Head injuries, concussion in particular, are common among hockey players.
Ice hockey is one of the most popular sports in Canada and continues to grow in popularity across the globe. This Olympic team sport is governed locally by BC Hockey, and is played on an ice rink with goals at each end, and players manipulating a puck using hockey sticks. Ice hockey is associated with a high risk of injury, particularly concussions, sprains, strains, and bruises; however, there is strong evidence that these injuries can be prevented.
(see Section 04 - Prevention)
Head injuries, concussion in particular, are common among hockey players.
Injuries to the knee, leg, and thigh are the most common in ice hockey
Injuries to the shoulder are very common in ice hockey.
Injuries to the arm are very common in ice hockey.
Injuries to the thigh, leg, and knee are the most common in ice hockey
Injuries commonly occur to the chest, ribs, neck, and back.
Ice hockey is a leading cause of sport-related injury reported to Canadian emergency departments. Minor hockey players are most likely to be injured in the upper extremities (23-55%), followed by the spine/trunk (13-32%), head (7-30%), and lower extremities (21-27%). At the junior level, lower extremity injuries are most common (25-34%), followed by upper extremities (10-35%), head (14-28%), and spine/trunk (6-15%). Men’s professional hockey players are most likely to be injured in the head (17%), thigh (14%) and knee (13%).
Head injuries account for 7-30% of all injuries at the youth level, 14-28% at the junior/collegiate level, and 17% among professionals. Concussions represent 18-66% of all youth injuries resulting in time loss from activity or that require medical attention.
Injuries to the spine and trunk account for 13-33% of all injuries at the youth level, 6-15% at the junior/collegiate level, and 14% among professionals. Upper extremity injuries account for 23-55% of all injuries at the youth level, 10-35% at the junior/collegiate level, and 24% among professionals. Lower extremity injuries account for 21-27% of all injuries at the youth level, 25-34% at the junior/collegiate level, and 45% among professionals.
Male hockey players experience more fractures than females (27% vs. 8%), more shoulder injuries (45% vs. 39%), and more injuries due to body checking (42.8% vs. 25.7%). (Note: female-only leagues do not allow body checking.)
It is estimated that...
View Summary of Incidence Rates
Youth hockey players are more likely to sustain injuries in games rather than during practice. Playing in a body checking league is associated with 2.5 to 3 times increased risk of all game-related injuries.
Preseason reporting of neck pain and headaches on the Sport Concussion Assessment Tool (SCAT) has been reported as a risk factor for concussion. A combination of any two symptoms on the SCAT is a risk factor for Pee Wee non-body contact and Bantam levels.
Elite Bantam and Midget players (AAA, AA, A) who score below the 25th percentile in athletic identity (the degree to which a participant identifies as being in an athletic role and seeks acknowledgement of that role) are at an increased risk of injury; scoring above the 25th percentile is associated with an increased risk of re-injury.
Mouthguard use reduces the risk of dental injuries.
Mandating full facial protection in youth hockey has decreased the number of head and facial injuries. Full facial protection is more effective than half-shield visors in preventing facial injuries and lacerations.
Players in an arena with flexible board/glass systems have a 30% lower risk of injury, including shoulder injuries and concussions, as compared to arenas with traditional board/glass systems.
Among professional players diagnosed with concussion, significant predictors of time loss from hockey include post-concussion headache, low energy or fatigue, amnesia, and abnormal neurological examination.
Defencemen are more likely to report a game-related injury resulting in time loss from activity as compared to forwards, while forwards, specifically centre, are more likely to suffer a concussion than other positions. Being a goaltender, being injured while the team is ‘on the road’, and body checking, are all predictors of an injury leading to loss of play in more than five games.
Low levels of off-season sport-specific training have been identified as a risk factor for groin injury.
Players with a history of injury are at an increased risk for future injury.
Training and regular practice are expected of athletes, but how much is too much? Your risk of injury can increase if you train too much or improperly. Learn more about how to find your training load “sweet spot.”
Playing in a non-body checking league is associated with a reduced risk of injury, including concussion.
Some muscle soreness or joint pain is expected when increasing your level of physical activity. It is important to listen to your body for persistent or worsening pain, and to know when to rest. Learn more about how to prevent injuries in ice hockey.
Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.
Personal protective devices such as helmets and mouthguards can be used to reduce the risk of injury.
Check your helmet regularly to ensure it is not cracked, loose-fitting or has missing pieces. Full facial protection is more effective than half-shield visors in preventing facial injuries and lacerations. When worn, the helmet should fit correctly and have all straps fastened appropriately.
It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for players and parents to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.
Teams that participate in fair play programs designed to decrease violence have a reduction in injuries and concussions due to fewer hits to the head and from behind.
It is important to learn proper checking skills (either body contact or body checking) at the applicable level of play to reduce the risk of head injury.
Lower body injuries are common in hockey. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the risk of injury.
The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.
Click here to view poster.
Oslo Sport Trauma Research Centre Neuromuscular Training
The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.
Learn more about exercises to help prevent shoulder injuries.
Learn more about exercises to help prevent knee injuries.
For more exercises, visit http://fittoplay.org/.
Get Set Neuromuscular Training
The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to ice hockey.
Download Get Set for Android.
Download Get Set for iOS.
Hockey Resources
Hockey Canada provides information on:
Sleep, Vigilance and Sport Injury Prevention
Being successful in physical activity requires a high degree of alertness, also known as vigilance. Sufficient sleep helps your body to recover, allows you to achieve your goals, and reduces your risk of injury. Getting less than 8 hours of sleep can increase your rate of injury by up to 70%! Watch this video to learn more about how sleep and vigilance are connected.
Sport-related Physicals
Ice hockey is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.
Learn more about Kids Health Sports Physicals.
Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.
Personal protective devices such as helmets and mouthguards can be used to reduce the risk of injury.
Players should check their helmets regularly to ensure they are not cracked, loose-fitting or have missing pieces. Full facial protection is more effective than half-shield visors in preventing facial injuries and lacerations. When worn, the helmet should fit correctly and have all straps fastened appropriately.
Teams that participate in fair play programs designed to decrease violence have a reduction in injuries and concussions due to fewer hits to the head and from behind.
It is important to teach proper checking skills (either body contact or body checking) at the applicable level of play to reduce the risk of head injury.
It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for coaches and teachers to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.
Lower body injuries are common in hockey. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of injury.
Sport Injury Prevention Research Centre Neuromuscular Training
The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.
Click here to view poster.
Oslo Sport Trauma Research Centre Neuromuscular Training
The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.
Learn more about exercises to help prevent shoulder injuries.
Learn more about exercises to help prevent knee injuries.
For more exercises, visit http://fittoplay.org/.
Get Set Neuromuscular Training
The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to ice hockey.
Download Get Set for Android.
Download Get Set for iOS.
Facilities
The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing ice hockey in secondary schools.
Learn more about implementing ice hockey in secondary schools
Hockey Resources
Hockey Canada provides information on:
Sport-related Physicals
Ice hockey is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.
Learn more about Kids Health Sports Physicals.
Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.
Personal protective devices such as helmets and mouthguards can be used to reduce the risk of injury.
Players should check their helmets regularly to ensure it is not cracked, loose-fitting or has missing pieces. Full facial protection is more effective than half-shield visors in preventing facial injuries and lacerations. When worn, the helmet should fit correctly and have all straps fastened appropriately.
Teams that participate in fair play programs designed to decrease violence have a reduction in injuries and concussions due to fewer hits to the head and from behind.
It is important to teach proper checking skills (either body contact or body checking) at the applicable level of play to reduce the risk of head injury.
It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.
Lower body injuries are common in hockey. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of injury.
Sport Injury Prevention Research Centre Neuromuscular Training
The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.
Click here to view poster.
Oslo Sport Trauma Research Centre Neuromuscular Training
The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.
Learn more about exercises to help prevent shoulder injuries.
Learn more about exercises to help prevent knee injuries.
For more exercises, visit http://fittoplay.org/.
Get Set Neuromuscular Training
The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to ice hockey.
Download Get Set for Android.
Download Get Set for iOS.
Facilities
The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing ice hockey in secondary schools.
Learn more about implementing ice hockey in secondary schools.
Skills Training
It is important to teach proper checking skills (either body contact or body checking) at the applicable level of play to reduce the risk of head injury. Hockey Canada provides a progressive approach to teaching checking.
Hockey Resources
Hockey Canada provides information on:
Sport-related Physicals
Ice hockey is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.
Learn more about Kids Health Sports Physicals.
The role of health professionals in preventing ice hockey injuries has two main components:
It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected.The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to diagnose and manage a concussion. CATT also includes resources on how to assess a potential concussion, as well as detailed Return to School and Return to Sport protocol.
Teams that participate in fair play programs designed to decrease violence have a reduction in injuries and concussions due to fewer hits to the head and from behind.
Proper checking skills (either body contact or body checking) for the applicable level of play reduces the risk of head injury.
Lower body injuries are common in hockey. The risk of all lower body injuries may be reduced by up to 50% by regular participation in a balance training exercise program with a resistance training component, such as a neuromuscular training warm-up program. Completing this warm-up program can lower the likelihood of injury.
Sport Injury Prevention Research Centre Neuromuscular Training
The Sport Injury Prevention Research Centre has developed a neuromuscular training warm-up program that can be adapted to many sports. Incorporating a warm-up program like this one into your training program at least two times per week has been associated with a significant reduction in lower body injuries.
Click here to view poster.
Oslo Sport Trauma Research Centre Neuromuscular Training
The Oslo Sport Trauma Research Centre has developed strength training exercises designed to prevent injuries to the shoulder, knee, and other areas of the body. This resource includes videos and PDFs for download.
Learn more about exercises to help prevent shoulder injuries.
Learn more about exercises to help prevent knee injuries.
For more exercises, visit http://fittoplay.org/.
Get Set Neuromuscular Training
The Get Set app contains exercises that can be done at home. Created by the Oslo Sports Trauma Center, Norwegian School of Sport Sciences, and Making Waves AS in 2014 for the International Olympic Committee, the app allows you to search by body part to view exercises that work to strengthen each area of the body, or search by sport to view a library of exercises that are specific to ice hockey.
Download Get Set for Android.
Download Get Set for iOS.
Sport-related Physicals
Ice hockey is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. The American Academy of Pediatrics provides information about pre-participation physical evaluation.
Learn more about Preparticipation Physical Evaluation.
Hockey Resources
Hockey Canada provides information on:
