Ice Hockey (Care of the Young Athlete)

Dehydration

There is a common misconception that
athletes who play in cold weather do not need to drink as much as those
playing in warm weather. In fact, hockey players training in cold
environments wear more clothing and may be unaware they are losing body
moisture. Dehydrated athletes often perform poorly in multiple game
situations like tournaments and during the last period of a game.

Hydration should take place before, during,
and after games and practices. In general, athletes should drink 5 to 8
ounces of water or an appropriate sports drink every 20 minutes, even if
they do not feel thirsty. Players not responding well, unable to drink, or
with difficulty breathing may need emergency medical attention.

Exercise-induced asthma

• Exercise-induced asthma is prevalent
  in hockey players who are prone to asthma because hockey is played
  in cold weather under dry conditions. Skaters should have a personal
  asthma action plan. Asthmatic skaters can prevent episodes by taking
  their medicines and using an inhaler before practices or games.
  Inhalers and spacers should always be on hand during activity.
  Skaters should stop skating and see a doctor if they have difficulty
  breathing while skating.

Frostbite

Cold weather, wet clothing, and
tight-fitting skates can lead to poor circulation and frostbite. Early signs
of frostbite are pale or white skin with numbness and tingling of the
exposed body part. It is important to dress in layers and wear wicking,
fast-drying wool or polypropylene underwear and socks. Cotton clothing is
not warm when wet and can contribute to frostbite and hypothermia by
lowering the body temperature. Treat frostbite by increasing circulation and
warming cold body parts in a heated room or under the clothes. Change wet
clothing often.

Head injuries

Concussions in hockey most often occur from
a blow to the head, from falls, or from being checked into the boards. A
concussion is any injury to the brain that disrupts normal brain function on
a temporary or permanent basis.

The signs and symptoms of a concussion range
from subtle to obvious and usually happen right after the injury but may
take hours to days to show up. Athletes who have had concussions may report
feeling normal before their brain has fully recovered. With most
concussions, the player is not knocked out or
unconscious.

Prematurely returning to play after a
concussion can lead to another concussion or even death. An athlete with a
history of concussion may be more susceptible to another injury than an
athlete with no history of concussion.

All concussions are serious, and all athletes with suspected
concussions should not return to play until they see a doctor.

Youth hockey programs in the United States
and Canada have active head injury prevention programs for athletes and
coaches. Safe play and properly fitting helmets can prevent concussions, as
does striking the boards at an angle with the head up when a collision
can’t be avoided.

Arm and leg injuries

Injuries of the extremities should be
treated with rest, ice, compression, and elevation (RICE). Nonsteroidal
anti-inflammatory drugs (NSAIDs) may help reduce pain and swelling, but
should be taken with food. Injured athletes should see their doctor if they
have pain while playing.

• Upper extremity injuries of
  the shoulder, arm, and wrist occur during falls or from
  being checked into the boards. Shoulder dislocations are very
  painful until put back into place. Persistent wrist or arm pain
  after a fall can signify a broken bone (even if there is no visible
  swelling or deformity) and should be iced and immobilized until it
  can be treated by a doctor.

• Groin strains are
  pulled or torn muscles or tendons of the inner thigh. Hockey players
  and goalies doing forced push offs or slides on skates may get this
  injury. Treatments that may help are ice, NSAIDs, thigh wraps,
  physical therapy, and modification of activity. Groin strains can be
  prevented by warming up properly and doing muscle stretching as a
  part of team practices and games.

• Knee injuries are more
  common in hockey than ankle injuries because the ankle and Achilles
  tendon are protected by a stiff boot. Knee injuries happen when the
  knee is forced or twisted to the side or back. If a ligament or
  cartilage is torn, a pop may be felt or heard, followed by visible
  swelling around the knee.

• Overuse injuries, such
  as Osgood-Schlatter disease (irritation of the growth plate causing
  a painful bony bump below the knee), occur in 10- to 15-year-olds
  who play active sports with running, jumping, or skating. In hockey,
  a combination of off-ice training, overtraining, and frequent
  practices and games may lead to Osgood-Schlatter, thus limiting or
  changing activity may help.

Eye injuries

In the past, blows from hockey sticks and
flying pucks caused many eye injuries. Now helmets with face masks have
decreased the number of eye injuries, but they still can occur. Any injury
that affects vision or is associated with swelling or blood inside the eye
should be evaluated by an ophthalmologist. The AAP recommends that children
involved in organized sports wear appropriate protective eyewear.