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How to skate around serious hockey injuries

April 18, 2000

BY DR. JAMES BRAGMAN

THE DETROIT RED WINGS ARE BEGINNING the march toward a third Stanley Cup in 4 years. If you're a recreational or weekend player who loves the high-speed, heavy contact sport of hockey, you know it has its own set of medical problems and injuries.

The most serious is head trauma. The two most common hockey head injuries that I see in my practice are concussions and skull fractures. Players can strike their heads against the ice or boards or get struck by a stick or puck. Fortunately, the introduction of helmets has reduced the number of head injuries in both the pro and amateur ranks. Although helmets are mandatory at the professional, college and youth levels, some recreational players forsake them. Get smart. If you play hockey, wear a helmet.

Facial injuries occur from being struck in the face by a stick, a puck or a skate. The best way to avoid facial and dental injuries is by wearing a face mask, or cage, and a mouth guard. If you do suffer a cut or bruise, immediately clean the wound and then ice the area until the swelling subsides. If the bruise is severe, you should see a doctor so X-rays can be performed to check for broken bones.

Occasionally, I examine players who have fallen on their elbows and torn the ligaments connecting the collarbone to the shoulder or caused a shoulder separation, or both. I sometimes see players who break their collarbones from hitting the boards or another player. Unfortunately, in hockey, protective shoulder pads are not heavy and do not provide the necessary cushion.

Not uncommon are fractures of the lower leg that result when the leg strikes the boards or net or is hit by a stick or puck. It usually is the smaller bone of the leg, the fibula, that breaks. If a foot fracture occurs from a slap shot or hard wrist shot, players should see a doctor immediately for casting, probably for 4-6 weeks.

To avoid injury, a sports doctor or trainer often can devise guards to protect areas most commonly injured during play.

Lower back and disk problems are among the most common that I see in my hockey-playing patients. This is because of the bent-over position they maintain while skating and stick handling. If you suffer back pain for more than a few days, you should see a doctor because it is difficult to tell the difference between a spasm, strain and disk injury.

To avoid injuring yourself while playing hockey, wear the proper protective equipment, particularly a helmet, face mask and mouth guard. Being macho will not save your teeth from being knocked out, but a mask will. Also, common sense dictates that you play at a level where you can compete and defend yourself and in leagues where rules are strictly enforced.

Finally, you will need to be in good condition so as not to get too tired. Fatigue leads to loss of coordination, and that causes mistakes in judgment that can lead to injuries.




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