Musculoskeletal Injuries in Ice Hockey: A Review of Epidemiology, Risk Factors, Mechanisms, and Rehabilitation

Abstract

Hockey players must have good coordination skills, agility, and control of their body movements. The main movement pattern is the skating, which consists of a support and a swing phase. Those who skate effectively can reach speeds up to 48 km/h. Traumatic injuries predominate in hockey, with medial collateral ligament injury being the most common injury in both genders (44/1,000 h). Overuse injuries account for a smaller proportion of injuries, with the hip joint being the most affected area. One of the most important internal risk factors is a previous injury. External risk factors relate to the level of play, player position, and the characteristics of the game. Repetitive skating patterns can cause femoroacetabular impingement syndrome. Inadequate skating technique results in a knee valgus position, which can damage the medial collateral ligament. Rapid changes of direction cause an injury of the hip adductor muscles. Torsional forces in the ankle during skating can lead to high ankle fractures, and shear forces between the tendons and the stiff tongue of the skate can lead to tendon inflammation. Prevention activities should include strengthening of the hip, knee and shoulder girdle muscles, and sport-specific exercises early in the season. At the end of the article, rehabilitation strategies for specific injuries are also discussed.