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Hockey, Lacrosse, and Skating

Hockey is a high-speed, high-impact sport. The bigger you are and the faster you go, the greater is the impact from something or somebody hitting you. Although hockey players are not as big as football players, they travel at higher speeds while gliding on ice and therefore experience much greater impacts. And ice is one of the hardest playing surfaces in sports.

The arena and the equipment also can lead to high-impact injuries. The boards around professional hockey rinks have some give in them, but this is not necessarily true for rinks at lower levels. When I played hockey as a youth in the Adirondack Mountains area, the boards were frozen into the ice. When you hit them, you knew it. Also, a hockey player can't skate out of bounds to avoid a check, as a football player can to avoid a tackle.

The metal goal cage is on magnets at the professional level but may be fixed to the ice at lower levels. When you are checked into it or skate into it, it does not move.

The puck is made of hard rubber with sharp edges and is frozen so that it slides better, which makes it even harder. It can come at you at a very high speed: a good slap shot moves at more than 100 miles per hour.

The sticks are used as weapons. Although there are penalties for high sticking and slashing, the fact that there are penalties indicates that violations do happen regularly.

The skate blades are razor-sharp. Professional players sharpen their blades between periods to ensure a sharp skating edge. Those edges can become a terrible hazard when a player falls and his skates turn up.

Dropping the gloves and fighting has, unfortunately, become a part of the game. This leads to the same traumatic injuries seen among boxers.


The usual head injuries from hockey are concussions and skull fractures. The head can hit the ice or the boards, both of which are hard, or it may be hit by a stick or the puck.

The introduction of helmets has helped to cut down the number of head injuries. Although helmets are no longer mandatory in the National Hockey League, most players still wear them. Helmets are mandatory at the peewee, high school, college, and professional minor league levels, but not at the recreational level, and many recreational players still do not wear helmets. I implore any hockey player to wear a helmet.


A hockey player can suffer cuts on his face from the puck, a stick, or a skate. Or he may end up with bruises and broken bones from hitting the ice or the boards or being hit by a stick or another player's fists.

A player can avoid facial injuries by wearing a mask, which is mandatory for young, inexperienced players but not for older ones. Not many recreational players use masks, and only goalies customarily wear them in professional hockey.

Small cuts need to be cleaned and then iced until the swelling subsides. Large, deep cuts may need stitches. Bruises should also be treated with ice. If they are severe, a doctor should take x-rays to check for any broken bones.


In the past, hockey players were notorious for their missing teeth. Being hit in the mouth by the puck, a stick, or a fist usually led to a gaptoothed smile.

Most professionals now wear mouth guards, but many recreational players do not. There is no question that mouth guards save teeth, and every hockey player should wear one. It doesn't have to be fitted, like the ones the pros wear. Even the less expensive, generic mouth guards can save you a trip to the dentist.


A hockey player who falls on the point of his elbow may stretch or tear the ligaments connecting the collarbone to the shoulder, which can separate the shoulder.

A hockey player can also break his collarbone from hitting the boards or another player with a shoulder check. Hockey shoulder pads are not as heavy as football pads, so they do not protect the shoulder as well. A collarbone may also fracture from being hit squarely with the puck.


Lower-back and disc problems are common among hockey players because of the bent-over position they maintain while skating and stickhandling, not to mention their frequent collisions with the boards.

If your back is sore, it could be bruised or sprained, a muscle could be pulled, or you could have a more serious injury, such as a disc problem. Since it's difficult to tell the difference, all seemingly minor back injuries that last longer than a few days should be seen by a doctor.


A hip check or a hip-first crash into the boards can damage the rim of the pelvis, leading to a hip pointer. To avoid this painful injury, every hockey player should make hip pads a part of his uniform.


You might expect hockey players to have a low incidence of knee injuries; when the knee is struck from the side, the foot slides on the ice, lessening the blow. However, hockey players often get their skates caught against the boards, where the foot can't slide. Or a stick can get caught in the skate blade and twist the knee violently, which is similar to the high torque applied to the knee when a ski doesn't release from its binding. All but the most minor knee injuries should be seen by a doctor.

"Housemaid's knee" is also common among hockey players. Though they wear knee pads, they frequently bang their knees on the ice or the boards lining the rink, and this can result in a large, fluid-filled swelling in front of the kneecap.


Fractures of the lower leg are particularly common in hockey. These result from the leg striking the boards or the goal cage or being hit hard by a stick. Usually, it's the small bone in the leg (fibula) that breaks.

Since the fibula is not weight-bearing, a player can usually return to activity within four or five weeks. A sports doctor or a trainer can devise a guard to protect the leg during play.


A foot may fracture from being hit by the puck. Often, a slap shot or wrist shot coming at high speed skims off the ice and slams into the side of the skate boot. Even the rigid boot cannot protect against a hard-driven puck, although the newer fiberglass boots do offer better protection than the old leather boots.

A broken bone in the foot requires immediate medical attention and casting, probably for four to six weeks.


To avoid injury from playing hockey, first and foremost avail yourself of all of the protective equipment, particularly a helmet, a face mask, and a mouthpiece. A macho attitude will not save your teeth from being knocked out, but a mask will.

Play at a level where you can compete and defend yourself. If necessary drop down a level and work your way back up. Play only in leagues where the rules are stringently enforced. Also, make sure the playing surface, the boards, and the goals are in good condition.

In addition, make sure you are in good condition so that you don't get overtired. A fatigued player loses coordination and makes mistakes in judgment that can lead to injuries.


Lacrosse is very similar to hockey. In fact, indoor or box lacrosse is played in a hockey rink without the ice; has teams of six men, the same as hockey; and is played according to basic hockey rules using a lacrosse ball and the heavier lacrosse stick.

Playing in a cleated shoe instead of a skate leads to more ankle and knee injuries in lacrosse than it does in hockey. Ankle sprains, knee sprains, ligament ruptures, and cartilage tears are also much more common in lacrosse. Some injuries have similar incidence rates in the two sports: shoulder separations and dislocations from falling and cuts and bruises from being hit with a stick.

Lacrosse is a continuous running sport and can lead to foot and heel pain, tibial stress syndrome, and runner's knee (see Chapter 25 for specific treatments).


Most traumatic injuries to recreational skaters are due to lack of skill. By increasing skill, skaters can easily avoid these injuries.

Most recreational skaters use figure skates, which can contribute to injuries. The doubleedged, rocker-type figure-skating blade has points in the front, and you must keep your weight back. This can be a problem for people who learned how to skate on hockey or racing skates, which allow you to glide on the front of the blade.

If you glide too far forward on a figure skate, you may catch a point in the ice and abruptly fall forward. You may fall on your face and suffer facial or head injuries. Minor cuts and bruises on the face and head should be cleaned and iced until the swelling subsides. If you have a headache for a few days or any vision problems, have a doctor check you for a possible concussion.

If you put your hands out to stop your fall, you may sprain or break a wrist. Make sure to get the wrist x-rayed to rule out the possibility of a fracture.


If you come home from an indoor skating session with a headache and you are tired, nauseous, and short of breath, you may be suffering from carbon monoxide poisoning. The engine of the Zamboni machine that smooths the ice emits carbon monoxide gas, just as a car does. This odorless, colorless, poisonous gas can collect indoors. If you develop symptoms that suggest carbon monoxide poisoning, consider switching to a rink that uses a battery-powered resurfacer, which does not emit carbon monoxide. Or, if you can, skate outdoors.


People who tend to overpronate their ankles have a difficult time controlling ice skates. Properly fitting skates, which hold the ankle firmly, along with ankle-strengthening exercises, such as those used to treat a sprained ankle, can be helpful. You may need to place an arch support or orthotic device in your skate to avoid rolling your ankle to the inside.


Figure skaters make gymnastic moves at high speeds and come down on a hard surface, not a soft mat; therefore, they suffer many traumatic injuries. Also, they don't land on a flat foot but, rather, on a thin blade with two edges. You never figure-skate on the whole width of the blade. You skate either on the inner edge or on the outer edge, changing edges as you change direction. If you come down from a jump so far over the edge that it cannot bite the ice, the blade slides out, and you can fall and injure yourself.


Figure skaters instinctively extend their hands to break a fall, as all skaters do. A crash to the ice from the height of a jump can break a wrist. The treatment is to cast the wrist for six to eight weeks or longer, depending on the bone that was broken.


A figure skater can sprain a knee by twisting in the air and stopping suddenly when the blade edge catches the ice. This is much like a football player catching a cleat in the ground while twisting the body. If the knee overrotates, ligaments can sprain or cartilage may tear.

If your knee swells up, you hear a clicking noise inside the knee, and it buckles when you move it, you may have torn cartilage.


A form of runner's knee is extremely common among figure skaters and is usually due to excessive pronation of the skate while the knee is bent. An orthotic can improve the foot position within the skate, and quadriceps exercises can be used to strengthen the knee.

Figure skating is also a jumping sport and therefore causes stress on the tendons under and above the kneecap. This can result in the pain and disability of jumper's knee. The treatment is to rest the knee until the pain subsides, ice it as long as it's tender, and take anti-inflammatory agents. This should be followed by a leg extension program to strengthen the knee.


Figure skaters commonly feel a pain on the top of the foot. This usually is due to an inflammation of the tendons that extend the toes, which cross over the bones on top of the foot.

If you experience this symptom, you probably are lacing your boots too tightly or have inadequate padding under the tongue. Pressure against the tendons causes them to become inflamed, resulting in pain. Use ice and anti-inflammatory agents until the pain subsides, and put a foam pad under the tongue of your skate.


Many ice skaters have also taken up one of the latest fitness fads, in-line skating, for their offseason conditioning. In-line skating, or roller blading, is a high-speed, low-impact workout that's great for cardiovascular conditioning and muscle strengthening. And it feels goodwhooshing along a road or in the park with the bicyclists, far ahead of the runners.

A 12-mile skate is the aerobic equivalent of about a 6-mile run and avoids the strain on your knees. The boots are lightweight, and the polyurethane wheels absorb shock well. Practice sprinting, and you add to your anaerobic conditioning. Skate long distances, and you enhance your aerobic capacity.

In-line skating is good for overall leg toning and for building strength and power. It tightens the hamstrings, develops the quadriceps muscles, improves the muscles around the hip joint, and tightens the buttocks. You can even strengthen your upper body by using rubbertipped ski poles. The swaying motion of poling works the triceps and the erector muscles in the spine, which are important for good posture.

In-line skating is a low-impact sport, but it can also be a sudden-impact sport. Common injuries include scrapes, bruises, and broken bones caused by falls. For your own safety, wear cycling or leather gloves, a lightweight bicycle helmet, knee and elbow pads, and stiff plastic wrist pads, which both protect against wrist injuries and help absorb the impact of falls. Although few in-line skaters wear helmets, all should, and they will soon be mandatory in races.

Since in-line skates are faster, smoother, and more maneuverable than conventional roller skates, stick to flat, paved, lightly traveled roads at first. In-line skating is easier for a beginner than ice skating or traditional roller skating, so an accomplished skater should be able to pick it up rather quickly.

The biggest problem facing in-line skaters is stopping. You cannot skid to a stop as you do on ice skates. The most effective brake you have is the heel stop, which is usually located at the rear of the right skate. Ask your local skate shop to show you how to use the brake. The dealer can probably recommend a qualified in-line skating instructor as well.

If you take all the precautions, in-line skating is not a dangerous sport. Always wear protective safety gear and never attempt any fancy movements unless you have practiced them. And always look ahead to plan a possible escape route.

How to Improve Your Game

Hockey has one of the best warmup periods of any sport, beginning with a skate-around and ending with shooting drills. These raise the body temperature adequately and increase blood flow to the muscles. Before play begins, however, you should stop and stretch.

The most important muscles to stretch are in the groin. These are the most frequently pulled muscles in hockey. Hamstring pulls are not as common as they are in running sports because hockey players take a shorter stride. You should stretch your entire leg but concentrate on groin stretches, the Yoga Lotus Stretch, and the Side Straddle Stretch, as described in Chapter 10.

Hockey is a sport that depends on leg strength. Increase quadriceps strength with the Leg Extension and Squat, and hamstring strength with the Leg Curl (all three in Chapter 1); increase calf strength with the Toe Raise, described in Chapter 12. Do the Toe Raise while holding as much weight as you can to increase the workload on the calf muscle. Or stand on one leg at a time so that your entire body weight is being lifted by one leg.

The wrists generate the power for most shots in hockey. The stronger your wrists, the more powerful your shot will be. Do the Wrist Curl, Reverse Wrist Curl, Unbalanced Wrist Rotation, and Roll-up with a broomstick, as outlined in Chapter 8. The heavier the weight, the stronger your wrist will become.

Lacrosse depends on strength and endurance. A bigger, stronger player is better equipped to withstand the body contact the sport demands. Both upper- and lower-body weight training is essential, as it is in hockey. Also, a lacrosse player should run long distances slowly to build aerobic conditioning and stamina, and then intersperse these distances with intervals of sprints to improve speed.

Recreational skaters also need to warm up properly before going into a heavy workout and should strengthen their legs in the same way as a hockey player.

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