Ice Hockey Injuries Research Articles

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.

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.

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.

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.

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

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.

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.

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.

World Federation of Athletic Training and Therapy World Congress 2022 Peer-Reviewed Track Abstracts, May 5–7, 2022, Winnipeg, Manitoba, Canada

World Federation of Athletic Training and Therapy World Congress 2022 Peer-Reviewed Track Abstracts, May 5–7, 2022, Winnipeg, Manitoba, Canada

Bodychecking experience and rates of injury among ice hockey players aged 15-17 years.

Background:Although high rates of injury occur in youth ice hockey, disagreements exist about the risks and benefits of permitting bodychecking. We sought to evaluate associations between experience with bodychecking and rates of injury and concussion among ice hockey players aged 15–17 years.Methods:We obtained data from a prospective cohort study of ice hockey players aged 15–17 years in Alberta who played in leagues that permitted bodychecking. We collected data over 3 seasons of play (2015/16–2017/18). We compared players based on experience with bodychecking (≤ 2 v. ≥ 3 yr), estimated using local and national bodychecking policy and region of play. We used validated methodology of ice hockey injury surveillance to identify all injuries related to ice hockey games and defined concussions according to the Consensus Statement on Concussion in Sport.Results:We included 941 players who contributed to 1168 player-seasons, with 205 players participating in more than 1 season. Compared with players with 2 years or less of bodychecking experience, those with 3 or more years of experience had higher rates of all injury (adjusted incidence rate ratio [IRR] 2.55, 95% confidence interval [CI] 1.57–4.14), injury with more than 7 days of time loss (adjusted IRR 2.65, 95% CI 1.50–4.68) and concussion (adjusted IRR 2.69, 95% CI 1.34–5.42).Interpretation:Among ice hockey players aged 15–17 years who participated in leagues permitting bodychecking, more experience with bodychecking did not protect against injury. This provides further support for removing bodychecking from youth ice hockey.

A Scoping Review of Injuries in Amateur and Professional Men's Ice Hockey.

Background:Orthopaedic injuries are common in ice hockey at all levels and can result in physical and psychological adverse effects on these athletes.Purpose:Primarily, to summarize published data on orthopaedic hockey injuries at the junior through professional level. Secondarily, to characterize the literature based on anatomic site injured, return-to-play rates, cause/mechanism of injury, time lost, and treatments used.Study Design:Scoping review; Level of evidence, 4.Methods:PubMed, EMBASE, Cochrane library, and SCOPUS were searched using the terms “hockey” and “injuries” using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and 4163 studies involving orthopaedic injuries were identified. Our inclusion criteria consisted of accessible full-text articles that evaluated orthopaedic injuries in men’s ice hockey athletes of all levels. We excluded case reports and articles evaluating women’s ice hockey injuries, as well as those evaluating nonorthopaedic injuries, such as concussions; traumatic brain injuries; and facial, dental, and vascular injuries, among others. Studies were divided based on level of play and anatomic site of injury. Level of evidence, year published, country of corresponding author, method of data collection, incidence of injury per athlete-exposure, and time lost were extracted from each article.Results:A total of 92 articles met the inclusion criteria and were performed between 1975 and 2020, with the majority published between 2015 and 2020. These were divided into 8 anatomic sites: nonanatomic-specific (37%), intra-articular hip (20.7%), shoulder (9.8%), knee (8.7%), trunk/pelvis (7.6%), spine (7.6%), foot/ankle (6.5%), and hand/wrist (2.2%). Of these studies, 71% were level 4 evidence. Data were obtained mostly via surveillance programs and searches of publicly available information (eg, injury reports, player profiles, and press releases).Conclusion:This scoping review provides men’s hockey players and physicians taking care of elite ice hockey athletes of all levels with a single source of the most current literature regarding orthopaedic injuries. Most research focused on nonanatomic-specific injuries, intra-articular hip injuries, knee injuries, and shoulder injuries, with the majority having level 4 evidence.

Association Between Preseason Fitness Level and Risk of Injury or Illness in Male Elite Ice Hockey Players: A Prospective Cohort Study.

Background:Little is known about the association between physical fitness and the risk of injury or illness in ice hockey. The least-fit players may be more prone to injury and illness.Purpose:To examine the association between preseason fitness level and injury or illness risk among elite ice hockey players during the regular season.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 133 male ice hockey players in the GET League (the premier professional league in Norway) completed 8 different exercises (40-m sprint, countermovement jump, 3000-m run, squat, bench press, chin-ups, brutal bench, and box jump) at the annual 1-day preseason testing combine. During the 2017-2018 competitive season, the players reported all health problems (acute injuries, overuse injuries, and illnesses) weekly (31 weeks) using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.Results:Overall, the players reported 191 acute injuries, 82 overuse injuries, and 132 illnesses. The least-fit tercile of players did not report more health problems (mean, 3.0; 95% CI, 2.2-3.8) compared with the most-fit (mean, 3.4; 95% CI, 2.6-4.2) or the medium-fit (mean, 2.7; 95% CI, 1.9-3.5) players. The most-fit players reported more substantial health problems (mean, 2.0; 95% CI, 1.6-2.5) compared with the medium-fit (mean, 1.3; 95% CI, 0.8 -1.8) and least-fit (mean, 1.8; 95% CI, 1.3-2.3) (P = .02) players. There was no association between low physical fitness and number of health problems when comparing the least-fit tercile of the players with the rest of the cohort (P > .05); however, there was an association between low physical fitness and greater severity of all health problems when comparing the least-fit tercile of players to the rest of the cohort after adjusting for time on ice per game, playing position, and age (P = .02).Conclusion:Low physical fitness was not associated with increased rate of injury or illness but was associated with greater severity of all health problems after adjusting for time on ice per game, playing position, and age.

Imaging of Hockey-related Injuries of the Head, Neck, and Body.

Hockey is a demanding contact sport with growing popularity around the world. This article is part of a review series in this issue of Seminars in Musculoskeletal Radiology that summarizes epidemiological research on the patterns of ice hockey injuries as well as provides pictorial examples for a radiologist's perspective. We focus on non-extremity pathologies which encompass many of the most devastating injuries of hockey, namely those involving the head, neck, face, spine, and body.

Which Sport Is More Dangerous: Ice Hockey or Field Hockey? A Review of the Head and Neck Injuries Associated With the Two Sports

Ice hockey and field hockey are contact sports with the potential for injury, especially to the head and neck regions. The purpose of this study is to estimate and compare hospital admission (injury severity) between ice hockey and field hockey of those who presented to the emergency department with head and neck injuries. The investigators designed and implemented a 20-year retrospective cohort study using the National Electronic Injury Surveillance System database. We included data related to ice hockey and field hockey injuries from January 2000 to December 2019 in this study. The primary predictor variable was sport played (ice hockey vs field hockey). Secondary predictor variables and covariates were derived from patient and injury characteristics. The primary outcome variable was hospital admission. Logistic regression was used to determine independent risk factors for the outcome variable. Our final sample was composed of 5,472 patients: 4,472 patients suffered head and neck injuries from ice hockey while the remaining 1,000 patients suffered head and neck injuries from field hockey. Players less than 18years old were associated with 2.07-fold odds of admission (P<.01). Injury to the head (odds ratio [OR]= 14.339; 95% confidence interval [CI], 2.0 to 105.1; P<.01) and neck (OR= 89.260; 95% CI, 11.2 to 712.6; P<.01) were independently associated with an increased odds of admission. Relative to contusions/abrasions, players who suffered a concussion (OR= 141.637; 95% CI, 11.5 to 1,741.5; P<.01), fracture (OR= 155.434; 95% CI, 17.0 to 1,419.2; P<.01), internal organ injury (OR= 186.450; 95% CI, 15.5 to 2,236.8; P<.01), or hematoma (OR= 23.046; 95% CI, 1.2 to 442.5; P<.05) were all independently associated with an increased odds of admission. Ice hockey was not an independent risk factor for admission relative to field hockey. The findings of this study suggest that ice hockey was more associated with injuries to the head and neck as well as with concussions and internal organ injury compared to field hockey. However, ice hockey was not associated with increased risk of hospitalization relative to field hockey.