Ice Hockey

01 Overview

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)
Athlete silhouette
View Common Injuries by clicking the blue dots on the silhouette

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.

02 Injury Statistics

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.)

Curious about the research on injuries?

It is estimated that...

View Summary of Incidence Rates

03 Risk Factors

  • Youth Hockey Players: Playing Environment

    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.

  • Youth Hockey Players: Preseason Concussion Symptoms

    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.

  • Youth Hockey Players: Athletic Identity

    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.

  • Youth Hockey Players: Mouthguard Use

    Mouthguard use reduces the risk of dental injuries.

  • Youth Hockey Players: Faceshield Use

    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.

  • Professional Hockey Players: Playing Environment

    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.

  • Professional Hockey Players: Post-Concussion Symptoms

    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.

  • Professional Hockey Players: Player Position

    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.

  • Professional Hockey Players: Off-season Training

    Low levels of off-season sport-specific training have been identified as a risk factor for groin injury.

  • Injury History

    Players with a history of injury are at an increased risk for future injury.

04 How can I prevent injury?

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.

  • Participant & Parent

    Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment

    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.

    Managing Concussions

    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.

    Education

    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.

    Skills Training

    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.

    Strength Training and Neuromuscular Training Program

    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.

    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.

    Other Considerations (about this section)

    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.

  • Coach & Teacher

    Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment

    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.

    Education

    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.

    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.

    Managing Concussions

    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.

    Strength Training and Neuromuscular Training Program

    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.

    Other Considerations (about this section)

    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.

  • Official & Administrator

    Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.

    Equipment

    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.

    Education

    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.

    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.

    Managing Concussion

    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.

    Strength Training and Neuromuscular Training Program

    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.

    Other Considerations (about this section)

    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.

  • Health Professional

    The role of health professionals in preventing ice hockey injuries has two main components:

    1. Providing ongoing education to players, parents, and coaches on effective injury prevention programs such as balance and resistance training; and
    2. Ensuring that injured players are completely healed and fit-to-perform before returning to ice hockey to prevent re-injury or chronic injury.

    Managing Concussion

    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.

    Education

    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.

    Skills Training

    Proper checking skills (either body contact or body checking) for the applicable level of play reduces the risk of head injury.

    Strength Training and Neuromuscular Training Program

    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.

    Other Considerations (about this section)

    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: