17 Common Roller Derby injuries (Prevention & Treatment)

All 17 common roller derby injuries, from ankle sprains and wrist fractures to ACL and meniscus tears, elbow damage and concussions.

Blocks and falls on the track add back, shoulder, hip, hand, facial, rib and neck injuries, and the list closes with leg fractures, abdominal injuries, dehydration and heat exhaustion.

Keep reading to arm yourself with knowledge and stay ahead in the game, ensuring a safer and more enjoyable roller derby experience.

For a rundown on the top roller derby brands, check out our guide to the top roller derby brands.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
Nearly half of female roller derby athletes surveyed, 48.7 percent, reported at least one injury in the previous 12 months.	female roller derby athletes (1,395 respondents), March to June 2015, published 2018	Cathorall ML, Peachey AA, International Journal of Injury Control and Safety Promotion, 2018
Among injured female roller derby athletes, ankles were hurt most often at 22.5 percent, followed by knees at 21 percent and head at 11 percent.	female roller derby athletes (1,395 respondents), March to June 2015, published 2018	Cathorall ML, Peachey AA, International Journal of Injury Control and Safety Promotion, 2018
An international survey found a concussion rate of 790.98 per 1,000 roller derby athletes, with current players averaging 2.2 concussions.	roller derby players from 25 countries (665 respondents), published 2022	Stockbridge MD, Keser Z, Newman RS, Frontiers in Neurology, 2022

Overview

Injury	Body area	Typical time out
Ankle sprains	Ankle	1 to 8 weeks, longer if fully torn
Wrist injuries (sprains, fractures)	Wrist	1 week to 6 months by injury type
Knee injuries (ACL, meniscus)	Knee	6 weeks to 12 months after ACL repair
Elbow injuries (sprains, dislocations)	Elbow	2 weeks to 6 months, longer if complex
Foot injuries (sprains, fractures)	Foot	2 to 16 weeks, longer after surgery
Back injuries (muscle strains)	Lower back	1 to 6 weeks
Shoulder injuries (rotator cuff, dislocations)	Shoulder	2 weeks to 6 months after surgery
Head injuries (concussions)	Head	2 to 4 weeks, months if repeated
Hip injuries (strains, dislocations)	Hip	2 weeks to 6 months if dislocated
Hand injuries (sprains, fractures)	Hand	2 to 12 weeks after surgical repair
Facial injuries (bruises, fractures)	Face	1 to 8 weeks depending on fracture
Rib injuries (fractures, bruising)	Chest	3 to 8 weeks
Neck injuries (strains, fractures)	Neck	1 to 8 weeks, months if fractured
Overexertion leading to heat exhaustion or heat stroke	Whole body	1 to 2 days, weeks after heat stroke
Dehydration	Whole body	Hours to 3 days
Leg injuries (fractures, strains)	Leg	2 weeks to 6 months after fracture
Abdominal injuries (from falls or contact)	Abdomen	1 to 3 weeks, months if an organ

Ankle sprains

A roller derby ankle sprain almost always overstretches the ligaments on the outside of the joint, above all the anterior talofibular ligament, when the foot rolls inward under the boot. The stiff skate cuff protects the joint on the track, so many sprains happen the moment a skater steps off the track, lands short on a jump, or catches a toe stop while the ankle is unsupported. Repeated crossovers on a tight track load the same outer ligaments over and over, which is why a second sprain often needs less force than the first.

Symptoms

• Sharp pain on the outer side of the ankle at the moment of the twist
• Swelling that appears within an hour, often over the bony bump
• Bruising that spreads into the foot after a day or two
• The ankle feels like it wants to give way on turns
• Pushing off in a crossover hurts more than skating straight

How serious it is: Sprains are graded 1 to 3: grade 1 stretches the ligament with mild swelling and normal stability, grade 2 partially tears it with clear swelling and some looseness, grade 3 is a complete tear with a joint that feels unstable. The main difference in practice is whether you can put weight on the foot and control the direction of the joint.

Typical time out: Roughly one to three weeks for a grade 1 sprain, four to eight weeks for a grade 2, and three months or more for a grade 3 or a sprain with a small bone chip. The spread is wide because the ligament heals faster than the balance control does, and returning before that control is back is the main reason sprains repeat.

See a doctor if: See a clinician if you cannot take four steps on the foot, if the bony bumps on either side of the ankle are tender to direct pressure, or if the ankle looks crooked, since those point to a fracture rather than a sprain.

What helps

• Load the ankle early within the limits of pain instead of resting it completely, since motion speeds the return of normal function
• Short cooling in the first hours if pain is high, then move on to gentle movement
• Balance and proprioception work, single leg stands progressing to unstable surfaces, because control is what fails on the second sprain
• Calf and peroneal strengthening, especially the muscles that pull the foot outward
• A lace up brace or taping for the first months back on skates, which lowers the repeat rate without much loss of speed

Wrist injuries (sprains, fractures)

Falling forward at speed sends the load through an outstretched hand into the wrist, where it stretches the ligaments between the small carpal bones or breaks the lower end of the radius. The scaphoid, a small bone at the base of the thumb, is the one most often broken and most often missed. Roller derby adds a particular twist because wrist guards spread the impact but also lever the joint backward at the edge of the splint.

Symptoms

• Immediate pain at the base of the hand after a forward fall
• Swelling across the back of the wrist
• Pain in the hollow at the base of the thumb when you press it
• Weak grip, opening a bottle or gripping a rail hurts
• Bending the wrist backward, as in a push up position, reproduces the pain

How serious it is: A mild sprain settles within days and leaves the wrist stable. A fracture of the distal radius may be undisplaced and treatable in a cast, or displaced and in need of plates or wires. A scaphoid fracture is the one that looks minor and matters most, because it can fail to heal if it is treated as a sprain.

Typical time out: One to three weeks for a mild sprain, six to twelve weeks for an undisplaced radius fracture, and three to six months for a scaphoid fracture or a fracture that needed surgery. Scaphoid injuries take longest because the blood supply to that bone is poor.

See a doctor if: Get an x ray if pain sits in the hollow at the base of the thumb, if the wrist looks bent like a fork, or if numbness runs into the fingers, and ask specifically about the scaphoid even when the first x ray is called normal.

What helps

• Imaging early rather than waiting, because a sprain and a scaphoid fracture feel similar in the first days
• A splint for the painful phase, then a planned return of motion instead of open ended immobilization
• Grip and forearm strengthening once the bone or ligament allows load
• Practicing derby falls that land on the forearms and knees rather than the hands
• Well fitted wrist guards with an intact splint, replaced when the plastic is cracked

Knee injuries (ACL, meniscus)

The anterior cruciate ligament tears when the knee collapses inward while the skate stays planted, typically during a sudden direction change, a hit taken side on, or a landing from a jump. The meniscus, the cartilage wedge between thigh bone and shin bone, tears in the same movement or slowly wears under repeated deep squatting in derby stance. Both structures are loaded hard in this sport because skaters spend long stretches in a low position with the knee bent and rotated.

Symptoms

• A pop or tearing feeling at the moment of injury
• The knee swells within a few hours
• A sense that the joint shifts or gives way when you turn
• Locking or catching, so the knee will not fully straighten, which points to the meniscus
• Pain deep in the joint line when squatting or twisting

How serious it is: ACL injuries range from a partial tear with a stable joint to a complete rupture with clear instability, and meniscus tears range from a small stable edge tear to a large flap that blocks the joint. Fast swelling with a pop usually means something structural rather than a bruise.

Typical time out: Six to twelve weeks for a small stable meniscus tear treated without surgery, three to six months after a meniscus repair, and nine to twelve months before returning to full contact derby after ACL reconstruction. The long timeline after ACL surgery is about restoring strength and control, not about the graft alone, and returning early raises the chance of a second tear.

See a doctor if: Seek care the same day if the knee swells rapidly, will not straighten, or feels unstable when you shift weight onto it.

What helps

• Early assessment by a clinician who tests stability, since the decision on surgery depends on it
• Quadriceps and hamstring strengthening, with attention to the hamstrings and glutes that resist the knee falling inward
• Neuromuscular training with cutting, landing and single leg control before returning to contact
• A structured return that adds skating, then agility, then contact in separate steps
• MRI when the knee locks or instability persists, rather than as a first reflex after every twist

Elbow injuries (sprains, dislocations)

Landing on an outstretched arm drives the forearm bones backward out of the joint or overstretches the collateral ligaments that hold the hinge together. A full dislocation is usually obvious, while a partial one may relocate on its own and leave only a swollen, sore joint. Roller derby produces these because falls happen at speed with the arm braced, and pads cover the point of the elbow but not the ligaments inside it.

Symptoms

• Immediate severe pain after landing on the arm
• The elbow looks out of shape or held bent and guarded
• Rapid swelling around the joint
• You cannot straighten or bend the arm through its normal range
• Pins and needles in the hand if the swelling presses on the nerve

How serious it is: Ligament sprains follow the usual grades 1 to 3. Dislocations are divided into simple, where only soft tissue is damaged, and complex, where a bone is broken as well. Complex dislocations often need surgery and carry a higher chance of lasting stiffness.

Typical time out: Two to four weeks for a mild sprain, six to twelve weeks after a simple dislocation that has been put back in place, and three to six months after a complex one with fractures. Elbows stiffen faster than most joints, so the recovery time depends heavily on how soon controlled movement starts.

See a doctor if: Go to an emergency department at once if the joint is visibly deformed, if the hand is numb, pale or cold, or if you cannot move the elbow at all, and do not try to reduce it yourself.

What helps

• Reduction and x ray by a clinician for any suspected dislocation, before any home measures
• A sling only for the first days, then early guided movement, since long immobilization is the main cause of a permanently stiff elbow
• Physiotherapy focused on regaining full extension, which is the range most often lost
• Gradual strengthening of the forearm and shoulder before returning to contact
• Fall training that spreads impact over the forearm and hip instead of the point of the elbow

Foot injuries (sprains, fractures)

Stiff skate boots concentrate load on the midfoot and the base of the fifth metatarsal, so a hard inward roll can sprain the ligaments across the top of the foot or snap that bone at its base. Long training blocks in tight boots also produce stress fractures in the metatarsals, where the bone fails gradually rather than in one moment. Toe stop work and repeated pushes off the ball of the foot add to that load.

Symptoms

• Pain on the top or outer edge of the foot when you push off
• Swelling across the midfoot that makes the boot feel tight
• A pinpoint sore spot on one bone rather than a general ache
• Pain that starts late in a session and comes earlier each week, which suggests a stress fracture
• Limping when walking barefoot even though the boot feels bearable

How serious it is: A simple ligament sprain settles in weeks. A fracture of the fifth metatarsal base or a midfoot ligament injury can look mild but is unstable, and a stress fracture that is skated through can become a complete break.

Typical time out: Two to four weeks for a mild sprain, six to ten weeks for most metatarsal fractures, and eight to sixteen weeks for a stress fracture or a midfoot ligament injury, longer if surgery is needed. Foot bones are slow because every step loads them.

See a doctor if: See a clinician if one specific bone hurts when you press it, if you cannot bear weight, or if bruising appears on the sole of the foot, which points to a midfoot injury.

What helps

• Imaging for any pinpoint bone pain, since stress fractures are invisible on early x rays and may need a repeat film
• Cutting training volume rather than stopping altogether where the injury allows walking
• Checking boot fit and heat molding, because pressure points cause and prolong these injuries
• Calf, foot and toe strengthening once pain allows, plus balance work before returning
• A staged return that builds skating minutes back over weeks rather than in one session

Back injuries (muscle strains)

Derby stance keeps the hips and spine bent forward for long periods, which loads the erector spinae and quadratus lumborum continuously rather than in bursts. Strains happen when those muscles are asked to resist a hit or a sudden twist while already fatigued in that flexed position. Blocking with the hips and torso adds rotation under load, which is the movement these muscles tolerate least.

Symptoms

• Tight, cramping pain across the lower back after a session
• Standing up straight from derby stance is the worst moment
• Muscle spasm that makes you hold the trunk stiff
• Pain on one side that worsens when you twist toward it
• Stiffness that is strongest in the morning and eases with movement

How serious it is: A mild strain is sore but leaves full movement, a moderate one causes spasm and clearly limits bending and twisting. Pain that runs down a leg past the knee, with numbness or weakness, is no longer a simple muscle strain and needs assessment.

Typical time out: One to two weeks for a mild strain and three to six weeks for a moderate one. The range depends mostly on whether the underlying endurance problem is addressed, since backs that were strained once in a heavy training block tend to strain again in the next one.

See a doctor if: Get medical help promptly if you have numbness in the groin or inner thighs, loss of bladder or bowel control, leg weakness, or back pain that wakes you at night in a resting position.

What helps

• Keep moving within pain limits, since bed rest slows recovery for back strains
• Hip hinge and trunk endurance work, planks, side planks and back extension holds rather than repeated sit ups
• Glute and hamstring strength so the hips carry more of the derby stance
• Breaking long low stance drills into shorter blocks during heavy training weeks
• Physiotherapy if pain lasts beyond a few weeks or keeps returning at the same point in the season

Shoulder injuries (rotator cuff, dislocations)

A fall onto the point of the shoulder drives the collarbone against the shoulder blade and injures the acromioclavicular joint, while a fall onto an outstretched or twisted arm can push the head of the humerus out of its socket. The rotator cuff, four tendons that hold that head centered, gets pinched or torn in the same falls and irritated by repeated blocking with the arms held high. Older skaters tear the cuff more readily because the tendon itself is less resilient.

Symptoms

• Pain over the top or front of the shoulder after landing on it
• A visible step or bump at the end of the collarbone
• The arm feels like it might slip out when you reach overhead or behind
• Weakness lifting the arm to the side or holding it out
• Pain that wakes you when you roll onto that side at night

How serious it is: Acromioclavicular injuries are graded type I to type III for the common range, from a stretched joint through a clear step deformity, with higher types being rarer and usually surgical. Dislocations matter most in how often they repeat, and rotator cuff problems range from irritation of the tendon to a full thickness tear.

Typical time out: Two to six weeks for a type I or II acromioclavicular injury, six to twelve weeks after a first dislocation, and four to six months after cuff repair or stabilizing surgery. First time dislocations in younger skaters repeat often, which is why the return is slower than the pain alone suggests.

See a doctor if: Seek urgent care if the shoulder is visibly out of place, if you cannot lift the arm away from your side at all, or if the arm or hand goes numb.

What helps

• Rotator cuff and scapular strengthening, external rotation and rows, as the core of both treatment and prevention
• Short sling use for comfort after a dislocation, then progressive loading rather than weeks of immobility
• Physiotherapy guided return with contact added last
• Surgical opinion after repeated dislocations, since each one damages the socket rim further
• Corticosteroid injection only as an exception for a stubborn painful cuff, because it eases pain short term but tends to leave tendons worse in the long run

Head injuries (concussions)

A concussion is a functional disturbance of the brain after an impact or a whiplash movement, not a bruise that shows on a scan. In derby it comes from the back of the head or the chin hitting the floor, from a hit that snaps the head sideways, or from a fall over another skater at speed. Helmets reduce skull fractures and scalp wounds but do not prevent the brain moving inside the skull, which is why concussion remains common in this sport.

Symptoms

• Headache or pressure in the head after a hit
• Feeling dazed, slowed down or in a fog
• Dizziness or trouble with balance off skates as well as on them
• Nausea, or light and noise feeling too intense
• Trouble remembering the jam or the minutes around the hit

How serious it is: Concussion is no longer graded by numbers. What matters is how many symptoms there are, how long they last, and whether this is a first event or a repeat, since repeated concussions take longer to settle and lower the force needed for the next one. Loss of consciousness happens in a minority of cases and is not required for the diagnosis.

Typical time out: Most skaters are symptom free within two to four weeks, with a graded return to contact taking at least another week after that. Recovery stretches to months where there is a history of previous concussions, migraine, or where the skater returned to full contact too early.

See a doctor if: Go to an emergency department for worsening headache, repeated vomiting, a seizure, one pupil larger than the other, weakness or numbness, slurred speech, or increasing drowsiness, and never let a skater with suspected concussion return to the track that day.

What helps

• Leave the track immediately and do not return the same day, with the decision made by someone other than the injured skater
• One to two days of relative rest from screens and intense mental work, then light activity that does not provoke symptoms
• Light aerobic exercise such as walking or a stationary bike started early, which shortens recovery compared with strict rest
• A stepwise return that adds skating, then non contact drills, then contact, with a day back a step if symptoms return
• Medical clearance before contact, and a serious conversation about the sport after repeated concussions

Hip injuries (strains, dislocations)

Hip strains in derby usually involve the adductors on the inner thigh or the hip flexors at the front, both loaded hard by crossovers, lateral pushes and holding the low stance. The bursa on the outer hip and the gluteal tendons that run over it get irritated by direct falls onto that side, which happen constantly in this sport. True hip dislocation is rare and requires the kind of force seen in a serious collision, not a routine fall.

Symptoms

• Pulling pain in the groin when you push out to the side
• Pain at the front of the hip when lifting the knee toward the chest
• Deep ache on the outer hip after falling on it, worse lying on that side
• Stiffness getting into and out of derby stance
• Pain that eases once warm and returns strongly afterward

How serious it is: Muscle strains follow grades 1 to 3, from a few torn fibers with normal strength to a complete tear with a palpable gap and clear weakness. A dislocation is a different order of injury, unmistakable and an emergency.

Typical time out: Two to six weeks for a grade 1 or 2 adductor or flexor strain, three months or more for a grade 3 or a tendon torn off the bone, and four to six months after a dislocation. Groin strains commonly linger because skaters return as soon as walking is painless, well before the muscle tolerates side loading.

See a doctor if: Get emergency help if the leg is shortened or rotated and you cannot move the hip after a heavy collision, and see a clinician if you felt a pop with immediate weakness.

What helps

• Progressive adductor strengthening such as the Copenhagen exercise, which has good evidence for both treating and preventing groin problems
• Hip flexor and gluteal strength work rather than stretching alone
• Managing training load, especially the number of crossover heavy sessions in a week
• Padded shorts to reduce the effect of repeated falls onto the outer hip
• Physiotherapy if groin pain persists beyond a few weeks, since several structures give similar symptoms and the treatment differs

Hand injuries (sprains, fractures)

Fingers get caught in another skater’s gear, jammed against the floor, or bent sideways during a pack fall, which sprains the collateral ligaments of the finger joints or breaks a metacarpal. The thumb is the classic case: forced away from the hand it tears the ligament on its inner side, which costs the pinch grip. Wrist guards protect the palm but leave the fingers and thumb exposed.

Symptoms

• A finger that swells and stiffens within minutes of being jammed
• Pain and looseness at the base of the thumb when pinching
• A finger that sits crooked or crosses its neighbor when you make a fist
• Bruising across the back of the hand after a direct impact
• Weak grip, and dropping objects

How serious it is: Most jammed fingers are grade 1 or 2 sprains that stay stable. A complete thumb ligament tear, a rotated finger fracture, or one where a tendon has pulled off the bone will not settle on its own and needs a hand specialist.

Typical time out: Two to four weeks for a simple jammed finger with buddy taping, four to eight weeks for most metacarpal fractures, and six to twelve weeks after thumb ligament repair. Skaters can often train off skates during much of this.

See a doctor if: See a clinician the same week if a finger looks rotated or crossed when you bend it, if you cannot straighten the fingertip, or if the thumb feels unstable when you pinch.

What helps

• Buddy taping a stable sprained finger to its neighbor and moving it early, since stiff fingers are harder to fix than sore ones
• X ray for any deformity, rotation or persistent pinpoint bone pain
• Hand therapy for thumb and finger injuries that stay stiff after the first weeks
• Removing rings before skating so a caught finger is not degloved or strangled by swelling
• Fall technique that tucks the fingers rather than splaying the hands

Facial injuries (bruises, fractures)

Elbows, shoulders and helmets meet faces in the pack, and falls put the chin and cheekbone onto the floor. The bones that break most often are the nose, the cheekbone and the thin floor of the eye socket, while teeth are chipped or knocked out when the jaw takes a direct hit. Bruising itself is bleeding under the skin from ruptured small vessels, which is why it spreads and changes color over days.

Symptoms

• Swelling and discoloration that spreads over the following days
• A nose that looks bent or breathes only on one side
• Double vision or numbness of the cheek and upper lip
• The bite feels wrong, teeth do not meet as they used to
• A cut that keeps bleeding or gapes open

How serious it is: Bruises and simple cuts are minor and heal on their own. Fractures matter when they change function or shape: a blocked airway through the nose, a changed bite, double vision, or numbness of the cheek all mean the fracture needs assessing within days, not weeks.

Typical time out: One to two weeks for bruising, four to six weeks off contact after a nasal fracture, and six to eight weeks after a cheekbone or eye socket fracture, longer if plates were used. Faces heal fast but bones that were reset need protecting from a second hit.

See a doctor if: Seek care the same day for double vision, numbness of the cheek, a changed bite, clear fluid from the nose, or a knocked out tooth, and take the tooth with you in milk or saliva.

What helps

• Brief cooling in the first hours to limit swelling and pain, without pressing on a possible fracture
• Assessment within a few days for any nasal fracture, since resetting it is far easier in the first two weeks
• A dentist the same day for a knocked out or loosened tooth
• A properly fitted mouthguard, ideally custom made, which also protects the jaw joint
• Screening for concussion after any impact to the face, because the two arrive together

Rib injuries (fractures, bruising)

A shoulder or elbow driven into the side of the chest bruises the rib and the muscles between the ribs, or cracks the bone itself. Because the ribs move with every breath, the injury never gets to rest, which is why it hurts far longer than the impact suggests. Cartilage where the rib meets the breastbone can also separate, giving front of chest pain that behaves like a fracture.

Symptoms

• Sharp pain at one point on the chest wall when you breathe in deeply
• Coughing, laughing or sneezing is much worse than sitting still
• Pain rolling over in bed or getting up from lying down
• Tenderness on pressing exactly one spot on the rib
• Shallow breathing because full breaths hurt

How serious it is: A bruised rib and a single cracked rib feel much the same and are managed the same way. It becomes serious with several ribs broken, breathlessness, or signs that the lung or spleen underneath was hurt.

Typical time out: Three to six weeks for bruising and four to eight weeks for a single fracture before contact is sensible, with tenderness sometimes lasting longer. Recovery drags where breathing stays shallow, because that leads to further chest problems.

See a doctor if: Get urgent care for shortness of breath, coughing blood, pain in the left shoulder tip after a hit to the left side, or a chest that moves oddly with breathing, since those suggest the lung or spleen is involved.

What helps

• Adequate pain relief with the specific aim of allowing deep breaths, not merely comfort at rest
• Deep breathing exercises several times a day to keep the lower lung inflated
• No tight strapping around the chest, which restricts breathing and raises the risk of chest infection
• Light movement and walking rather than lying still for days
• Medical review if breathing is short or pain suddenly worsens

Neck injuries (strains, fractures)

Most derby neck injuries are strains of the muscles running from the skull to the shoulder blades, caused by the head snapping forward and back when a hit lands or a fall stops abruptly. The same whiplash mechanism can irritate the small facet joints between the vertebrae. Fractures of the cervical spine are rare but possible when a skater lands on the head with the neck bent.

Symptoms

• Stiff, aching neck that is worse the morning after the hit
• Turning the head to check behind you is limited and painful
• Pain spreading into the upper shoulders and base of the skull
• Headache starting at the back of the head
• Muscle spasm on one side that pulls the head off center

How serious it is: A strain hurts and stiffens but leaves normal strength and sensation in the arms. Any pain in the midline of the neck bones, numbness, tingling or weakness in an arm points beyond a strain and needs imaging.

Typical time out: One to three weeks for a mild strain and four to eight weeks for a more severe whiplash injury. A fracture is a different matter entirely and is measured in months under specialist care.

See a doctor if: Do not move a skater and call emergency services if there is midline neck pain after a head first fall, or if there is numbness, tingling or weakness in the arms or legs.

What helps

• Early gentle movement in all directions rather than a collar, since prolonged immobilization worsens whiplash outcomes
• Deep neck flexor and upper back strengthening once the acute pain settles
• Imaging when there is midline bone pain, arm symptoms, or a high energy mechanism
• Reviewing the hit that caused it, because taking blocks with the head down is what exposes the neck
• Physiotherapy for symptoms that persist beyond two to three weeks

Overexertion leading to heat exhaustion or heat stroke

Full pads, a helmet and long sleeves trap heat, and many bouts are skated in halls without air conditioning, so the body loses the ability to shed the heat it produces. Heat exhaustion is the stage where circulation struggles with fluid loss, while heat stroke is the point at which core temperature rises so far that the brain is affected. The change from one to the other can happen quickly, and confusion is the signal that matters.

Symptoms

• Heavy sweating with weakness and a pounding pulse
• Dizziness, light headedness or feeling faint at the bench
• Nausea, headache, cramping in the legs
• Skin that is clammy and pale, or in the severe case hot and dry
• Confusion, slurred speech or unsteadiness, which is the serious sign

How serious it is: Heat exhaustion leaves the skater exhausted but mentally clear and improves with cooling and fluids. Heat stroke means altered mental state with a very high core temperature and is a medical emergency where minutes count.

Typical time out: Return to light training after a day or two once heat exhaustion has resolved and hydration is normal. After heat stroke, expect several weeks under medical guidance with a gradual reintroduction of heat exposure, because heat tolerance stays reduced for a while.

See a doctor if: Treat any confusion, strange behavior, collapse or loss of consciousness in the heat as heat stroke, call emergency services and start cooling immediately rather than waiting.

What helps

• Get out of the gear and into a cool place at the first symptoms, since pads are the main barrier to heat loss
• Aggressive external cooling for suspected heat stroke, cold water immersion where available, while help is on the way
• Fluids with electrolytes rather than plain water alone when sweating has been heavy for hours
• Building up heat exposure gradually over one to two weeks before a hot tournament
• Planned bench rotations and hydration breaks written into bout day rather than left to the individual

Dehydration

Sweating under full pads in a long scrimmage removes water and sodium faster than most skaters replace it, which lowers blood volume and makes the heart work harder for the same effort. Performance and concentration drop before thirst becomes urgent, so the skater usually notices the fatigue before the cause. Losses continue between bouts on a tournament day, which is why the second day is usually worse than the first.

Symptoms

• Thirst, dry mouth and dark yellow urine
• Fatigue and heavy legs disproportionate to the effort
• Headache, especially late in a session
• Dizziness on standing up quickly
• Muscle cramps in the calves or hamstrings toward the end of play

How serious it is: Mild dehydration is corrected within hours by drinking and eating normally. It becomes serious with fainting, a racing pulse at rest, very little urine, or confusion, which means fluid replacement under medical supervision.

Typical time out: Hours for a mild case, with normal training the next day. One to three days off where there was fainting or severe cramping, because the muscle and circulation need to recover before another hard session.

See a doctor if: Get medical help for fainting, confusion, a fast pulse that will not settle at rest, or urine that stays very dark or brown after drinking, since brown urine after intense effort can mean muscle breakdown.

What helps

• Drink to a plan across the session rather than only when thirsty, checking urine color as the simple gauge
• Add sodium through an electrolyte drink or salty food when sessions run long or the hall is hot
• Weigh yourself before and after a hard scrimmage to see how much you actually lose
• Start the session already hydrated rather than trying to catch up during it
• Avoid alcohol the night before a tournament day, since it adds to the fluid deficit

Leg injuries (fractures, strains)

Hamstring and calf strains happen when the muscle is stretched while contracting, typically in a sudden acceleration out of the pack or a slip where one leg shoots forward. Fractures of the tibia or fibula come from a direct hit with a skate or a fall in which the boot holds the ankle rigid and the force travels up the bone. The stiff boot protects the ankle and passes load to the shin, which is why lower leg fractures appear in derby more than in most skating sports.

Symptoms

• A sudden pulling or tearing sensation in the back of the thigh or calf
• Bruising appearing down the leg over the following days
• Pain on stretching the muscle or pushing off hard
• Immediate inability to bear weight after a direct blow, which points to a fracture
• A visible dent or gap in the muscle in a severe tear

How serious it is: Muscle strains are graded 1 to 3, from a few fibers through a partial tear to a complete rupture with a palpable gap. Fractures are divided by whether the bone has shifted, since undisplaced ones may be treated in a cast while displaced ones usually need a nail or plate.

Typical time out: Two to six weeks for a grade 1 or 2 hamstring or calf strain, three months or more for a complete tear, and three to six months for a tibia fracture, longer if surgery was required. Hamstring strains repeat easily, which is why the last weeks of rehabilitation matter more than the first.

See a doctor if: Seek urgent care if you cannot bear weight after a direct blow, if the leg is visibly deformed, or if the calf becomes tight, swollen and numb, which can mean pressure building inside the muscle compartment.

What helps

• Eccentric strengthening, Nordic curls for the hamstring and slow lowering heel raises for the calf, both well supported for treatment and prevention
• Load the muscle early within pain limits instead of waiting for it to feel normal
• A criteria based return, matching strength side to side before full contact rather than counting days
• Sprint and acceleration exposure in training so the muscle is used to the speed at which it tore
• X ray for any suspicion of fracture, and immediate assessment for a tight, worsening calf

Abdominal injuries (from falls or contact)

A knee, elbow or helmet into the belly can strain the abdominal muscles or bruise the organs behind them, above all the spleen on the left and the liver on the right. Muscle strains and bruising are far more common and settle on their own, but injury to a solid organ can bleed slowly and become obvious only hours later. That delay is the reason abdominal impacts are treated more cautiously than their first appearance suggests.

Symptoms

• Winded feeling and difficulty catching your breath right after the hit
• Aching or cramping pain in the belly wall when you sit up or twist
• A bruise or firm swelling over the impact point
• Pain in the tip of the left shoulder, which can accompany a spleen injury
• Feeling faint, sweaty or increasingly unwell in the hours after the hit

How serious it is: A muscle strain or bruise of the abdominal wall is mild and improves day by day. Injury to the spleen, liver or bowel is the serious form and is suspected when pain worsens rather than settles, when the abdomen is rigid, or when the skater becomes pale and light headed.

Typical time out: One to three weeks for a wall strain or bruise. Organ injuries are managed in hospital and keep an athlete out of contact for at least six to twelve weeks, with the exact time set by the specialist and follow up imaging.

See a doctor if: Go to an emergency department for worsening abdominal pain, a hard or rigid belly, blood in the urine, vomiting, pain at the tip of the shoulder, or feeling faint in the hours after an impact.

What helps

• Observation for the rest of the day after a heavy blow, with someone who can act if things worsen
• Immediate medical assessment rather than waiting where pain increases instead of easing
• Gradual return of trunk work for a simple wall strain, starting with isometric holds
• Padded shorts and good fall technique to lower the number of direct blows
• Avoiding contact sport for the full period advised after any organ injury, since a second hit is the real danger

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Roller Derby

• Drill falling until it is automatic: single and double knee falls, the four point fall and the baseball slide put the load on pads instead of hands, wrists and tailbone, and they only work under pressure if they were practiced under pressure.
• Train the ankles and hips for the low derby stance rather than just skating in it. Single leg balance, calf raises and Copenhagen adductor work address the ankle, groin and knee, the three places skaters lose most time.
• Keep gear honest. Cracked wrist guard splints, flattened knee pad foam and a helmet that has taken a hard hit no longer do their job, and a boot that does not hold the heel drives both ankle and foot problems.
• Build up contact gradually after any break. Injury rates rise when skaters go straight from months of light skating back into full scrimmage, so add speed first, then contact, then bout intensity.
• Skate with the head up and the chin off the chest. Blocking with the head down exposes both the neck and the crown of the helmet, which is the position that turns a routine fall into a concussion.
• Plan recovery into the week. Two hard scrimmages back to back with no easy day between them is where fatigue related strains and the worst falls tend to appear.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• Any suspected concussion, meaning confusion, memory gaps, dizziness or a headache after a hit. The skater leaves the track and does not return that day, whatever they say about feeling fine.
• Midline neck pain, or numbness, tingling or weakness in the arms or legs after a head or neck impact. Do not move the skater and call emergency services.
• A limb that looks deformed, or a joint that will not move at all, which suggests a fracture or dislocation and needs an emergency department rather than the bench.
• Inability to bear weight for a few steps after an ankle, foot or leg injury, especially with pinpoint tenderness over a bone.
• Shortness of breath, coughing blood, or abdominal pain that worsens over the hours after a hit, particularly with faintness or pain at the tip of the shoulder.
• Confusion, collapse or strange behavior in a hot hall, which is treated as heat stroke until proven otherwise: call for help and start cooling at once.

Sources

• Cathorall ML, Peachey AA, International Journal of Injury Control and Safety Promotion, 2018
• Stockbridge MD, Keser Z, Newman RS, Frontiers in Neurology, 2022

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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