Summary

In this descriptive epidemiologic register-based study on injuries among male professional ice hockey players in the Swedish Hockey League we examined the injury rate, incidence, severity and burden and found a similar incidence of injury as earlier European studies in the field but a higher proportion of concussions than earlier Swedish studies with checking as the most common injury mechanism.

Abstract

Background

Ice hockey is a fast sport were the risk of injury is high. Moreover, playing at a professional level likely increase it even more. Checking and collisions are common. The speed and intensity are higher and the players more athletic and skilled than before. Although this sport has gone through changes no epidemiologic study describing the current injury pattern in Swedish hockey has been presented since the early 1990s. The number of other European studies are also few.

Purpose

To report the game-related incidence, burden and severity of injury among professional male ice hockey players during six seasons in the Swedish Hockey League (SHL). To describe rate of injury, types, locations and mechanisms.
Study Design: Descriptive epidemiologic study

Methods

In 2007 a web-based injury surveillance system, the Swedish National Sports Injury Registry, was launched for use in all SHL teams. It included a standardised injury and illness data form. Injury data has been prospectively collected by the team therapist and physician in every team using a combination of time-loss and medical attention definition including sutured lacerations, tooth injuries and fractures. Extracted injury data, from the last six SHL-seasons before the league was shut down due to Covid-19 pandemic 2020, where used.
The study was approved by the Swedish ethical review authority (ethics ID: 2020-02920). Anonymized register data were used for all calculations. Descriptive analysis was performed in IBM SPSS (version 27).

Results

2208 injury events were captured in an injury form in the registry (regular/post season games/practices). 298 (13,5%) recorded as reinjuries. 1297 players played at least one game in the league during this period.
The overall regular season incidence of injury, six seasons (2013/2014-2018/2019) was 57.8 injuries/1000 player-game hours.
Mean severity of injury (days) was 17.2 (SD=47,3; Median 6.0, IQR 2.0-15.0; Skewness 8.96).
The injury burden was 994.2 days absence/1000 player-hours.
1636 (74.1%) injuries were recorded in games where 1468 (66.5%) during regular season and 168 (7.6%) during post season. Moreover, 570 (25.8%) occurred during practice, where 480 (21.7%) during on ice practice and 91 (4.1%) off ice (weight lifting/other physical training).
1396 (63.2%) of injuries occurred during home games/practices and 806 (36.5%) during away games/practices.
The most common types of injuries were contusions (20.2%), strains (16.4%), concussions (12.6%), laceration (12.0%) and sprains (11.2%).
Head-neck (29.3%) was the most commonly injured body region, followed by hip-groin (15.2%) and knee (10.9%).
Checking (29.3%) was the most common mechanism of injury and together with collision (6.9%) they accounted for 36.2% of all injuries. Sudden onset overload (12.8%) the second most common and contact with puck (10.7%) third, followed by high sticking or other stick contact (8.6%).

Conclusion

Contusion was the most common type of injury, followed by strain. The proportion of concussions were higher compared with earlier Swedish studies but in line with levels reported in recent European studies. Player contact was the most common mechanism where checking caused most injuries. Hip-groin and knee injuries were also associated with longer time-loss.
Keywords: Athletic injury; epidemiology; ice hockey