THE SPORTS DOCTOR

KEEPING HOCKEY INJURIES ON ICE

By Dr. Michael Gross

Ice hockey is one of the most popular winter sports, and participation on all levels and by both sexes continues to grow. This finesse sport requires speed, power and teamwork. The unique nature of the game of hockey results in specific injuries, all of them should be recognized and treated properly if they occur. However, the best treatment is often prevention, and many of them can be avoided. Therefore, a working knowledge of injury risk, sport-specific conditioning and injury prevention strategies are essential for athletes, coaches and parents.

The chances of sustaining any injury are dependent on many variables. These include the level of participation, player position, game versus practice exposure, protective equipment, violent behavior and personal susceptibility due to pre-existing injury and style of play. Injuries occur much more frequently in games than in practice, and the risk of injury in a game increases with each higher level of participation.

In an effort to reduce hockey injuries, many studies have been done in order to better understand the risks and to come up with preventative measures. Rule changes, enforcement of existing rules and protective equipment standards are attempts to improve the safety of the game. Attention has also been directed toward education of coaches, players, parents and officials. Potentially dangerous actions such as checking from behind and the use of the helmet or the stick as a weapon must be eliminated from the game.

Before taking to the ice to play hockey, two things are necessary: participants must have mastered basic skating skills (such as skating forward and backward) and they should have the necessary equipment to prevent injury. Ice hockey requires a lot of protective equipment and it must fit properly to effectively protect the player. It’s essential to wear appropriate ice hockey safety equipment, including helmets, pads and protective gear, to reduce both the risk and severity of injury. Even so, a hockey player may still sustain an injury on the ice.

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Additional tips for preventing injuries include:

◦ Obtaining a preseason screening examination by an experienced athletic trainer or physician to identify existing injuries and uncover deficiencies.

◦Participating in a sports-specific conditioning program to avoid physical overload.

◦ Obtaining high-quality equipment that fits well and is not damaged, worn-out or undersized.

◦ Enforcement of existing rules. Players and coaches

should always demonstrate sportsmanship and mutual respect for their opponents and the officials.

Overuse injuries are cumulative aches and pains that occur over time and can often be prevented with appropriate training and rest. Traumatic injuries are often accidents that occur suddenly and can’t be avoided but require immediate first aid. When an injury occurs, prompt evaluation and treatment by an experienced sports physician are the keys to safe and efficient return to the ice. Following treatment, a post-injury evaluation ensures successful healing and guides safe return to play. The intrinsic hazards of playing hockey cannot be eliminated, but the risk of injury can be substantially reduced. Fortunately, the overwhelming majority of hockey injuries are mild. Most injuries involve the soft tissues: bruises (contusions), muscle pulls (strains), ligament tears (sprains) and cuts (lacerations).

Athletes may suffer a concussion without getting “knocked out” (loss of consciousness). Players, coaches and parents should be aware of the typical symptoms and signs, including “not feeling right” and a headache. Any player experiencing symptoms or displaying signs of a concussion should not return to play and should be medically evaluated.

SHOULDER INJURIES

The most common shoulder injuries in hockey are a shoulder separation and a broken collarbone. These injuries occur from direct contact of the shoulder with another player, the boards or the ice. Treatment can include a sling, rest and in serious cases surgery.

The point of the elbow is a frequent area of contact, which can result in the development of bursitis. Thick and scarred bursal tissue – which feels like bone chips, but isn’t – can be a source of recurrent inflammation.

along with Congressman Josh Gottheimer were also invited. though, and has been on this journey ever since. The fresco, which was commissioned “I knew I wanted to do this,” Grimaldi said. “I had by the Grewal family and painted by an eye-opening moment at Ithaca where I realized I famed artist Cortney Wall, pays hom-wanted to develop age to Grewal and the selflessness he up-and-coming artdisplayed throughout his life. It features ists and write their his words, “Dream big, work hard, any-songs. I was in the thing is possible.”middle school band and played jazz “The mural was my idea,” Grewal-Virk band in high school. said. “I wanted to do something for him I started writing because he spent so much time at Hackwhen I was about 12 ensack. He was there sometimes for a as far as songs go. It month because of his issues.” wasn’t until Ithaca that I dove into The mural serves not only as a reminder making pop music.” of what Grewal meant to the community but also what Grewal-Virk has acGrimaldi said the complished, stepping out of her father’s end goal is get that shadow to create her own legacy. While one big song, turn there are times when she simply looks it into five or 10 like a suburban mom enjoying a quiet big songs and then cup of coffee, she continues to prove ride the momentum that success will bring. He loves that she is so much more. working with young artists who have yet to have their big breakthrough, helping them lay the foundation for what can be a successful career. “There are so many talented people who don’t get the opportunity to do this,” said Grimaldi, who added that someday he would also like to teach. “I had no family in the business when I started. I kind of want to be the person I wish I had when I got into the music world. That, mixed with writing for the major players, is a cool balance. I want to write more hits and grow until this [his work] is super sustainable. This is not an easy thing at all.” It may not be “an easy thing” overall but right now everything for Grimaldi appears to be smooth like butter.

The best prevention method is wearing elbow pads that fit well and have an opening for the elbow, soft padding and a plastic outer shell. WRIST INJURIES A fall on the outstretched arm or contact with the boards that forces the wrist up or down may cause a fracture. Players should try bracing themselves against the boards using their forearms instead of using their

hands. Hockey players are at risk for low-back injuries due to the flexed (forward) posture of skating and the frequent hyperextension (backward) stress. Low-back pain and/ or a pulled muscle are the most common injuries. Stretching of the hip flexors along with strengthening of the back and abdominal muscles will help avoid these injuries. Shivi Grewal at the unveiling of his father’s mural in June 2021.

HIP INJURIES Probably my favorite element of my test E450 All-Terrain was how well it handled NVH. Equipped with an The hip joint and groin muscles are susceptible to injury due to the mechanics of the skating stride. Some inline six-cylinder, turbocharged engine that produces about 360 horsepower and nearly 370 lb.-ft. of torque, you wouldn’t know it. That’s because the engine is silky of the most common soft tissue injuries in hockey smooth. While you will hear the motor spin up if you players include a groin strain and a hip flexor strain. push it, the sound is not overly intrusive into the cabin. Off-season strengthening and dedicated stretching before and after practice are important to prevent these Helping this was the fact my test vehicle had the Acousinjuries. In addition, a direct blow to the outside of tic Comfort Package, meaning, it boasted additional the hip can cause a hip pointer or trochanteric bursi sound deadening insulation as well as thicker glass to tis. Hockey pants with reinforced padding over these reduce noise. It really pays off as at speed it sounds as vulnerable areas may help protect them. though you’re traveling at 20-30 mph when in reality you’re doing three times that. You won’t stress your KNEE INJURIES vocal cords in this E, that’s for sure. Once again, this is a trait found in the flagship model. All in all, I was extremely impressed during my time with the All-Terrain. Not only did it deliver with space, comfort and excellent control of NVH, it also did the unexpected. Power was more than adequate, which says something coming from someone who regularly drives autos with more than 600 horsepower, and when in Sport mode you can have a giggle or two. During an Everglades excursion we had to slow down to travel for about five

miles on dirt roads. In most vehicles this isn’t exactly a brilliant situation since you can damage the underside of your car. But with the All-Terrain, the button to raise the vehicle’s ride height came in handy. Phew!"It is so hard to keep them reading. Reading has become a challenge Add in the extra utility provided by having a long roof and in the modern age. There are so many places you can go to not read. It

I quickly found myself examining this E450 even closer. Frankly, I am considering adding one to my fleet. has fallen out of favor and because they [students] have access to so much technology, reading pales by comparison. So film is a great Why, you ask? Well, it’s this simple: It can do anything and it flies under the radar. For me, that’s as close to perfect as platform.” it gets. Make mine black on black, fully loaded and optioned with the 19-inch AMG wheels, please.

The medial collateral ligament is most susceptible to Dr. Michael Gross is the founder and director of a sprain because of the leg position – pushing off the Active Orthopedic and Sports Medicine. He is the inside edge of the skate blade – and contact to the chief of sports medicine at Hackensack/Meridian outside of the knee. Anterior cruciate ligament (ACL) University Medical Center. Dr. Gross has written disruption and meniscus tears (torn cartilage) can also numerous articles and book chapters on sports occur but are less common in hockey than in other injuries. He has taken care of some of Bergen sports such as football, soccer and basketball. County’s finest athletes, from weekend warriors

to professional athletes. Dr. Gross can be reached

The mechanics of the skating stride makes the hip by email at drgross@activeorthopedic.com.and groin muscles susceptible to injury. Some of the most common soft tissue injuries in hockey players include a groin pull and a hip flexor pull. A severe strain can be a nagging injury that limits performance throughout the season. A direct blow to the outside of the hip can cause a bruise (contusion) of the iliac crest (hip pointer) or trochanter (trochanteric bursitis). Avoiding injuries in hockey has to do with properly fitted equipment, making smart plays, following the rules and a lot of luck because hockey is inherently risky. Understanding how the injuries occur, recognizing them when they occur and seeking the best treatment will help you enjoy the game at whatever level you are playing. Loccke said one of her inspirations for using film in the classroom is to provide her underclassmen with a reward. Her students are always asking her if there is a film that corresponds with the book so she uses the film as a payoff once the students have finished reading the novel. She shows as many as three movies a year to her underclassmen. Time constraints – her classes are 40 minutes long – usually prevent her from showing more. “A lot of what they read they read on their own [and not in class],” Loccke said. “The movie is a great way to provide a communal feeling and it provides something they can share together. You can have a discussion and share it and the movie is something we all experience at the same time so it is very unifying.” Such was the case when Loccke addressed the largest classroom of her career on TCM.