Descriptive epidemiology of collegiate men's ice hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004

Abstract

Objective: To review 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for men's ice hockey and to identify potential areas for injury prevention initiatives.

Background: The NCAA began injury surveillance of men's ice hockey during the 1988-1989 academic year. These data represent all 3 NCAA divisions; the last Division II championship, however, was held during the 1998-1999 academic year.

Main results: The rate of injury was more than 8 times higher in games than in practices (16.27 versus 1.96 injuries per 1000 athlete-exposures [A-Es], rate ratio = 8.3, 95% confidence interval [CI] = 7.9, 8.8). A significant average annual increase of 1.3% in game injury rates occurred over the sample period (P = .05), but practice rates stayed static (P = .77). Preseason practice injury rates were more than twice as high as regular-season practice rates (5.05 versus 1.94 injuries per 1000 A-Es, rate ratio = 2.6, 95% CI = 2.4, 2.9, P < .01). The majority of game and practice injuries occurred to the lower extremity. Knee internal derangement (13.5%) was the most common lower extremity injury reported for games, whereas pelvis and hip muscle strains (13.1%) were the most common injury reported during practices. Player-to-player contact was the most frequent game mechanism of injury (50.0%). The majority of injuries occurred between the blue line and face-off circles (28.0%), in the corner (23.5%), and in the neutral zone (21.4%).

Recommendations: Preventive efforts should focus on strategies that limit player-to-player contact in the neutral zone and at the top of the offensive and defensive zones. In addition, clinicians and researchers should identify risk factors and interventions for muscle strains at the pelvis and hip region.

Figure 1. Injury rates and 95% confidence intervals per 1000 athlete-exposures by games, practices, and academic year, men's ice hockey, 1988–1989 through 2003–2004 (n = 4673 game and 1966 practice injuries). Game time trend, P = .05. Average annual change in game injury rate = 1.3% (95% confidence interval = 0.0, 2.5). Practice time trend, P = .77. Average annual change in practice injury rate = −0.2 (95% confidence interval = −1.6, 1.2)

Figure 2. Game and practice injury mechanisms, all injuries, men's ice hockey, 1988–1989 through 2003–2004 (n = 4673 game and 1966 practice injuries). “Other contact” refers to contact with items such as pucks, boards, or the ice. Injury mechanism was unavailable for 1% of game injuries and 2% of practice injuries

Figure 3. Sport-specific game injury mechanisms, men's ice hockey, 1988–1989 through 2003–2004 (n = 4673). Injury mechanism was not available for all injuries

Figure 4. Game concussion injury mechanisms, men's ice hockey, 1988–1989 through 2003–2004 (n = 422)

Figure 5. Game injuries by player position, weighted percentages, men's ice hockey, 1988–1989 through 2003–2004 (weighted n = 1967). Percentages of injuries are weighted according to the following distribution of players on the ice during typical play: 3 forwards, 2 defense players, and 1 goalie

Figure 6. Game time of injury, men's ice hockey, 1988–1989 through 2003–2004 (n = 4673)

Figure 7. Location at time of game injury, men's ice hockey, 1991–1992 through 2003–2004 (n = 3929). Data on location were not available until the 1991–1992 season