical for concussions so as to know when it is safe for a player to be pulled out of a game or when to return to play. The typical course of concussion treatment is aimed at individualizing the treatment to the patient and to ensure that their environment at school, home and sports are conducive to healing. This typically means no heart rate increasing activity for at least 2-3 weeks, followed by monitored light exertional activity if symptoms persist. This is crucial in the healing of the concussion and the gradual return to play for safety of the individual. Also, ensuring symptoms causing triggers are avoided at home along with getting plenty of sleep and eating a healthy diet. Symptomatic treatment of headaches and nausea is also beneficial. Lastly, ensuring that the young athlete has needed accommodations at school so as to not endorse symptoms while at school to ensure proper healing of their injury and reintegration into school.
Prevention is key for the prevention of medial collateral ligament and AC joint injury as well. Because of the quick position changes on the ice, stress is put on the inside of the knee, and subsequently the MCL, putting it at risk of injury. MCL and AC joint injuries are both treated initially with imaging to ensure there is no fracture, followed by rest, ice, compression and elevation of the affected limb. Further workup including and MRI may be needed as well as surgery if the injury is bad enough.
Injuries are unavoidable and are inherent in any game and sport. But with proper coaching, teaching, and evaluation of injuries when they do happen, youth hockey in particular can be a sport that can provide many benefits to new young players.
By Clayton Andrews & Mo Mortazavi, MD
CDC. Brain Injury safety tips and prevention. CDC. https://www.cdc.gov/headsup/basics/concussion_prevention.html. Accessed February 16, 2017.
Hockey. Concussion information. http://www.usahockey.com/safety-concussions. Accessed February 16, 2017.
Hockey injuries. Children’s Colorado. https://www.childrenscolorado.org/doctors-and-departments/departments/orthopedics/programs/sports-medicine-center/sports-injuries-we-treat/hockey/. Accessed February 17, 2017.