Youth
Hockey

Part 2

Ice Hockey Safety

Ontario Minor Hockey Association's S.T.O.P. (Safety Towards Other Players) Program

In 1996, Kevin Stubbington of Windsor Minor Hockey developed the Safety Towards Other Players (S.T.O.P.) program in hopes of raising awareness of the dangers of checking from behind in the game of hockey.

The National Youth Sports Safety Foundation, Inc. (NYSSF)   A national non-profit, educational organization dedicated to reducing the number and severity of injuries youth sustain in sports and fitness activities. The Foundation is the only organization in the country solely dedicated to this objective.

Injuries

Brain and Spinal Cord Issues

Help Stop Ice Hockey Injuries, Physicians Urge

Minneapolis - The Minnesota Medical Association, representing about 9,500 physicians throughout the state, warns of the injuries associated with body checking in ice hockey and urges coaches, parents, fans and players to take steps to reduce risk.

One Minnesota study found that body checking accounted for 59 percent of hockey injuries (20 percent from legal checking and 39 percent from illegal checking) and that rules violations were responsible for another 27 percent.

Most injuries are contusions, sprains, strains, and fractures. But occasionally, injuries can be severe. A direct blow to the top of the head of a player in the chin-down position can result in a paralyzing cervical spine injury. In a study of 117 hockey players with spine or spinal cord injuries, the most common cause was a punch or check from behind that sent the player headfirst into the boards.

"Hockey is an exciting, fast paced game," said John Van Etta, M.D., president of the Minnesota Medical Association. "But it’s important to learn how to reduce the risk of catastrophic injury. Just one tragedy is one too many."

Common hockey injuries

Most hockey injuries occur due to impact and trauma. The use of proper equipment such as adequate padding in shoulder pads and hockey pants and proper fitting helmets can decrease your risk. The establishment of effective rules and their enforcement also significantly decreases injury rates. Giving penalties for high sticking, checking from behind and elbowing have all helped to reduce injuries.

Virginia Boro, B.Sc., PT, is the Director of the Virginia Boro Physiotherapy Clinic, at the Nepean Sports Medicine Centre

Sudden death of a young hockey player: case report of commotio cordis

Deady B, Innes G

Royal Columbian Hospital New Westminster, BC, Canada.

Despite the use of protective gear, a 15-year-old hockey player died when he was struck in the chest by a puck. This is the fifth recorded hockey death related to so-called commotio cordis, that is, blunt chest injury without myocardial structural damage. In light of inadequacies of commercial chest protectors currently in use for hockey, the authors hope to educate players and coaches about the danger of blocking shots with the chest. 

Physicians should be aware that commotio cordis represents a distinctive pathological condition, in the event of which immediate recognition, precordial thump, CPR, and defibrillation are potentially lifesaving. Appropriate medical supervision at amateur hockey games, 911 telephone access, and on-site automated external defibrillators are issues that deserve careful consideration. 

Factors associated with significant injuries in youth ice hockey players

Reid SR, Losek JD

Pediatric Emergency Medicine, Children's Hospitals and Clinics, St. Paul, Minnesota 55102, USA. Krinandsam@aol.com

STUDY OBJECTIVE: To assess the implementation of published injury prevention strategies in injured youth ice hockey players, to examine factors contributing to current youth ice hockey injuries, and to assess attitudes of participants toward injury-risk activities.

CONCLUSION: While compliance with protective equipment requirements was good, rule enforcement was perceived to be inadequate. Elimination of checking would potentially reduce the number of significant injuries more than would the enforcement of existing rules. Injured youth hockey players are underinformed about the hazards of their sport and are too willing to engage in potentially injurious activities.

How risky is Canada's favourite game?

by Darryl Osborne — The Peak, Simon Fraser University

Troy lies motionless for several minutes. He keeps saying that he cannot feel his arms or legs. As the minutes continue to pass with no sign of movement, a hush falls over the once-boisterous crowd and players from both teams, with grave concern, surround the young man. His spine has been damaged. In one split second Troy has gone from a budding NHL superstar to a quadriplegic.

Gladiators on ice

An overview of ice hockey injuries in youth

Risk factors

Ice hockey offers ample opportunity for injuries: Players wear skate blades, use sticks, and shoot pucks. They travel at high speeds, on a slippery surface, in a space that is confined by boards. Moreover, some players play hockey as a collision sport. 

Body Checking

Clearly, body checking (collision) increases the likelihood of injury. In a study of high school players, body checking accounted for 38% of all injuries, with illegal play being responsible for another 26%. Collision accounted for 50% of all injuries in another study of youth hockey. In still another study, body checking accounted for 59% of all injuries (20% resulting from legal checking and 39% from illegal checking), with rule violations being responsible for another 27%. When fracture rates were compared in body-checking versus non-body-checking leagues among 49 Canadian Peewee teams, researchers found that fracture was 12 times more common in the body-checking leagues. 

Body checking contributes not only to the number of injuries sustained but also to their severity. In a study of 117 hockey players with spine or spinal cord injuries, the most common cause of such injury was a push or check from behind (by an opponent) that catapulted the player headfirst into the boards. 

Nevertheless, collision is allowed in boys' ice hockey at the Peewee level, even though size and physical maturity differ considerably among boys under 16 years of age. Weight can range from 34 to 70 kg (75 to 155 lbs) for Peewees and from 37 to 90 kg (80 to 200 lbs) for Bantams. According to one study, larger Peewee players exerted an impact force 70% greater than that exerted by their smaller teammates.

Lax Rule Enforcement

Rule enforcement is especially important in a game that can result in serious injury or death. One youth hockey study, however, showed that for 29 injuries resulting from tactics judged illegal, only four penalties were assessed. Also, researchers studying catastrophic injury noted that rules were frequently not enforced and players were injured as a result of illegal play. 

Violence

Violence in hockey is a problem at all levels of play, including the youth level, and body checking contributes to it. Investigators in one study described the environment of one in three youth hockey games in which an injury occurred as hostile: Players called one another names and fought; parents became angry; and referee calls were hotly disputed. Fifteen percent of all injuries were deemed intentional. The same authors found that 26% of Peewee and Bantam players who understood that checking from behind could cause serious injury or death reported that they would be willing to do so if "angry" or to "get even." According to another group of researchers, the risk of concussion was four times higher among players who identified "Playing hockey helped me to get rid of tensions and aggressions" as their first or second reason for playing than among those who identified other reasons.

Hockey Helmet Safety

WINTER SPORT SAFETY

What sport involves a piece of equipment that can move at speeds of 160 km/hour, but weighs only 170 grams? Players of this sport can move at 40 km/hour and weigh about 100 kilograms. Hint: it is a winter sport. The answer...ice hockey. Ice hockey combines the grace of skating with the aggressiveness of football. The nature of this fast-paced, sometimes violent game also carries the risk of head and brain injury.

Dr. C.R. Honey at the University of British Columbia reviewed the medical literature published between 1966 and 1997 for injuries related to ice hockey. He found that children between the ages of 5 and 17 years suffered between 0 and 2.8 concussions per 1000 player-hours. High school players had about the same incidence of concussions. Concussion rates for university hockey players were as high as 4.2 per 1000 player-hours and those for elite amateurs were as high as 6.6 per 1000 player-hours. There were no data for professional players.

Most concussions occurred during body checking, when one player slams into another. Concussions from being struck by a puck were rare. Although helmets, which are now required during most amateur hockey games, reduce the number of concussions, a better way to decrease head injuries may be to ban body checking for young players. More severe penalties, such as increased time in the penalty box for illegal body checking, may also reduce concussions. Dr. Honey believes it may be more effective for referees to watch players more closely and attempt to stop play before a player receives a concussion. (Bold added.)

In addition to helmets, full face shields are required for players in many hockey associations in the United States and Canada. These shields are worn to reduce head and neck injuries. A recent study to determine if these shields actually work was published last December (J. Amer. Med. Assoc., 1999). Researchers in Canada at the University of Calgary studied 642 university hockey players from 22 teams. During games, players on 11 teams wore full face shields and players on the other 11 teams wore only half face shields.

Although the number of concussions and neck injuries was not different among those players wearing full and half face shields, time on the ice lost due to a concussion was less in those players wearing full face shields. There were also fewer injuries to the face and teeth of those players wearing full face shields.

Ice hockey is no different from other contact sports: protective gear and proper training are required for full enjoyment and safety of the game. And that piece of equipment that travels at 160 km/hour and weighs only 170 grams? It's a hockey puck!

References:

Honey, C.R., Brain injury in ice hockey, Clin. J. Sport Medicine, 8:43-46, 1998.

Benson, B.W., Mohtadi, N.G.H., Rose, M.S. and Meeuwisse, W.H., Head and neck injuries among ice hockey players wearing full face shields vs half face shields, J. Amer. Med. Assoc., 282:2328-2332, 1999.

What Every Parent and Athlete Should Know About Sports Concussion

What is Concussion?

Concussion is the most common form of head injury for athletes. It is associated with disorientation, and sometimes with loss of consciousness (LOC) followed by amnesia (forgetting) of what happened both immediately before and after the injury.

A Message to Parents and Young Athletes

The NHL is now routinely assessing for concussion and providing baseline neuropsychological screening for their players. Now, there is a national trend to provide baselines for our high school and young athletes who are also at risk for concussion. Baselines that are performed prior to injury provide valuable information to help later determine when the player is ready to return to play, as well as if he/she is in need of treatment. Baseline screening includes noninvasive tests that measure attention, memory and other cognitive skills. However, it is not intelligence or achievement testing. Neuropsychological testing is often more sensitive to the effects of mild head injury than MRI, CT, or neurological exam. 

1 )   When going into the boards, try to put up your hands, arm, or shoulder to cushion your collision.

2)   If you are unable to get your hand, arm, or shoulder up to cushion your collision, then be sure to keep your head up. Don't put your head down.

Proper Safety Equipment for Ice Hockey

More than 2 million boys and girls under the age of 18 are playing hockey in the United States. Several rule changes, technological advancements in equipment, and mandatory wearing of helmets and face masks have made hockey a safer sport for all to play and enjoy.

Hockey is a collision sport and injuries do occur. But with certified, quality, well-fitting equipment, the frequency and severity of these injuries can be decreased. 

Winning the Stanley Cup Final Series is related to incurring fewer penalties for violent behavior

Ice hockey has become the fastest growing sport in many parts of the world. Although European ice hockey has evolved into a highly refined game, based on skill and finesse, the North American version of the sport is still based heavily on violence. Catastrophic and disabling injuries are being reported with increasing frequency. These injuries are in many cases caused by violent player behavior which, the researchers pointed out, may be supported by coaches who cling to the belief that such behavior contributes to winning.

Opinion: Rough play on ice

"Hockey is a great sport. I'm just afraid that if we don't do something about the violence and the increasing possibility of injury, it will soon be relegated to the same category as ancient Roman gladiatorial combat."

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