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Prevent Concussions

08/08/2013, 9:15am MDT
By USA Hockey

This information is from the recent cover article in The Journal of Musculoskeletal Medicine which will need to be referenced (Michael J. Stuart MD. Managing and Preventing Ice Hockey Injuries. J Musculoskeletal Med. January, p.37-44, 2005. Here is an excerpt on the head and face.


HEAD AND FACE
Mandatory use of standardized helmets has apparently reduced the incidence of skull fractures and intracranial hematoma. Despite helmet protection, concussions occur with alarming frequency. Concussions encompass a graded set of clinical syndromes that may or may not involve loss of consciousness. A direct blow to the head, face, neck or elsewhere on the body may cause a concussion by transmitting an impulsive force to the head. The resultant brain injury is due to a rapid onset, short-lived impairment of neurological function that resolves spontaneously.5 The acute symptoms reflect a functional disturbance rather than a structural injury. Players should always report symptoms such as prolonged headache, confusion, visual disturbance, and loss of memory or concentration. (Table 2) Health care professionals should look for concussion signs and maintain a high index of suspicion. (Table 2) A recurrent blow to the head can be serious, since repeated concussions cause cumulative damage and the severity can increase with each incident. After an initial concussion, the chance of a 2nd concussion is several times greater.
 
Physicians and athletic trainers should always rule out an associated neck injury when evaluating a player with a suspected concussion. Obtain a concussion history, since prior brain injury can affect severity and risk of recurrence. Perform a "sideline" evaluation, including a neurological examination, balance testing, and mental status assessment for orientation, attention, memory and concentration. Repeat the evaluation after 15 minutes both at rest and after exertion. No grading systems or return to play guidelines to date have been scientifically validated; therefore, common sense and caution should guide judgment. A symptomatic player should never return to play or be left alone. The player should be monitored regularly, medically evaluated after the injury and cleared for return to play by a physician. Neuropsychological testing, if available, may provide insight into concussion severity and recovery.
 
Facemasks have dramatically reduced the risk of eye injuries, including periorbital lacerations. Eye trauma from a stick, puck or elbow to players wearing partial or no protection can cause hyphema, orbit fracture, retinal detachment, or globe rupture. A blinding eye injury to a hockey player wearing full facial protection has never been reported. Full facial protection also reduces the risk of facial lacerations and dental fractures. A prospective cohort observational analysis in the United States Hockey League demonstrated a 4.7 times greater risk of eye injury with no protection compared to partial protection (visor or half-shield).6 No eye injuries occurred to players wearing full protection. This study demonstrated that both full and partial facial protection significantly reduce injuries to the eye and face without increasing concussions. All youth, high school and college players in the United States are required to wear full facial protection. USA Hockey rules now also mandates full facial protection for all Junior players. However, players 18 years of age and older may wear a half shield (visor) if they sign a waiver. The helmet and half shield must not be worn tilted back so that the bottom of the visor is above the tip of the nose. Improper positioning of the visor may direct a stick or puck toward the eye. A violation of this rule is a misconduct penalty. The helmet should be secured with a padded four-buckle chinstrap to prevent migration and protect the chin.
 
The mouth guard is a required piece of equipment for youth hockey in the United States, but is optional for college and junior players. A form-fit mouthguard not only protects the teeth, but may also prevent concussions and injuries to the temporomandibular joint.


NECK

Serious neck injuries (cervical spine fractures) are usually the result of a direct axial load to the top of the head with the cervical spine slightly flexed.7,8 This mechanism occurs in hockey when a player slides on the ice without control or is pushed or checked from behind and hits the boards. The risk of spinal cord injury, including quadriplegia, may be increasing and appears to be higher in hockey than football. Helmets and facemasks have been implicated in this apparent increased incidence of neck injuries because players feel invincible and officials are more lenient in calling penalties. No scientific research to date supports these contentions. However, a false sense of security may lead to violent attitudes and tactics. Prevention of catastrophic injuries involves the cooperation of players, coaches, and officials. Dangerous violent acts must not be disguised as aggressive physical play. Players should learn to protect themselves by making initial board contact with another part of their body other than their head. When sliding on the ice or being checked near the boards, attempt to make board contact with the shoulder blade or buttock areas. If head contact does occur, players should avoid the position of vulnerability by always keeping their "heads up" (in other words: "don't duck"). Coaches should teach body contact and control skills so that players can effectively and safely give and take checks. Athletes and coaches must always practice the objectives of sportsmanship, including respect for their opponents. Conditioning programs should include strengthening of the neck muscles. Existing rules, like checking from behind, charging, and boarding, must be strictly enforced. Non-officials (players, coaches, and fans) must support the on-ice officials who are trained to differentiate illegal from legal contact in order to eliminate dangerous actions. A larger ice surface ("Olympic-size" rink) may decrease player-board contact, which may decrease the risk of injury, especially to the head and neck.
 
Acute airway trauma to the larynx, hyoid and cervical soft tissues from a stick or puck blow to the throat may be life threatening. Beware of the "choking sign", stridor, hoarseness, hemoptysis, and subcutaneous emphysema. Any suspected airway injury should be evaluated at a hospital since luminal obstruction from edema or hematoma may be delayed. Diagnosis requires evaluation with flexible bronchoscopy and laryngoscopy followed by a CT scan.
 
Neck lacerations by the skate blade are potentially catastrophic, but uncommon.

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Called up to The Show

09/26/2016, 10:45am MDT
By Kelly Erickson

Three USA Hockey officials earn the chance to officiate in the NHL for the first time this season

For the majority of young hockey players, their dream is to skate in the National Hockey League. They want to be the next Zach Parise, Patrick Kane, Ryan Suter — the list goes on. This season, starting in NHL training camps, three young Americans will make their dream a reality, with one caveat — instead of playing, they’ll be officiating.

Ryan Daisy, Furman South and Cameron Voss, three USA Hockey officials, were each recently offered NHL contracts and will attend their first NHL training camps this fall.

“It’s been a dream come true, really,” South said. “I’ve dreamt of being in the NHL my whole life. I grew up playing hockey from a young age and have been a hockey fan my whole life. Ever since I learned to skate it was always a dream of mine to be in the NHL. For most of my life I have dreamt of being there as a player, but once I was done playing, my dream was to make it as an official. And I made it. I can’t wait to have my first NHL game.”

Daisy echoed the sentiment, noting that making it to the NHL level as an official has been a goal of his for awhile.

“It feels awesome,” Daisy said. “I’m sure there will be a lot of emotions going on in my first game, the first time I touch the ice in the NHL with the NHL crest on my sweater that I’ve been dreaming about for years. I’m definitely looking forward to it.”

It’s a dream made reality for all three, and the ultimate payoff for many years of hard work and sacrifice.

“It’s an accumulation of all the sacrifices my family has made for me, all the supervisors and friends along the way that have helped me,” Voss said. “It wasn’t just me, it was a collection of people that pushed me and made me believe and work hard. It’s a pretty overwhelming feeling being at this point. I’m just glad all the sacrifices that we’ve made have paid off. I’m very blessed and humbled by the whole experience.”

Voss, South and Daisy were drawn to officiating from different paths, but once on it, they both climbed through the ranks and took advantage of the USA Hockey officiating development initiatives, including summer camps and the USA Hockey Officiating Program for South and Daisy to hone their skills.

Voss was the first of the three to don the zebra stripes, becoming an official at age 12, working alongside his father. It was his way to help pay for his hockey gear and get extra ice time. After closing his collegiate career at the University of St. Thomas in Minnesota, pursuing a career as a ref became a reality. He attended an officiating summer camp and saw all the opportunities available to work in higher-level hockey, and before long, he was working his way through them, spending time at the youth, high school, junior, NCAA Division I and professional levels in the American League.

“My eyes lit up really wide and I was just eager to start the process,” Voss said.

“USA Hockey gave me lots of opportunities to learn and hone my craft. The people involved in USA Hockey, they sacrificed a lot of time … they helped me out tremendously, especially at the grassroots level. They let me learn and grow and even let me fail and learn from those experiences. USA Hockey helped me from when I first started when I was 12 to when I got the call (from the NHL) in July.”

South played NCAA hockey at Robert Morris University. When he graduated in 2012 at age 24, he simply wanted to find a way to stay involved in the sport about which he was so passionate. He tried coaching, he instructed at camps and then he got a chance to ref a game and he loved it. He’s officiated everywhere from high school up, spending last season in the American Hockey League.

“It kind of came naturally to me and I realized it was something I wanted to pursue,” South said. “A couple of years later, it seems to have worked out.”

Daisy was drawn to officiating because it was a way to be in the game, to skate on the ice. His dream of becoming an official firmly solidified when he joined the USA Hockey Officiating Development Program during his senior year of college. With some early success, he was offered a contract to work in the United States Hockey League full-time, fueling his aspirations.

“(USA Hockey) will do everything in their power to help you achieve your dreams, no matter what level of hockey it is,” Daisy said.

From his Level 1 seminar to summer camps to his job in the USHL, Daisy has felt extreme support from every manager and mentor along the way, noting they all wanted to help him be a better official.

“You’re learning from the best,” Daisy said. “You’re learning from guys that are either currently in the NHL, have been in the NHL, officials that have worked international hockey and college hockey. They’re out there helping you become better.”

South also credits the USA Hockey Officiating Development Program as a factor in his success, noting Scott Zelkin, the Officiating Development Program manager, and the program itself gave him every opportunity to succeed as an official. To make his dreams come true.

“I can’t say enough about USA Hockey and the Officiating Development Program,” South said. “I wouldn’t have had this chance with the NHL if it wasn’t for those guys, that’s for sure.”

USA Hockey Mourns Passing of Walter L. Bush, Jr.

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3

How do we come up with the rules?

09/26/2016, 11:00am MDT
By USA Hockey

Q-and-A with USA Hockey Director of Officiating Education Program Matt Leaf on the playing rule change process

Every season, USA Hockey strives for improvement in the game and its rules. Every four years we get to take steps toward making the rule changes official, thanks to the playing rule change process. We enter that period this season, with the final decision on prospective changes taking place at USA Hockey’s Annual Congress in June 2017. The new rules will go into effect for the 2017-18 through the 2020-21 season.

So how does the process work? In order to get a handle on what this rule change process entails, we caught up with USA Hockey’s Matt Leaf, director of the Officiating Education Program and staff liaison to the Playing Rules Committee. He helped us answer some need-to-know questions.

USA Hockey: Walk us through the process from when a proposal is received, to having it get into the official playing rules.

Matt Leaf:
The first thing you need to know is that USA Hockey has a very diverse and experienced Playing Rules Committee that thoroughly reviews and considers each proposal. The committee is made of key USA Hockey volunteers that represent coaches, officials, players and administrators. Contrary to what some people believe, it is not one or two people sitting in an office deciding rule changes.

Playing rule change proposals are submitted to me as the staff liaison to the committee. Once received, I format them into a document that compares the current language to the proposed change for each proposal. The Playing Rules Committee meets early winter and will discuss and make a preliminary recommendation on each proposal. These recommendations are then forwarded on to the various councils/sections and committees and are also posted on USAHockey.com. The board of directors will review and make any amendments to the proposals during the Winter Meeting and they are again posted on USAHockey.com for all of our membership to see.

The Playing Rules Committee will meet once more during the Annual Congress in an open forum and will review each proposal, taking into consideration any feedback received from the respective councils/sections and committees. At this time, they will make a final recommendation on each proposal to be presented to the board of directors for adoption or defeat. The board can accept the recommendation of the Playing Rules Committee or can make its own determination. Once the board has voted and adopted the changes, work on editing the rulebook gets started right away so the new version can be ready at the start of the season.

USA Hockey: So a lot of people are involved. Who can submit playing rule change proposals and how can they do so?

Leaf:
Any member of USA Hockey can submit a playing rule change proposal.  According to our bylaws, they can be accepted until Nov. 1 prior to the Annual Congress when they get voted on. A formal proposal form can be found on USAHockey.com.

USA Hockey: What are the types of changes USA Hockey is looking for? Is there a certain philosophy that the Playing Rules Committee tries to follow?

Leaf:
The Playing Rules Committee is looking for any change that will make the game better and/or will make the rules clearer and easier to understand without compromising the spirit and intent of the rules.

There are four main areas dealing with the game that the committee takes into consideration when reviewing possible changes:

  1. Fair Play – No competitor gains an advantage and the rules are equal for all participants.
  2. Safety – Players must be allowed to compete in a safe environment where players committing dangerous actions are held accountable. Although this does not exclude physical play, it must be done so within the rules and with a respect for the opponent.
  3. Adaptability – Proposed changes must recognize the changing game and also the wide range of ages, skills and participation that has to be included.
  4. Balance between offense and defense – A natural fairness between the two, where neither side dominates. This includes a special emphasis on encouraging puck possession and development of all hockey skills.


In addition, there are five areas from a rules writing style standpoint that are taken into consideration. This includes making sure common rules are placed within the same rule or section (codification); minimizing exceptions to the rules; clear and precise language (brevity); use of clearly defined words and expressions relevant to the game (definitions); and use of fundamental statements that allow readers to understand and properly apply the rules without learning each rule verbatim (local organization).

USA Hockey: You are entering your 23rd year as staff liaison to the Playing Rules Committee, and you’ve probably seen nearly every type of proposal. Is there one that stands out in your mind that might be considered a little bit “out there?”

Leaf:
There have certainly been a few submissions over the years that caused some head-shaking and gave members of the Rules Committee a reason to chuckle. A few that stand out include the creation of a two-point line where any goal scored from behind the designated line would be worth two points. The rationale was that it could boost scoring and give a team that was behind a better chance to catch up. The second memorable one was a proposal to add a section in the rules pertaining to goalkeepers that would allow for a “shooter tutor” to be used in an official game if one team did not have a goalkeeper present.

I’m sure there are a few others that I could dig up, but those are the two that immediately come to mind.

USA Hockey: Anything else you want to share with our readers?

Leaf:
Yes. After being involved and working with this core group of volunteers who make up the Playing Rules Committee for so long, I can say they are an extremely knowledgeable and diligent bunch.  They really do put the time and effort to consider every single proposal and are extremely thorough in discussing the impact the change would have while looking at the big picture of protecting the game. Regardless of whether you agree with every rule or decision they made, you have to respect the process and their determination to do what is best for the game. I am very proud to work with this group and our membership should be equally as proud to know the rules of the game are in very capable hands.

Tag(s): Concussion Information