Hockey Injuries Research Articles

Functional knee stability in elite field hockey depends on playing class and gender

Field hockey, a physically demanding Olympic sport, carries a high risk of lower limb injuries, yet data on injury risk in elite field hockey are limited. Functional knee stability is important for injury prevention and a safe return to sport. This study is the first to investigate functional knee stability in elite field hockey, considering gender and playing class, and establishes reference data for functional knee stability by using a standardized test battery that assesses one- and two-legged stability, jumping tests, speed, and agility. 72 elite field hockey players, 30 males and 42 females (age 19.82 ± 3.74 years) were divided into High Playing Class (HPC) and Moderate Playing Class (MPC). HPC players showed significant better performance in all functional tests except balance tests (p <0.01-0.024). Females showed significantly better one- and two-leg stability (p <0.01) with lower injury rates, indicating the relevance of gender considerations. The study emphasizes the importance of balance and stability in the prevention of lower limb injuries in Olympic field hockey and also highlights the importance of considering pre-existing deficits in functional knee capability when assessing athletes for return to sport. These results can help improve athletic performance, identify individual strengths and weaknesses, prevent injury or re-injury, and facilitate return to sport after injury.

Head and neck ice hockey injuries in children: an analysis of the NEISS database

ObjectiveOur objective was to describe non-concussion head and neck ice hockey injuries in children in the US. MethodsThis is a retrospective cohort study using data from the NEISS database. The NEISS database was reviewed from 2010 to 2021 for injuries in the head, neck, mouth, eye, and ear related to ice hockey in children 1–18 years old. Records where the only injury was a concussion or internal head injury were removed. Frequencies were calculated and chi-squared tests were performed. Results475 children were included, with mean age of 13.1 years old (95 % CI 12.7–13.4), and 426 (89.7 %) were male. Females were significantly younger with mean age 11.8 years versus 13.2 years for males (t = −2.4, df = 473, p = .018). 110 (23.2 %) injuries were related to hockey sticks, 92 (19.4 %) involved a fall, and 32 (6.7 %) were subsequent to body checking. 301 of the injuries (63.4 %) were lacerations, 71 (14.9 %) contusions or abrasions, and 26 (5.5 %) strains and sprains. The type of injury varied according to head and neck region (p < .001). 231 (82.8 %) of facial injuries, 16 (76.2 %) of ear injuries, and 33 (62.3 %) of oral injuries were lacerations. Eight (1.7 %) patients were admitted or observed overnight, while the rest were discharged home. ConclusionFemale ice hockey players sustain injuries at younger ages than males, which may reflect the loss of older girls from the sport. In older boys, injury rates may reflect the loss of mandated full face protective shields.

Safe2Play in youth ice hockey: injury profile and risk factors in a 5-year Canadian longitudinal cohort study

Introduction Ice hockey is a popular global sport with growing participation for boys and girls yet remains a high-risk sport for injury. While the evidence for some risk factors, such as bodychecking policy is well established, other risk factors such as player sex have been understudied. The objectives of this study were to examine factors associated with rates of game-related injury, game-related injury resulting in >7 days of time-loss, and practice-related injury in youth ice hockey. Materials and methods Safe2Play was a five-year prospective cohort study (2013–2018). All injuries were identified using validated injury surveillance methodology. Multilevel Poisson regression (adjusting for cluster by team and including multiple imputation of missing covariates) was used to estimate incidence rate ratios (IRRs) for player sex, age group, bodychecking policy, year of play, level of play, weight, previous injury within last 12 months, previous lifetime concussion history, and position. Results A total of 4418 male and female ice hockey players (representing 6584 player-seasons) participating in under-13 (ages 11–12), under-15 (ages 13–14) and under-18 (ages 15–17) age groups were recruited. There were 1184 game-related and 182 practice-related injuries. Factors associated with game-related injury included female sex (IRR = 1.57; 95% CI: 1.18–2.08), previous injury (IRR = 1.46; 95% CI: 1.26–1.70) and lifetime concussion history (IRR = 1.41; 95% CI: 1.23–1.62). Goaltenders had a lower rate of injury (IRR = 0.54; 95% CI: 0.40–0.72) relative to forwards, as did players exposed to policy disallowing bodychecking in games (IRR = 0.44; 95% CI: 0.35–0.55). Female sex (IRR = 1.90; 95% CI: 1.10–3.28) and lifetime concussion history were also significantly associated with practice-related injury (IRR = 1.53; 95% CI: 1.08–2.18). Conclusions Based on data from a large 5-year Canadian youth ice hockey longitudinal cohort, several factors associated with injury were identified. Future injury prevention strategies should consider age, sex, previous concussion and injury history, and body checking leagues. Future research in female youth ice hockey including female-only leagues should be a priority to inform prevention strategies in this understudied population.

Body Checking Injuries in National Collegiate Athletic Association Men's Ice Hockey: Findings From the NCAA Injury Surveillance Program 2009/10 to 2019/20.

To describe the epidemiology of body checking injuries in the National Collegiate Athletic Association (NCAA) Men's Ice Hockey. Secondary data analysis of historical cohort data. A convenience sample of injuries in NCAA Men's Ice Hockey during the 2009/10 to 2019/20 academic years. NCAA student-athletes. Event type, season, time loss, body part, diagnosis, player position, and mechanism. This study examined injuries that occurred during practice or competition, regardless of time loss, reported to the NCAA Injury Surveillance Program. Injury counts, rates, and proportions were used. The injury rate and proportion ratios with 95% confidence intervals were also constructed. Three independent logistic regression models were constructed to examine differential odds of time loss (≥1 day; TL) injury and the 2 most common injuries, between body checking injuries and all other injuries. Overall, 1290 body checking injuries (rate = 1.59/1000 athlete-exposures) were reported during the study period. Most were attributed to the upper extremity (42%) or head/neck (27%). The competition injury rate generally decreased after 2012/13. After adjusting for covariates, odds of (1) a TL injury was lower and (2) an acromioclavicular sprain was higher among body checking injuries as compared with injuries attributed to all other activities. Odds of concussion was not associated with body checking injuries. Body checking injuries were frequently attributed to the head/neck and upper extremities, and the rate of these injuries during competition appeared to be decreasing. Still, improvements in helmet and shoulder pad technology may further improve health and safety.

Poster 339: Outcomes of Anterior Cruciate Ligament Reconstruction in Competitive Ice Hockey Players: Outcomes, Reoperations, and Return to Play at 7 Years Mean Follow-Up

Objectives: Ice hockey is a physically demanding sport, with young athletes prone to anterior cruciate ligament (ACL) injuries. Currently, there is a paucity of data examining the results of ACL reconstruction (ACLR) in competitive hockey players. The purpose of this study was to assess return to hockey (RTH) and reoperation rates following ACLR for ACL injuries in a cohort of competitive hockey players. Methods: All competitive ice hockey players (including, youth, high school, juniors, collegiate, or professional) with a history of ACL injury and subsequent ACLR at a single academic institution between 2000 and 2022 were identified. Exclusion criteria included ACL injuries that did not occur during hockey, history of ACLR prior to hockey injury, and recreational hockey players. Graft failure was defined as a retear (as determined via clinical or advanced imaging evaluation) and/or revision ACLR. Results: Ultimately, 50 knees in 44 hockey players were included at a mean (± standard deviation) follow-up time of 7.0 years ± 5.4 years (Table 1). The mean age at the time of index surgery was 18.9 years ± 3.0 years, with 38 males (76%), and the distribution of bone-patellar tendon-bone (BPTB) and hamstring tendon (HT) autografts was 40 (80%) and 10 (20%), respectively. RTH occurred in 66% of hockey players at a mean of 10.2 months ± 6.2 months. Graft failure occurred in 9 knees (18%) at a mean of 5.9 years ± 5.8 years after the index ACLR. All patients who sustained a retear underwent reoperation. Kaplan-Meier survivorship free from surgical failure of the entire cohort was 94% at 1 year, 88% at 5 years, 74% at 10 years, and 67% at 15 years (Figure 1A). BPTB autograft demonstrated a lower failure rate compared with HT autograft (13% vs 40%; P = 0.041) and was associated with better survival compared with HT autograft up to 15 years after the index ACLR (80% vs 39%; P = 0.047; Figure 1B). Conclusions: ACL injury remains a concern for competitive hockey players after ACLR. Return to competitive ice hockey was observed in 66% of athletes after ACLR, with 18% of hockey players experiencing graft failure and undergoing subsequent reoperation. BPTB autograft was associated with better survival than HT autograft.

Overview of systematic reviews on the most common sports injuries

The frequency and nature of sports injuries depend primarily on the specific sport that an individual play. In this article we review systematic reviews to identify and highlight the most prevalent injuries in basketball, football, volleyball, ice hockey, rugby, and handball. We collected data on the prevalence rates of the most common injuries across these sports, revealing that the most common injuries are lateral ankle sprains, concussions, hamstring strains, quadriceps strains, and various internal knee derangements. Notably, the majority of these injuries affect the lower extremities, which are under the most stress during athletic activities. We also provide insights into preventive measures for the three most common injuries. This compilation of data from different sports will prove valuable to kinesiologists, coaches, and sports professionals, helping them to develop comprehensive training programs aimed at preventing injury and improving overall athletic performance.

The effect of length of sport experience on the prevalence of non-specific back pain and injury in soccer and ice hockey

Background: Back pain is one of the most common health problems not only in the general population but also in athletes. However, there is a lack of evidence-based findings on the dose-response effect of athletic training on back pain and injuries. The aim of this study was to determine whether training experience affects the intensity of back pain and the number of injuries in moderate-to-high performance team sport athletes. Methods: A total of 147 male soccer players (age 27.8 ± 5.9 y; training experience 17.2 ± 5.6 y) and 179 male ice hockey players (age 29.2 ± 5.9 y; training experience 20.5 ± 6.1 y) were asked to complete questionnaires focusing on back pain and injuries: Oswestry Disability Index (ODI) and McGill Pain Questionnaire (MPQ). Results: Spearman correlation analysis revealed significant positive associations between length of training experience and the occurrence of thoracic pain (p=0.005), low back pain (p=0.016), thoracic injuries (p=0.006), and ODI (p=0.007) in soccer players. In hockey players, training duration was significantly correlated with low back pain (p&lt;0.001) and injuries (=0.006), ODI (p&lt;0.001), affective dimension (p&lt;0.001), evaluative dimension (p=0.002), miscellaneous dimension (p=0.027), and total MPQ (p=0.029). Conclusions: The results of this study suggest that the length of training experience is another important factor influencing low back pain. Therefore, it is necessary to focus more attention on more experienced players and to include significantly more compensatory exercises and recovery time in their training process.

Youth Female Field Hockey Players Physical Condition

Introduction: lower limb injuries and low back pain are common injuries in field hockey that have different risk factors. The aim of this study was to characterize youth field hockey players’ physical condition to determine their possible injury risk factors. Methods: youth field hockey players of the Club Deportivo Universidad Católica of Chile were assessed during April and May of the 2022 season. The test used were: Ely’s, Thomas, Ober and AKE for flexibility, Biering Sorensen, Plank Test, Sport Specific Endurance Plank Test, Single Leg Bridge Test, Lunge Test, Hop Test (single, triple and croo-over) and Y Balance Test. Statistical analyses were performed using R Statistical Software (2023.09.0+463; R Core Team 2023). Results: 87 youth field hockey players from the under 14, 16 and 19 were assess (age 15.1 ± 1.5). Poor core and back extensor endurance was found, along with poor hamstring strength and unipodal balance. Significant difference was found between categories in the plank test and sport specific endurance plank test (p&lt;0.001). Conclusion: several impairments were found in chilean youth field hockey players that could pose a risk of injury, however, further research is needed in order to determine if these impairments really are risk factors in this sport and population.

Effects of Balance and Proprioceptive Exercises on the Balance of Ice Hockey Players and the Risk of Lower Limb Injuries

Background. Most ice hockey injuries are contact, but about 15% are non-contact musculoskeletal injuries and lower body injuries account for 30-45% of all injuries in ice hockey players. It is believed that proprioception and balance training can improve neuromuscular control, improve its ability to synchronise the muscle joint to improve dynamic stability and improve human performance, so balance and proprioception are suggested exercises as a regular part of training. The aim. To determine the effects of a 6-week balance and proprioception training exercises on balance and lower extremity injury risk in ice hockey players. Material and methods. 20 men were randomly divided into experimental and control groups. Six weeks were applied to the research group balance and proprioception exercises, twice a week for 45 minutes next to their regular training. The control group continued with regular training. Before and after the study, static balance was assessed by the flamingo test, dynamic balance and lower extremity injury risk by the modified star excursion test, and injury risk assessment using the Functional Movement Assessment. Results. In the intervention group after 6 weeks the static balance of the right and left leg improved statistically significantly (p&lt;0,05), the dynamic balance of the right and left leg in the front, posteromedial, posterolateral directions (p&lt;0,05), but functional movement patterns did not change statistically significantly (p&gt;0,05). A statistically significant difference was found between the groups in the dynamic balance of the left and right leg in the front, posteromedial, and posterolateral directions (p&lt;0,05) and the static balance of the right leg (p&lt;0,05). The results of the intervention group were better compared to the control group. Conclusions. After the application of balance and proprioception training exercises, the static and dynamic balance of ice hockey players improved and the risk of injury in ice hockey players decreased. Recommendations. Balance and proprioception exercises should be included in hockey physical training to improve static and dynamic balance and reduce the risk of injury. When performing balance and proprioception exercises, we recommend incorporating a variety of specific movements that are similar to those performed by athletes during training and competition. In order to determine the cause of injuries and their risk, it is very important to carry out regular tests, store them and analyse them. Keywords: balance, proprioception, hockey, injury risk

Perceived social pressure and intention to play through injuries in junior ice hockey: The sporting environment matters

ABSTRACT Playing when injured is a risky yet common business among ice hockey players. Conceptualized within the framework of the theory of planned behaviour, the current cross-sectional study aimed to test a multiple-mediator model linking players’ perceived social pressure to their intention to play when injured. We tested whether social pressure is directly and indirectly (via attitudes, subjective norms, perceived behavioural control avoidance, and situational temptation) related to intention to play when injured. We recruited 186 junior players aged 16–20 years (mean age = 17.85; standard deviation = 1.35) from two Norwegian ice hockey leagues (under 18 and under 20 years of age). The data were analysed using a linear regression procedure and a bias-corrected bootstrapping technique to measure indirect effects. The results revealed a positive direct and indirect (via attitudes, subjective norms, and situational temptation) relationship between players’ perceived social pressure and their intention to play when injured. In conclusion, players that perceived pressure to play despite being injured, who perceived positive consequences of doing so, who believed that people close or important to them approved of them doing so, and who perceived game-specific temptations, were more likely to report a stronger intent to play the game when injured.

Mixed-methods process evaluation of the injury prevention Warming-up Hockey programme and its implementation

Warming-up Hockey (WUP) is an effective injury prevention programme to reduce acute field hockey injuries among youth. This paper describes the process evaluation of the nationwide scaling-up. We conducted a...

Verletzungen in der 1. Inline-Skaterhockey-Bundesliga

Inline skater hockey is a sport originating from ice hockey, which is practised in Germany by about 6000 athletes. There are some differences to ice hockey, which lead to a special risk profile of the athletes.All 315 active players of the First German Inline Skater Hockey League in the years 2018 and 2019 were contacted to participate in an online survey. The subjects of the study completed an anonymised 83-item multiple-choice questionnaire about injuries, training frequency, training content, and sports equipment. 178 athletes responded and 116 questionnaires could be analysed (100 men, 8 women, 8 without information/16 goalies, 55 forwards, 44 defenders).The overall injury incidence was 36.98 per 1000 hours. Minor injuries (wounds, bruises, and blunt muscle injuries) most frequently comprised leg injuries (9.4/1000 hours) and arm injuries (7.2/1000 hours). Relevant injuries (fractures, dislocations, and ligamentous injuries) were most common to the foot (2.4/1000 hours) (n=147) and to the head (1.9/1000 hours) (n=140) and knee (1.7/1000 hours) (n=126). Of 76 fractures, 48 (63.2%) resulted from direct or indirect body contact. Goalkeepers suffered more knee injuries compared with field players, while field players sustained more shoulder injuries. Head injuries (fractures, dental injuries, traumatic brain injuries) were significantly more frequent in players without face protection (3.0/1000h vs. 1.8/1000h). Players who did not perform additional fitness training had significantly more relevant injuries. In this group, knee injuries occurred more frequently as well (4.2/1000h vs. 1.3/1000h). The duration of stretching exercises showed a negative correlation with overall injury incidence (0 minutes: 53.5/1000 hours, 1-4 minutes: 55.8/1000 hours, 5-9 minutes: 23.5/1000 hours, ≥10 minutes: 21.5/1000 hours, p<0.05).In particular, mild injuries occurred with a highly significant reduction in frequency if the subjects performed stretching exercises. Inline skater hockey in the First German League is characterised by a high risk of injury, which can be compared with professional ice hockey. Serious injuries are mainly caused by physical contact. Relevant injuries are most common to the head and lower extremity. The implementation of fitness training had a positive influence on the frequency of injuries. In the context of further professionalisation of this sport, these findings can contribute to the prevention of injuries in inline skater hockey.

15-year regional emergency department study of youth sport and recreational injuries

Purpose: The aim of this study was to determine frequency and distribution of sports- and recreation-related injuries (SRIs) affecting children and adolescents who visited a northern tier regional medical center emergency department during a 15-year period.Material and methods: A descriptive epidemiologic design was employed to retrospectively examine age, gender, month and year of injury, location of injury, sport/recreational activity, mechanism of injury, type and severity of injury, hospital admission and length of stay. Frequency of reported injuries were compared in categories of single factors using Chi-square tests of homogeneity. The impact of risk factors – gender, age class, and sport/activity – on incidence ratios were analyzed via Poisson regression. All statistical analyses were run in R.Results: Findings heretofore unreported or inconsistent with previous emergency department (ED) studies include a peak injury occurrence of SRIs during September; a preponderance of head/neck injuries and fractures and a higher percent of admitted patients; frequent occurrence of ice hockey injuries; increased severity of injury during ages 10-14; and a trend during 2000-2014 showing increased injury rate of various types of recreational injuries. Findings consistent with previous ED studies included variable distribution of injuries by age, gender and sport/activity; increased frequency of SRIs during ages 12-15 years and during the warmer months of the year; and trends of increased frequency of SRIs affecting females, increased injury rate of closed head injuries, and decreased occurrence of bicycle injuries during the study period. Further to these findings, several suggestions are made to inform and guide local injury prevention efforts and further research. Conclusions: Our study results provide information on a region-specific occurrence and distribution of SRIs in a northern tier hospital catchment area that can be valuable to guide regional injury prevention efforts and further research to evaluate specific patterns identified and success of prevention efforts.

Injury patterns of non-fatal accidents related to ice hockey, an analysis of 7 years of admission to a Level-1 Emergency Centre in Switzerland.

This study was carried out to identify the frequency and types of injuries in adult ice hockey, in order to better understand injury patterns and identify potential areas for injury prevention. We conducted a retrospective database review of acute injuries reported in ice hockey in patients presenting to a Level-1 adult Emergency Centre in Switzerland. Patients between January 1, 2013 and December 31, 2019 and over 16 years of age were identified in our computerised patient database. Each consultation was reviewed to derive information on demographics, playing level and the features of the injury, including location, type, mechanism and consequences. Different age groups were compared, as were amateur and professional players. A statistical analysis was performed. A total of 230 patients were identified. The most common diagnoses were fracture (28.3%), contusion/abrasion (23.9%), laceration (12.6%) and concussion (10.4%). The most commonly affected body parts were the face (31.3%), the shoulder/clavicle (13.0%) and the head (12.2%). Most lesions were caused by player-player contact (37.4%), contact with the puck (24.3%) and falls (10.9%). In comparison to the younger cohorts, patients >36 years of age more frequently suffered injuries caused by falls, (p < 0.001) and were less frequently injured by player-player contact (p = 0.01813). In amateur players, significantly more injuries were caused by stick contact (OR 0, 95% CI (0.00-0.83), p = 0.02) and surgery was more rarely performed (OR 2.35, 95% CI 0.98-5.46, p = 0.04). Injuries continue to play a major role in ice hockey, especially in the face and due to player-player contact. Future investigations should focus on player-player contact and possible effective preventive measures. Players must be encouraged to employ face protection and to wear a mouth guard at all times.

Contact injuries in field hockey and the potential role for personal protective equipment

ABSTRACT Field hockey is played with sticks and a hard ball. It is fast-paced, with athletes playing together in close proximity. Athletes may be at increased risk of sustaining injuries through contact. The aim of this study was to investigate the epidemiological characteristics of contact injuries in field hockey. Data were collected during the 2017/2018 and 2018/2019 Irish Hockey League seasons. This study included two methods of data collection among male athletes: self-reported injuries and via those reported by the teams’ physiotherapists. Injuries were defined as any physical complaint sustained during field hockey, supplemented by medical attention and time-loss injuries. Only contact injuries were included for analysis. Overall, 107 contact injuries were incurred, giving rise to an injury incidence rate of 3.1/1000 h, and accounting for 33.1% of all injuries. Athletes had an absolute risk of 0.372 of sustaining a contact injury. Contusions (48.6%) were the most common type of contact injury, while injuries to the head/face (20.6%) were the most frequently reported location. Contact injuries represent an important proportion of all injuries. Rule changes to mandate the use of personal protective equipment in field hockey may assist in reducing the absolute risk and severity of contact injuries in field hockey.

Two Minutes for Roughing: A National Analysis of Ice Hockey Injuries from American Trauma Centers.

Hockey is a high-impact sport that carries a risk of injury. No national-level studies defining the burden of injury in this sport have yet been performed. This study sought to analyze patient demographics, injury types and severity, and outcomes after trauma sustained while playing hockey. Retrospective analysis of hockey-related injuries was performed using the National Trauma Data Bank (NTDB) (2007-2018). Patients were identified based on ICD-9 and -10 codes without exclusions. Demographics, clinical/injury data, and outcomes were examined using univariate analysis. Subgroup analysis was performed by patient sex. Hockey injuries (n = 306) comprised <1% of the NTDB. Median age was 15years [IQR 13-25] (range 5-71). Most patients (n = 279, 91%) were male. Lower extremities were the most frequently injured body region (n = 88, 29%). Head injuries occurred in 19% (n = 57). Facial injuries occurred in 6% (n = 17). Tooth loss was infrequent (n = 2, 1%). One (<1%) death occurred after a hockey-related brain injury. Clinical/injury data between male and female hockey players were comparable apart from a significantly higher rate of upper extremity fractures among the female cohort (22% vs 4%, P < .001). Perceptions that hockey players may frequently sustain head, face, and tooth injuries from collisions, fighting, or stick/puck impacts were not supported by this national-level study, in which lower extremity fractures were the most common injury. While hockey injury prevention equipment has primarily focused on head/face protection (eg, helmets and mouthguards), this analysis suggests increased focus on extremity protective measures is warranted.

Winter breaks: How do they affect injuries in field hockey?

The Irish Hockey League (IHL) introduced an eight-week winter break for the first time in the 2018/2019 season. We evaluated the effects of this eight-week break by comparing injury outcome metrics in the 2018/2019 (winter break) season and the 2017/2018 (no winter break) season. Prospective cohort study. Each season was split into three distinct periods: period one consisted of the first nine weeks of each season; period two, weeks ten to 18; and period three, the final weeks. For the 2018/2019 season, the winter break was implemented in period two (weeks 10 to18). Relative risk with 95 % CI and injury incidence (1000h) were compared across the two seasons. Overall, 173 and 150 injuries we incurred during the 2017/2018 (no winter break) and 2018/2019 (winter break season) seasons respectively. Compared to 2017/2018 season, total injury incidence rate, injury severity, and injury burden were all significantly higher in period three during the 2018/2019 season (i.e., following the winter break). Furthermore, injured athletes had a 2.5-times higher relative risk of sustaining an injury after the winter break. Relative risks of 15.3 and 21.4 were observed for lower back injuries and fractures after the winter break, when compared with no break. Although fewer injuries were incurred during the 2018/2019 season, significantly more injuries were sustained in the period after the implementation of the winter break when compared to the corresponding period during the 2017/2018 season.

Are Self-Reported and Parent-Reported Attention Problems and Hyperactivity Associated With Higher Rates of Concussion in Youth Ice Hockey Players?

To examine the association between self-reported and parent-reported attention problems and hyperactivity and rates of injury and concussion in Canadian youth ice hockey players. Secondary analyses of 2 prospective cohort studies. Canadian youth ice hockey teams. Ice hockey players (ages 11-17 years) were recruited by team, over 4 seasons (2011-2016). A combined 1709 players contributing 1996 player-seasons were analyzed (257 players participated in more than one season). Data were collected from preseason baseline questionnaires, including child and parent proxy forms of the Behavior Assessment System for Children, second edition. Injury and concussion rates and incidence rate ratios (IRR) comparing players with and without self-identified or parent-identified attention problems and hyperactivity, adjusted for covariates (ie, body checking policy, previous injury/concussion, and age) and a random effect for team, were estimated using multiple multilevel negative binomial regression. When analyzed continuously, rates of concussion increased with higher self-reported and parent-reported measures of attention problems [IRR SELF = 1.025; 95% confidence interval (CI): 1.011-1.040; IRR PARENT = 1.032; 95% CI: 1.008-1.057]. Self-reported hyperactivity was significantly associated with concussion (IRR = 1.021; 95% CI: 1.007-1.035), but parent-reported hyperactivity was not (IRR = 1.005; 95% CI: 0.983-1.028). A T score ≥ 60 cutoff combining attention problems and hyperactivity scores (an estimate of probable attention-deficit hyperactivity disorder) was not significantly associated with rates of injury or concussion. Attention problems and hyperactivity may place youth ice hockey players at increased risk of concussion and injury. Preseason assessments could identify players for targeted concussion education and risk reduction strategies.

Association of Training and Game Loads to Injury Risk in Junior Male Elite Ice Hockey Players: A Prospective Cohort Study.

Training and game loads are potential risk factors of injury in junior elite ice hockey, but the association of training and game loads to injuries is unknown. To investigate the association of chronic training and game loads to injury risk in junior male elite ice hockey players. Cohort study; Level of evidence, 2. In this prospective cohort study, we monitored all health problems among 159 male junior ice hockey players (mean age, 16 years; range, 15-19 years) at sports-specific high schools during the 2018-2019 school year. Players reported their health problems every week using the Oslo Sports Trauma Research Center Overuse Questionnaire on Health Problems (OSTRC-H2). The number of training sessions and games was reported for 33 weeks. We calculated the previous 2-week difference in training/game loads as well as the cumulative training/game loads of the previous 2, 3, 4, and 6 weeks and explored potential associations between training/game loads and injury risk using mixed-effects logistic regression. The players reported 133 acute injuries, 75 overuse injuries, and 162 illnesses in total, and an average of 8.8 (SD ±3.9) training sessions and 0.9 (SD ± 1.1) games per week. We found no association between the difference of the two previous weeks or the previous 2- 3- and 4-week cumulative, training or game load and acute injuries, nor the difference of the two previous weeks, or the previous 4- and 6-week cumulative, training or game load and overuse injuries (OR, ∼1.0; P > .05 in all models). In the current study of junior elite ice hockey players, there was no evidence of an association between cumulative exposure to training/game loads and injury risk.

Scoping Review of Injuries in Amateur and Professional Men's Ice Hockey: Letter to the Editor.

Scoping Review of Injuries in Amateur and Professional Men's Ice Hockey: Letter to the Editor.