In the Penalty Box with a Physical Therapist

In a high-impact sport like hockey, players risk injury at any given moment. Injuries occur very quickly and can range from mild to serious. Most hockey injuries occur at the shoulder joint, including clavicle fractures, labral tears, acromioclavicular joint sprain/separation, and shoulder dislocations due to checking, blocking, and hitting into boards. Others include overuse injuries, concussions, ankle fractures, knee joint ligamentous damage, hip capsular damage and groin strains, lower back contusions and fractures, and thigh/lower leg muscle strains. Caused by high impact collisions at fast speeds against other players, rink boards, goal posts, hockey sticks, flying pucks, and falls onto the ice, these injuries are common amongst players of all ages and skill levels, from youth to adult and recreational to professional. 

Injury Awareness and Prevention
The most common question I’m asked as a Physical Therapist (“PT") is, “What can I do to make sure an injury does not happen?”One of the most important things we can do to promote player safety is ensuring that athletic gear—helmets, mouthpieces, shoulder pads, shin pads, and skates, just to name a few—is specifically fitted and customized for the athlete’s body type. In addition, it’s essential that athletes work with proficient coaches, athletic staff, and trainers from a young age in order to promote understanding and execution of skills, including how to handle bodily impacts. 

Pre-season screenings for athletes are becoming more prevalent, with some leagues even making them mandatory. These screenings, often performed by PTs, entail assessing multiple functional movement patterns for weaknesses and muscle imbalances that can pose risk of injury. PTs analyze mechanics in dynamic sport-specific activities such as squatting, lunging, jumping, hopping, and running. Players are evaluated for areas lacking the strength, flexibility, motor control, and proper motor recruitment patterns required for high speed and plyometric activities on the ice. Following screening and assessment, players can participate in an individualized hockey-specific strength and conditioning program with a PT or athletic trainer. Participation in this type of program has been clinically shown to reduce injuries. Athletes should always remember to warm up and stretch prior to games and practices, as well as to perform a cool down post-activity. Drinking water and other fluids are also essential to maintaining proper hydration and avoiding additional problems during play.

Athletes who have suffered an injury on or off the ice should consult a medical professional. In the state of New Jersey, patients can take advantage of Direct Access—a program in which patients can be evaluated and treated by a PT without a prescription from a doctor. This facilitates quicker treatments and an earlier return to play. By beginning their rehab with a PT, athletes can begin decreasing discomfort, reducing swelling, promoting circulation, and facilitating soft tissue healing immediately. PTs can guide athletes through modality applications (ice, heat, electrical stimulation), and gentle exercise to help them return to a more stable condition. Athletes will only be able to return to play after a Physical Therapist and Medical Doctor/Orthopedist have cleared them. 

Hockey is a sport that involves immense skill, physicality, speed, and impact. Players themselves can vary in height, size, and speed, thus making hockey one of the most versatile sports. However, players, coaches, and parents must be aware that the high speeds and physical nature of the sport can cause a wide range of injuries, regardless of the player’s position, size, or skill level. Taking preventative measures to reduce the risk of injury, including pre-season screening, hockey-specific strengthening programs, and seeking medical treatment for injuries sustained, is critical to promoting success and safety on the ice for players of all ages.