Hockey Injuries

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Hockey Injuries

• Presented to USA Hockey Coaches
• by
• Dr. Susan B. Hoppe, Ed.D, ATC

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3 key injuries topics to know

1. Neck injuries
2. Concussions/Head injuries
3. Prevention and Training Techniques including
   nutrition tips

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Spine Anatomy

• Different curves in the spine built for shock
  absorption
• More likely to have cervical spine fractures
• More likely to herniate discs in lumbar spine

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Functional Anatomy

• Movements of the spine include flexion,
  extension, right and left lateral flexion and
  right and left lateral rotation
• Minimal movement w/in the thoracic region
• Superficial and deep musculature functioning and
  abdominal muscular functioning affect movement
• Flexion and extension
• Trunk rotation and lateral flexion

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• Cervical Spine Conditions
• Mechanisms of Injury

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Neck Injuries

• If an athlete tells you that
• They cant move their fingers or toes
• Something feels different in my fingers or toes
• They have a burning, tingling or numb sensations
  in any of their extremities
• They have any pain along their spine
• What should you do?

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DO NOT MOVE THEM!
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Neck injury management

• At a game
• Tell your athlete not to move
• Ask them where their pain is located
• Ask the EMTs for assistance
• At practice
• Do not allow the athlete to move
• Ask them where the pain is located
• Call 9-1-1 if there is any question that there is
  a fracture present

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Concussions Head injuries
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Concussion

• An impairment of normal neurological function due
  to a blow to the head or abrupt movement of the
  head

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Mild concussion

• Minimal intensity
• Dazed and disoriented
• No amnesia or any other signs of serious head
  injury
• Back to normal in 5 15
• No further play that day

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Moderate Concussion

• Mild intensity
• No loss of consciousness (LOC)
• Slight temporary anterograde amnesia (cant make
  new memories)
• Minor mental confusion
• Tinnitus
• Dull headache

• Unsteady
• Minor dizziness
• Post-concussion problems
• Headaches
• Irritability
• No further play that day

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Severe Concussion

• Balance problems
• Automatism
• No return to play that day

• S S of mild and moderate concussions
• Loss of consciousness
• Moderate tinnitus
• Retrograde amnesia (before injury) and or
  anterograde amnesia (after injury)
• Mental confusion

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What do you need to know?

• If there are any residual symptoms, athlete
  cannot play
• Every concussion is differentsymptoms may last 5
  minutes or 5 months
• Never give them aspirin or Ibuprofen
• The second hit is when more damage can be done!

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Postconcussion Syndrome

• Etiology
• Condition which occurs following a concussion
• May be associated with head injuries that dont
  involve a LOC or in cases of severe concussions
• Signs and Symptoms
• Athlete complains of a range of postconcussion
  problems
• Persistent headaches, impaired memory, lack of
  concentration, anxiety and irritability,
  giddiness, fatigue, depression, visual
  disturbances
• May begin immediately following injury and may
  last for weeks to months

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Postconcussion Syndromecontinued

• Management
• Health care team should treat symptoms to
  greatest extent possible
• Return athlete to play when all signs and
  symptoms have fully resolved (upon physicians
  direction)

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Second Impact Syndrome

• Etiology
• Result of rapid swelling and herniation of brain
  after a second head injury before symptoms of the
  initial injury have resolved
• Second impact may be relatively minimal and not
  involve contact w/ the cranium
• Impact disrupts the brains blood autoregulatory
  system leading to swelling, increasing
  intracranial pressure

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Second Impact Syndrome

• Signs and Symptoms
• Often athlete does not have a LOC and may looked
  stunned
• W/in 15 seconds to several minutes of injury
  athletes condition degrades rapidly
• Dilated pupils, loss of eye movement, LOC leading
  to coma, and respiratory failure

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Second Impact Syndrome (continued)

• Management
• Life-threatening injury that must be addressed
  within 5 minutes with life saving measures
  performed at an emergency facility
• Best management is prevention from the ATs
  perspective

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Prevention of Head injuries

• Protective equipment
• Headgear
• Helmets and facemask
• Mouthpieces (teeth)
• Proper techniques in initiating contact
• Education about concussions and second impact
  syndrome

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Prevention of other injuries

• Dynamic warm up
• Flexibility
• Core stability
• Equipment needs
• Proper care of small injuries before they become
  big problems
• Nutritional needs

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Dynamic warm-up

• Major muscle groups
• Move laterally as well
• Controlled movements
• Progress to quicker and higher intensity
  activities
• Should be sweating BEFORE on the ice

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Flexibility

• Static stretching
• Throughout day, not just 10 minutes on ice before
  after practice
• Only need to hold 15 seconds x 3 sets
• Hip mobility is key

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Core strength Abdominal Muscles
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Core not just Abs!
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Exercises
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Lets try a couple
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Nutrition Keys to Success

• Breakfast
• Eating balanced meals
• Healthy Snacking
• Recovery nutrition
• Hydration

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Breakfast

• Improves concentration
• Enhances focus
• Jump-starts the metabolism
• Helps muscles maximize strength
• Boosts endurance
• Supports weight control
• Contributes to increased academics

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• ½ Fruits and Vegetables
• ¼ Protein
• ¼ Whole Grains
• Small Amount of Fats
• Hydration

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• ¼ Fruits and Vegetables
• ¼ Protein
• ½ Grains
• Small Amount of Fats
• Hydration

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Healthy Snacking

• Choose nutrient-rich foods
• Dont go more than 4 hours without eating
• Choose items high in fiber and antioxidants to
  keep your system functioning at its peak

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Recovery Nutrition 3 Rs

• Refuel Eat simple carbs to replace those used
  during activity
• Rebuild Eat protein to promote muscle repair
  maximize muscle strength
• Rehydrate Drink water, sports drinks, flavored
  milk to replenish fluids electrolytes lost in
  sweat

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Hydration

• Important for achieving peak performance
• Helps prevent heat illness
• Early signs of dehydration
• Thirst
• Flushed skin
• Increased body temperature
• Faster breathing and pulse rate
• Increased perception of effort
• Decreased exercise capacity

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Hydration tips

• Drink every 15 minutes during exercise
• Drink 3 cups of fluid for every pound lost during
  physical activity
• Individuals check urine for color

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If ever in doubt about your athletes health

• Ask a health care provider!

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Any questions?

• Dr. Susan Hoppe, EdD, ATC
• sbritton_at_d.umn.edu