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Safety Tips 

To help your child avoid injury while playing ice hockey, follow these safety tips from the American Academy of Pediatrics, the American Academy of Orthopaedic Surgeons, USA Hockey, and other sports and health organizations. (Note: Adults should follow this guidance, too.)

• Before your child starts a training program or plays competitive ice hockey, take him or her to the doctor for a physical exam. The doctor can help assess any special injury risks your child may have.
• Make sure your child wears all the required safety gear every time he or she plays and practices. All youth, high school, and college ice hockey leagues require players to wear the following gear: a helmet with foam lining and full face mask; a mouth guard; pads for the shoulders, knees, elbows, and shins; and gloves. Some leagues recommend neck guards. All equipment should be certified by the HECC (Hockey Equipment Certification Council), the CSA (Canadian Standards Association), or the ASTM (American Society for Testing and Materials).
• Make sure your child's equipment fits properly. The helmet should fit snugly with a strap that gently cradles the chin when it's fastened.
• Insist that your child warm up and stretch before playing. Exercises that strengthen the neck and increase flexibility may help prevent injuries.
• Teach your child not to play through pain. If your child gets injured, see your doctor. Follow all the doctor's orders for recovery, and get the doctor's OK before your child returns to play.
• Make sure first aid is available at all games and practices.
• Talk to and watch your child's coach. Coaches should enforce all the rules of the game, encourage safe play, and understand the special injury risks that young players face. Coaches should limit body checking (some youth leagues prohibit it). Checking from behind should never be allowed. This move, which is an illegal play, has been associated with a high rate of injury.
• Teach your child to avoid head contact with the boards or other players. Serious head and neck injuries can occur from this kind of contact.
• Above all, keep ice hockey fun. Putting too much focus on winning can make your child push too hard and risk injury.

Who Is Affected?

More than 500,000 amateur athletes in the U.S. play ice hockey, a game that carries significant risk of injury for players of all ages. Ice hockey is the second leading cause of winter sports injury among children.

The most common types of injuries are sprains and contusions (bruises) to the thigh, knee, and ankle. Lower extremity injuries account for about one-third of the injuries in ice hockey. A high rate of facial lacerations and head injuries (including concussions) is also associated with this sport. Cases of paralysis and death resulting from head and spinal cord injuries have been reported, but these catastrophic injuries are rare.

Body checking is the most commonly reported cause of injury and is associated with the more severe injuries. Many of the players injured by body checking collide with goal posts and the boards. Contact between opponents, usually in the form of body checking, is associated with 46 percent of all minor injuries and 75 percent of major injuries.

Safety gear and changes in the rules of play have significantly reduced both the number and severity of injuries related to ice hockey. Many head injuries have been prevented by the use of helmets and the elimination of body checking. A reduction in eye injuries has occurred through the addition of full face guards on helmets and the stricter enforcement of penalties for "high sticking." Neck guards have reduced the number of both soft tissue and spinal injuries. Currently, most youth leagues and some high school leagues require these safety measures. Other leagues recommend these measures, but are lax on enforcement. A much greater reduction in injuries could be achieved if all amateur–and professional–leagues mandated these safety practices.

Safety Resources 

American Academy of Orthopaedic Surgeons

Through the public information link on the AAOS home page (www.aaos.org), you can access fact sheets on injury prevention for many popular sports, including hockey. You can reach AAOS at 1-800-346-2267.

National Athletic Trainers Association

On NATA's home page (www.nata.org), you'll find a link to sports injury information, including statistics and prevention tips. NATA's phone number is 214-637-6282.

NYSSF (www.nyssf.org) has a variety of fact sheets on sports safety available for purchase. Call NYSSF at 617-277-1171.

National Pediatric Trauma Registry

The NPTR, which studies the causes, circumstances, and outcomes of injuries to children, has a fact sheet on sports injuries on snow and ice (www.nemc.org/rehab/factshee.htm) that includes information about ice hockey.

USA Hockey

USA Hockey's "Heads Up Hockey" brochure gives hockey players tips on preventing spinal cord injuries. For a copy, call 1-800-495-USAH. A program kit with posters, videos, a program guide for coaches, and player materials is available by calling 1-800-667-0781.

References 

The data and safety tips in this fact sheet were obtained from the following sources:

Caine D, Caine C, Lindner K, editors. Epidemiology of Sports Injuries. Champaign, IL: Human Kinetics, 1996:247-267.

McCabe M, Roose B. Hockey neck guards made mandatory. Detroit Free Press 1999 May 13. 

National Foundation of State High School Associations. Focus on the rules: Ice hockey. 

National Pediatric Trauma Registry. Sports injuries on snow and ice. NPTR fact sheet #3. October 1993.

USA Hockey. Heads Up Hockey: Safer, smarter, better. Colorado Springs: USA Hockey.