Common Hockey Injuries
Hockey is an exciting sport that has been engrained in our Canadian culture for many decades. Hockey demands speed, agility, and physical strength, but it also carries a risk of injuries due to its intense nature. Some injuries, such as AC joint separations and high ankle sprains, are common in due to mechanisms of trauma that can be specific to hockey. Other injuries, such as concussions and MCL sprains are seen in hockey but also in other contact sports. From sprains and strains, contusions and fractures, understanding these common injuries is important for players, coaches, and parents alike.
This page delves into the most common hockey injuries, describing their symptoms, mechanism, treatment and prevention. Whether you’re a seasoned athlete or just starting out, knowledge is key to maintaining health and safety in this fast-paced sport.
Knee Hockey Injuries
Knee Anterior Cruciate Ligament (ACL) Tear
The ACL is a very important ligament deep inside the knee that is crucial for providing knee stability in sports or physical activities that involve twisting or pivoting motions. An ACL tear occurs when there is a sudden stop or change of direction especially with a pivot or twist; also occurs from a direct impact that hyperextends the knee.
Symptoms Include:
Rapid swelling, pain, “pop” at time of injury, difficulty weight-bearing and giving-way. Besides acute injury management, treatment for ACL tears includes intensive physiotherapy, bracing, neuromuscular retraining and often surgical reconstruction.
Knee Meniscus Tear
The meniscus is a rubbery layer between the knee bones made of cartilage that acts as a shock absorber for the knee joint. Meniscus tears commonly occur from injuries that involve deep squatting, twisting or sometimes direct impact, and can often occur at the same time as knee ligament injuries.
Symptoms Include:
Pain, swelling, loss of motion and sometimes mechanical symptoms such as catching or locking. Besides acute injury management, treatment for meniscus tears includes physiotherapy, manual therapy, strengthening and may requires surgery.
Knee MCL (Medial Ligament) Sprain
The MCL is a ligament at the medial or inner side of the knee. An MCL sprain involves tearing or stretching that typically occurs from an impact to the outer (lateral) side of the knee which forces the knee to buckle inward (medially).
Symptoms Include:
Pain at the medial side of the knee, local swelling and feeling “loose” if severely torn. Besides acute injury management, treatment includes physiotherapy and bracing, and usually does not require surgery.
Shoulder & Upper Extremity Hockey Injuries
Shoulder Dislocations
Occurs when the arm bone of the shoulder joint (the “ball” part of the joint called the humeral head) completely displaces out of the shoulder socket (glenoid fossa). Caused by a traumatic fall or sudden strain on the shoulder that forces the shoulder into an extreme position of abduction (arm moved to the side), external rotation and overhead position. Common in contact sports such as hockey and football.
Symptoms Include:
Severe pain, feeling like shoulder is “out of joint”, visible deformity of the shoulder, and decreased range of motion. Besides acute injury management, treatment includes putting the shoulder back into place (“reducing” the dislocation) as soon as safely possible followed by a period of immobilization in a sling; this is followed by physiotherapy and a shoulder strengthening program; sometimes requires surgery to prevent recurrent instability.
AC Joint Separation (Shoulder Separation)
Very different injury from a shoulder dislocation. Typically caused by a traumatic blow to the tip of the shoulder such as a hockey player getting hit hard shoulder first into the boards. Involves the spraining or tearing of the ligaments that connect the collarbone to the acromion bone (part of the shoulder blade).
Symptoms Include:
Pain, swelling, a visible bump or deformity at the top of the shoulder and a lack of range of motion. Besides acute injury management, treatment includes using a sling initially, then physiotherapy to regain range of motion and strength. Occasionally a brace is used, and in severe rare cases surgery is needed.
Clavicle Fracture (Broken Collarbone)
A broken collarbone can be a very painful injury and is common in hockey, especially in adolescent players. Typically caused by a blow to the outside part of the shoulder, hockey players sustain clavicle fractures from bodychecks or other trauma to the shoulder such as falling into the boards.
Symptoms Include:
Severe pain, as well as swelling and sometimes a visible bump or deformity in the are of the collarbone. Besides typical Acute injury management, treatment includes being assessed by a physician (commonly in the ER) and with X-Rays, followed by immobilization in a sling, pain management, and then physiotherapy once the injury starts to heal. Sometimes, in severe cases, surgery is needed to get the fracture to heal properly.
Shoulder Labral Tear
The labrum is the rim of cartilage (rubbery shock absorber) around the shoulder socket. The labrum can get injured or torn from trauma such as a shoulder dislocation, direct impact, severe twist, or sudden forceful throwing or other overhead motion. Shoulder labral tears may also occur from overuse in sports such as baseball.
Symptoms Include:
Pain, decreased range of motion, instability and mechanical sensations (clicking, catching, snapping, etc.). Besides acute injury management, treatment includes physiotherapy, other types of therapy, special injections and sometimes requires surgery.
Elbow Bursitis
Inflammation and swelling of the bursa (fluid-filled sac that normally decreases friction) at the back (posterior) of the elbow. Typically caused by repetitive contact or acute trauma, especially in hockey when you fall elbow-first to the ice.
Symptoms Include:
Swelling (looks like a jiggly ball at the back of the elbow) that is often not painful, but can be sensitive to the touch. Treatment includes diligent icing and compression, avoiding any contact at all to the posterior elbow and anti-inflammatory medications or creams. Sometimes draining the fluid is needed but only rarely.
Wrist Sprain
Overstretching or tearing of the ligaments that stabilize the bones in the wrist. Typically caused by trauma such as falling onto your outstretched hand, sudden twists or impacts to the wrist.
Symptoms Include:
Pain, swelling and decreased range of motion. Besides acute injury management, treatment includes physiotherapy and bracing.
Hip & Groin Hockey Injuries
Hip Flexor Strain
Torn or “pulled” muscle/tendon at the front of the hip. Typically caused by suddenly flexing the hip (raising thigh in front of you), especially against resistance; sometimes caused by a fall or sudden twist. Common in sports such as hockey, football and soccer.
Symptoms Include:
Pain at the front of the hip or in the groin, pain and weakness when flexing your hip, and sometimes swelling. Besides acute injury management, treatment includes physiotherapy, addressing biomechanics such as poor core stability, other types of therapy (e.g., chiropractic, massage therapy), compression shorts, and taping or strapping.
Hip Labral Tear
The labrum is the rim of cartilage (rubbery shock absorber) around the hip socket. The labrum can get injured or torn, typically caused by twist or other hip trauma. Some people are predisposed to labral tears from hip structural abnormalities.
Symptoms Include:
Pain, decreased range of motion, and mechanical sensations (clicking, catching, snapping, etc.). Besides acute injury management, treatment includes physiotherapy, other types of therapy, special injections and sometimes requires surgery.
Femeroacetabular Impingement
Pinching between the bones in the hip joint, usually related to structural or anatomic abnormalities. Predisposes to hip labral tears and possibly osteoarthritis later in life. More common in some sports such as hockey.
Symptoms Include:
Pain, decreased range of motions, stiffness and sometimes mechanical sensations (e.g., clicking, popping, catching). Treatment initially includes physiotherapy, core and gluteal strengthening program, manual therapy, anti-inflammatory medication, but may require surgery to correct the underlying structural problem.
Groin Strain
Common in hockey, a groin strain is caused by overstretching or tearing of the muscles of the inner thigh. The skating motion in hockey involves rapid and sudden contraction and stretching of the groin muscles which can cause them to become injured or overused. Sudden twisting motions or changes in direction can also cause groin strains.
Symptoms Include:
Pain in the groin area, especially in the push-off and recovery phases of the skating stride. Besides acute injury management, treatment includes physiotherapy, addressing biomechanics such as poor core stability, other types of therapy (e.g., chiropractic, massage therapy), compression shorts, and taping or strapping.
Ankle & Foot Hockey Injuries
High Ankle Sprain (Syndesmotic Sprain)
Special type of ankle sprain that can be more difficult and troublesome. This sprain occurs a bit higher up in the ankle than the typical ankle sprain, involving the ligaments that hold the leg bones (tibia and fibula) together. Typically occurs from a forceful twist of the ankle and foot into external rotation and dorsiflexion, and is the most common ankle sprain in hockey players.
Symptoms Include:
Pain and swelling that is just above the ankle joint, feeling unstable and difficulty weight-bearing. Besides acute injury management, treatment often includes a period of immobilization in a boot-cast, followed by physiotherapy to regain strength, range of motion and balance sense. Surgery is needed in severe cases.
Ankle Bursitis
Inflammation and swelling in a bursa (fluid-filled sac) typically located at the medial (inner), lateral (outer) and posterior (back) parts of the ankle. Typically caused by direct contact or pressure on the bursa (e.g., tight skates or shoes), and can be related to acute trauma or chronic overuse. Common in hockey players and figure skaters.
Symptoms Include:
Local swelling (like a small ball of swelling) and pain that is typically worse on direct contact to the area. Besides acute injury management, treatment includes footwear or skate modifications, physiotherapy, orthotics, anti-inflammatory creams and medications, compression, fixing underlying biomechanical issues and sometimes require specialized injections.
Back & Spine Hockey injuries
Lower Back Muscle Strain or Sprain
A “pull” or tear of the muscles in your lower back area. Typically caused in hockey by body checks, collisions, awkward falls or sudden movements.
Symptoms Include:
Pain, stiffness and decreased range of motion. Besides acute injury management, treatment includes physiotherapy, exercises to improve core strength, exercise to improve postural support, chiropractic and massage therapy.
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Lower Back Herniated Disc (Slipped Disc)
The disc is a rubbery fluid-filled shock absorber between the bones (vertebrae) of the spine. A herniated disc occurs when the disc lining (capsule) tears allowing the thick disc fluid to squeeze out. Typically caused in hockey by body checks, collisions, awkward falls or sudden movements, especially when the mechanism involves leaning forward. May be associated with “sciatica”.
Symptoms Include:
Pain (especially bending forward and sitting), stiffness and lack of motion. Besides acute injury management, treatment includes physiotherapy, exercises to improve core strength, exercise to improve postural support, chiropractic and massage therapy.
Head & Neck Hockey Injuries
Whiplash
Neck injury that involves a rapid back-and-forth or rotational movement of the head, commonly seen in motor vehicle accidents but also in contact sports such as hockey. Results in diffuse pulling or straining of the soft tissue of the neck (muscles, ligaments and tendons).
Symptoms Include:
Symptoms include neck pain, stiffness and decreased range of motion. Besides acute injury management, treatment includes physiotherapy, exercises to improve postural support and stability, massage therapy and chiropractic.
Concussion
A concussion is a traumatic injury to your brain that results in abnormal brain function and related symptoms. Typically, in hockey, a concussion results from either a direct blow to the head (such as an elbow or shoulder contacting your head from a bodycheck), or from a blow to your body that results in a twisting motion to her head.
Typical concussion symptoms can include headache, visual changes, confusion, nausea, light and sound sensitivity, ringing in your ears, fatigue, feeling “out of it”, mood changes, sleep problems, dizziness, as well as other symptoms. Concussions can have devastating complications if not treated properly.
Concussion management usually involves being assessed by a medical physician, followed by treatment that may include physiotherapy, vision therapy, vision implements, neck treatment (physio, chiropractic, massage), and cognitive and mood therapy. Appropriate cognitive rest for your brain, as well as appropriate physical rest from exercise are important. A gradual progressive return to school, work and exercise is done under appropriate medical supervision.
Neck Herniated Disc (Slipped Disc)
The disc is a rubbery fluid-filled shock absorber between the bones (vertebrae) of the spine. A herniated disc occurs when the disc lining (capsule) tears allowing the thick disc fluid to squeeze out. Typically caused in the neck by bending or twisting injury, especially if sudden or traumatic. May be associated with a pinched nerve or cervical radiculopathy.
Symptoms Include:
Pain, stiffness and lack of motion. Besides acute injury management, treatment includes physiotherapy, exercises to improve postural stability and support, massage therapy and chiropractic.
Cervical Muscle Strain
A “pull” or tear of the muscles that support your neck. Typically caused by sudden movements and other trauma.
Symptoms Include:
Pain, stiffness and decreased range of motion. Besides acute injury management, treatment includes physiotherapy, exercises to improve postural stability and support, massage therapy and chiropractic.
Players are advised to wear appropriate protective gear, including helmets, pads, and mouthguards, to minimize the risk of injuries. Regular conditioning, strength training, and proper technique can also contribute to injury prevention.
If injuries occur, seeking prompt medical attention is crucial for appropriate diagnosis and treatment.
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