13 Common Ice Hockey injuries (Prevention & Treatment)

The 13 most common ice hockey injuries: concussions, cuts and contusions, ankle sprains and fractures, shoulder dislocations and MCL or ACL damage.

Skating and shooting add groin injuries, hamstring pulls, muscle strains and overuse problems, and the list closes with facial injuries, hip trouble and a broken collarbone.

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
NCAA men’s ice hockey players sustained 7.65 injuries per 1,000 athlete exposures across five seasons.	NCAA men’s ice hockey players, all divisions, 2014/15 through 2018/19 seasons (published 2021)	Epidemiology of Injuries in National Collegiate Athletic Association Men’s Ice Hockey, Journal of Athletic Training (2021)
Games are far riskier than practice in college hockey: 20.57 injuries per 1,000 exposures in competition versus 3.14 in practice.	NCAA men’s ice hockey players, all divisions, 2014/15 through 2018/19 seasons (published 2021)	Epidemiology of Injuries in National Collegiate Athletic Association Men’s Ice Hockey, Journal of Athletic Training (2021)
Concussion was the single most common diagnosis in NCAA men’s ice hockey, making up 9.6 percent of all reported injuries.	NCAA men’s ice hockey players, all divisions, 2014/15 through 2018/19 seasons (published 2021)	Epidemiology of Injuries in National Collegiate Athletic Association Men’s Ice Hockey, Journal of Athletic Training (2021)
The most common specific diagnoses in college hockey were concussions at 9.6 percent, AC joint sprains at 7.3 percent and MCL tears at 3.7 percent.	NCAA men’s ice hockey players, 2014/15 through 2018/19	Boltz et al., Journal of Athletic Training 2021 (NCAA Injury Surveillance Program)
Banning body checking in Canadian Pee Wee hockey cut the game injury rate by 50 percent and the concussion rate by 64 percent in 11 and 12 year old players.	Pee Wee ice hockey players aged 11 and 12 in Calgary, Alberta (883 before, 618 after), 2011/12 season versus 2013/14 season (published 2017)	The risk of injury associated with body checking among Pee Wee ice hockey players, British Journal of Sports Medicine (2017)

Overview

Injury	Body area	Typical time out
Concussions	Head	1 to 4 weeks, months if it persists
Lacerations and Contusions	Skin and soft tissue	Days to 6 weeks by depth
Ankle Sprains and Fractures	Ankle	1 to 12 weeks, months if fixed
Shoulder Injuries (including dislocation and AC joint separation)	Shoulder	1 week to 6 months by type
Wrist Injuries	Hand and wrist	2 to 12 weeks, longer if it is bone
Overuse Injuries	Whole body	4 to 12 weeks of managed load
Knee Injuries (including MCL and ACL strains or tears)	Knee	2 weeks to 12 months
Groin Injury	Groin	2 to 8 weeks, longer if chronic
Muscle Strains	Thigh and hip	2 to 8 weeks, 3 months if complete
Hamstring Pull	Back of thigh	2 to 12 weeks, longer at the tendon
Facial Injuries	Face	Days to 8 weeks by injury
Hip Injuries	Hip	2 weeks to 6 months
Broken Collarbone	Collarbone	6 to 12 weeks, 3 months if plated
Olecranon Bursitis	Elbow	0 to 6 weeks, longer if infected
Low Back Strain and Facet Joint Irritation	Lower back	1 to 6 weeks, 3 months if bony
Neck Stinger (Brachial Plexus Injury)	Neck	Minutes to 6 weeks if weak
Finger Fracture and Joint Sprain	Finger	0 to 6 weeks, 12 if fixed
Thumb Ulnar Collateral Ligament Sprain	Thumb	3 to 6 weeks, 12 after surgery
Scalp Laceration and Skull Contusion	Head	Days to 2 weeks, more with concussion
Lace Bite (Anterior Foot and Ankle Tendon Irritation)	Foot	0 to 2 weeks once padded
Rib Contusion and Fracture	Ribs	1 to 6 weeks
Metacarpal Fracture	Hand	4 to 8 weeks, 12 if fixed
Toe Fracture	Toe	2 to 6 weeks
Shin Contusion and Periosteal Bruising	Shin	Days to 2 weeks if just bruised

Concussions

A concussion is a functional injury to the brain, not a structural one you can see on a normal scan. It happens when a check into the boards, a fall onto the ice or a blow to the head makes the head accelerate and then stop suddenly, so the brain tissue is stretched and its chemistry is briefly disturbed. In hockey the classic mechanisms are a shoulder or elbow to the head, a hit from the blind side and the back of the head striking the ice.

Symptoms

• Headache or a feeling of pressure in the head after a hit
• Feeling dazed, slowed down or ‘not right’ for minutes to days
• Dizziness, nausea or trouble with balance on the bench
• Sensitivity to arena light and noise
• Trouble concentrating, plus poor sleep in the following nights

How serious it is: Older grading systems that ranked concussions from 1 to 3 on the ice are no longer used, because severity only becomes clear from how long symptoms last. A player whose symptoms clear within a week sits at the mild end, while symptoms that persist for a month or more, or a history of repeated concussions, mark the severe end.

Typical time out: Most players are symptom free within one to four weeks and then need several more days to work through a stepwise return to skating, contact and games. Symptoms lasting beyond a month, a previous concussion in the same season or neck and vision problems on top can stretch the absence to three months or longer, which is why the range is so wide.

See a doctor if: Go to an emergency department at once if the player loses consciousness, vomits repeatedly, becomes increasingly drowsy or confused, has a seizure, has weakness or numbness in an arm or leg, or the headache keeps getting worse.

What helps

• Off the ice immediately and no return the same day, whatever the player says
• One to two days of relative rest, then light activity such as walking or an easy bike that does not clearly worsen symptoms, because complete darkened room rest delays recovery
• A graded return in stages, with at least 24 hours per stage and full medical clearance before any contact
• Assessment of the neck and of eye movement, since neck strain and vision problems often mimic and prolong concussion symptoms
• A doctor or athletic trainer who knows sport concussion, especially after a second concussion or with symptoms beyond two weeks

Lacerations and Contusions

A laceration is a cut through the skin, usually from a skate blade, a stick blade or the edge of a visor, and it can go deep enough to reach tendon, nerve or artery, especially on the neck, forearm and back of the hand. A contusion is bleeding inside a muscle or against the bone after a direct blow from a puck, a shoulder or the boards, most often on the thigh, hip, shin and upper arm.

Symptoms

• Bleeding from a clean edged wound, often more than it looks like it should
• A dark, tender, firm swelling under the skin hours after a hit
• Pain when the bruised muscle contracts or is stretched
• Stiffness and lost range in the joint next to a big bruise
• Numbness or weakness past a deep cut, which suggests nerve involvement

How serious it is: A cut that only involves skin can be closed and forgotten, while one that gapes, spurts, reaches fat or muscle, or sits over a tendon, joint or the neck is a different injury and belongs in an emergency room. For contusions the mild form is tender but the joint still bends, the severe form is a muscle that will not stretch past half its normal range on the day after.

Typical time out: A simple stitched cut usually costs a few days to two weeks, mostly to keep the wound protected. A deep thigh or hip contusion takes two to six weeks and occasionally longer if the muscle stays tight, and a cut involving tendon or nerve is measured in months because it becomes a surgical repair.

See a doctor if: Get medical help immediately for a neck cut, for bleeding that does not stop under firm pressure within ten minutes, for numbness or lost movement beyond the wound, or for a bruised limb that becomes tensely swollen and severely painful out of proportion.

What helps

• Firm direct pressure with a clean pad first, before anything else is done to the wound
• Rinse with clean running water or saline, then have deep or dirty wounds closed and checked for tetanus cover within hours
• Short cooling of a fresh bruise for pain relief in the first hours, without strapping the limb rigidly
• Gentle pain free movement of the bruised muscle from day one, kept within a comfortable range, since immobilizing a big thigh bruise stiffens it
• See a doctor if a bruised muscle is still hard and cannot be stretched after two weeks, because that can be calcification in the muscle

Ankle Sprains and Fractures

A stiff skate boot protects the ankle in most positions, so the injuries that get through are the ones the boot cannot control. The common ones are a high ankle sprain of the syndesmosis, the ligament sheet between shin bone and calf bone, when a skate catches and the foot twists outward, and a fracture of the fibula or of the small navicular and talus bones after a direct blow from a puck or a collision along the boards.

Symptoms

• Pain above the ankle joint, higher than a classic rolled ankle, when the foot is twisted outward
• Pain on pushing off and on the crossover stride rather than on straight skating
• Swelling that appears within an hour and a boot that suddenly feels tight
• Not being able to put full weight on the foot for more than a few steps
• A hard, tender lump on the bone that stays sore weeks later

How serious it is: Ligament injuries are graded 1 to 3, from stretched fibers with a stable joint to a complete tear with instability. A high ankle sprain of the syndesmosis takes roughly twice as long as the same grade of a normal ankle sprain, and any fracture where the bone pieces have shifted is a surgical problem rather than a rehab problem.

Typical time out: A grade 1 low ankle sprain costs one to three weeks, a grade 2 to 3 sprain four to eight weeks, and a high ankle sprain six to twelve weeks. An undisplaced fracture needs six to twelve weeks in a boot, and a fracture fixed with a plate or screws usually means three to six months before contact hockey.

See a doctor if: Have it x rayed the same day if the ankle is visibly crooked, if you cannot take four steps on it, or if pressing directly on the bone at the back of either ankle bone is sharply painful rather than the soft tissue around it.

What helps

• Early protected weight bearing in a boot or on crutches rather than complete rest, as the ankle recovers faster when it is loaded within pain limits
• Balance and single leg control work off the ice, started once walking is comfortable, since it lowers the risk of a repeat sprain
• Calf and peroneal strengthening, plus attention to skate fit and lacing so the boot supports without cutting into the front of the ankle
• Taping or a brace for the first months back, most useful after a repeat sprain
• Imaging rather than more waiting if bone pain over a specific point has not settled in two weeks

Shoulder Injuries (including dislocation and AC joint separation)

Falling onto the point of the shoulder or being checked into the boards drives the shoulder blade down while the collarbone stays put, which tears the acromioclavicular ligaments that join them. Landing on an outstretched arm or being caught with the arm out and turned back instead pushes the head of the upper arm bone out of the socket at the front, tearing the labrum and stretching the capsule as it goes. AC joint sprains are the second most common specific diagnosis in college hockey after concussion.

Symptoms

• Immediate pain right on top of the shoulder with a step or bump you can feel
• Pain reaching the arm across the chest or lying on that side
• With a dislocation, a sudden dead arm feeling and an arm you hold against your body
• A flattened outer shoulder contour with a dislocation
• Weakness or a sense that the shoulder will slip when you raise the arm overhead

How serious it is: AC separations run from type I to type III for the injuries treated without surgery, up to types IV to VI where the collarbone end is clearly displaced and surgery is usual. For dislocations the deciding factors are age and recurrence: a first dislocation under about twenty carries a high chance of dislocating again, which is what pushes players toward stabilization surgery.

Typical time out: A type I or II AC separation costs one to three weeks, a type III three to eight weeks, and a surgically treated separation four to six months. A first shoulder dislocation treated without surgery costs roughly six to twelve weeks before contact, while stabilization surgery means five to seven months, because the repaired labrum needs that long to hold against a check.

See a doctor if: Seek care the same day if the shoulder is visibly out of place, if you cannot lift the arm at all, or if the hand or arm is numb, cold or weak, which points to nerve or vessel involvement.

What helps

• Sling only as long as it hurts, days rather than weeks, then start pain free movement
• Rotator cuff and scapular strengthening, since control of the shoulder blade is what protects the joint under contact
• Progressive loading toward the positions of the sport, including pushing and holding off an opponent, before any return to contact
• A discussion about stabilization surgery after a second dislocation or in a young player who wants to keep playing contact hockey
• Imaging for a shoulder that stays weak after four to six weeks, to look for a labral or cuff tear

Wrist Injuries

Most hockey wrist injuries come from a fall onto an outstretched hand at speed or from a slash across the back of the wrist. That load goes through the scaphoid bone, the distal radius and the triangular fibrocartilage complex on the little finger side, which is the structure loaded when you rotate the stick and take a slap shot. The scaphoid matters most, because its blood supply is poor and it can fail to heal if the fracture is missed.

Symptoms

• Pain in the hollow at the base of the thumb when you grip a stick
• Pain when you twist the forearm, for example turning a door handle
• Swelling across the back of the wrist that limits bending it backward
• Clicking or a giving way feeling on the little finger side when you push off the ice
• Weak grip that shows up when you try to shoot

How serious it is: A sprain settles steadily within a few weeks. Bone pain at a single point, particularly at the base of the thumb, is treated as a fracture until an x ray or MRI says otherwise, since scaphoid fractures are often invisible on a first x ray and become far harder to fix once they have failed to unite.

Typical time out: A simple sprain costs one to three weeks. A distal radius fracture usually means six to twelve weeks, and a scaphoid fracture eight to twelve weeks in a cast, longer if it does not unite. Triangular fibrocartilage tears are unpredictable and can take three months or more because the shooting motion loads exactly the injured structure.

See a doctor if: Get an x ray if the wrist is deformed, if pressing in the hollow at the base of the thumb is sharply painful, or if the fingers are numb or tingling after the fall.

What helps

• A wrist splint for comfort in the first one to two weeks, not for months
• An x ray or MRI early for point tenderness at the base of the thumb, since a missed scaphoid fracture is the costly outcome
• Grip and forearm rotation strengthening once bone injury is ruled out
• Return to shooting in steps, from passing to wrist shots to slap shots, rather than straight back to full load
• Well fitting gloves with an intact cuff, since slashes land where the cuff has worn away

Overuse Injuries

Overuse injuries develop when tendon, bone or cartilage is loaded again before it has adapted from the last load, so the tissue slowly changes rather than tearing at one moment. In hockey the typical sites are the adductor and hip flexor tendons at the pubic bone from the skating stride, the hip labrum from deep flexion in the skating stance, and the low back from staying bent forward. Off ice they show up as patellar or Achilles tendinopathy from a sudden jump in dryland training.

Symptoms

• Pain that starts a few minutes into a session and eases once you are warm, then returns worse afterward
• Soreness the morning after a hard practice that has been getting longer over weeks
• A precise painful spot on the tendon or bone rather than a general ache
• Loss of speed or shot power before any real pain shows up
• Pain climbing stairs or getting out of the car with hip and groin problems

How serious it is: The mild form hurts at the start of activity only and settles with load management. The severe form hurts during and after the session and eventually at rest, and if the tissue involved is bone, a stress reaction can progress to a true stress fracture, which changes the treatment completely.

Typical time out: Rarely a full absence, more often reduced load for four to twelve weeks while the tendon is rebuilt. Tendinopathy that has been present for months usually needs three months of consistent loading work, and a bone stress injury needs six to twelve weeks of protected loading, so the honest answer depends on how long it was ignored.

See a doctor if: See a doctor if the pain wakes you at night at rest, if it hurts to hop on that leg, or if a bony point stays tender to touch for more than two weeks, all of which suggest bone rather than tendon.

What helps

• Reduce the aggravating load rather than stopping everything, and keep total ice and dryland volume roughly steady from week to week instead of spiking it
• Slow heavy strength work for the affected tendon, including eccentric loading for Achilles and patellar tendinopathy, three sessions a week for at least twelve weeks
• Adductor strengthening such as the Copenhagen exercise for groin related pain, which is one of the few measures with good evidence in this sport
• A physiotherapist early rather than after three months, because the technique and load errors that caused it are easier to correct than the tendon is to repair
• Cortisone injection only as an exception in tendon problems, since it can relieve pain briefly but tends to leave the tendon worse over a year

Knee Injuries (including MCL and ACL strains or tears)

The medial collateral ligament on the inner side of the knee is the classic hockey ligament injury, torn when a check or a fallen player forces the knee inward while the skate is fixed on the ice. The anterior cruciate ligament tears when the knee twists over a planted skate or in a non contact cut, and the meniscus, the cartilage cushion between the bones, is often damaged in the same event. MCL tears are among the most common specific diagnoses in college hockey.

Symptoms

• Pain along the inner joint line when the knee is pushed inward
• A pop at the moment of injury followed by the knee swelling within a few hours, which points to the ACL
• A feeling that the knee will give way when you turn on it
• Locking or catching, or not being able to straighten the knee fully, which suggests the meniscus
• Deep pain and difficulty squatting that persists for weeks after the hit

How serious it is: MCL injuries are graded 1 to 3, from a stretched ligament with a stable joint to a complete tear with clear opening on testing. Most MCL tears including grade 3 heal without surgery, while a complete ACL tear does not heal and requires reconstruction if the player wants to return to a pivoting contact sport.

Typical time out: A grade 1 MCL sprain costs one to three weeks, grade 2 three to six weeks and grade 3 six to twelve weeks in a hinged brace. An ACL reconstruction means nine to twelve months before contact hockey, and a meniscus repair three to six months, because the repaired tissue heals slowly and returning early is what causes repeat tears.

See a doctor if: Get it looked at within days if the knee swelled up within a few hours of the injury, if it locks or will not straighten, or if it gives way on level ground.

What helps

• A hinged brace and early controlled movement for MCL injuries, which do best when the knee keeps moving
• Quadriceps and hamstring strengthening plus single leg control work, started as soon as swelling allows
• For an ACL tear, structured prehabilitation to get full extension and good quadriceps strength before any surgery, which measurably improves the outcome
• Return to play judged by strength and hop testing against the other leg, not by the calendar
• MRI if a swollen knee is still unstable or locked after two weeks

Groin Injury

The adductor muscles run from the pubic bone to the inner thigh and brake the leg at the end of every skating stride, then pull it back under the body. Injury is usually a strain at the tendon where adductor longus meets the pubic bone, and with repeated load it becomes adductor related groin pain, a chronic tendon problem rather than a single tear. Weak hip adduction strength before the season is the clearest predictor of who gets it.

Symptoms

• Sharp pain in the inner thigh or at the pubic bone during a hard first stride
• Pain when you squeeze your knees together
• Tightness that eases with warm up and returns after the game
• Pain getting out of a car or rolling over in bed in more advanced cases
• Loss of stride power on one side before any obvious pain

How serious it is: Acute strains are graded 1 to 3, from a few torn fibers to a complete tendon avulsion off the pubic bone. The chronic form is graded less formally: it counts as mild while it only hurts during play and severe once it hurts on everyday movement, and the chronic form is the one that ends seasons.

Typical time out: A grade 1 strain costs two to four weeks, grade 2 four to eight weeks and a full avulsion three months or more. Chronic adductor related groin pain typically needs eight to sixteen weeks of a supervised strengthening program, and the spread is wide because players who return at the first pain free day usually reinjure it.

See a doctor if: See a doctor if you felt a distinct pop with immediate loss of power, if there is a visible bulge or extensive bruising down the inner thigh, or if the pain is accompanied by testicular pain or a lump, which needs a hernia to be excluded.

What helps

• Progressive adductor strengthening, with the Copenhagen adduction exercise as the core exercise, continued through the season and not only during rehab
• Return in stages: skating without contact, then sprint starts, then battles, rather than straight into a game
• Address hip range of motion and single leg control, since a stiff or weak hip pushes the load onto the adductor tendon
• Off season preparation, because most groin injuries appear in the first weeks back on the ice after a break
• Imaging and a specialist opinion if pain at the pubic bone persists beyond three months despite consistent strengthening

Muscle Strains

A strain is a tear of muscle fibers where the muscle joins its tendon, which is the weakest link when a muscle is stretched and contracting at the same time. In hockey this happens at the hip flexors during an explosive first stride, at the quadriceps when a leg is checked while it is loaded, and at the calf on a hard push off. Fatigue late in a shift and cold muscles after sitting on the bench both raise the risk.

Symptoms

• A sudden grabbing pain in the muscle during an explosive movement
• Pain when you stretch the muscle and when you contract it against resistance
• Bruising appearing a day or two later, often lower down the leg than the injury
• A tender spot or a small dent you can feel in the muscle belly
• Limping or a shortened stride for several days

How serious it is: Strains are graded 1 to 3: grade 1 is a few fibers with almost full strength, grade 2 is a partial tear with clear weakness, grade 3 is a complete tear with a palpable gap and marked loss of function. A tear close to the tendon or at the point where it attaches to bone heals more slowly than one in the middle of the muscle belly.

Typical time out: Two to four weeks for a grade 1 strain, four to eight weeks for grade 2 and three months or more for a complete tear or a surgical repair. Tears near the tendon consistently take longer than the grade alone suggests, which is why an early return based on how it feels is unreliable.

See a doctor if: Have it assessed if you felt a snap and cannot bear weight, if you can feel a gap in the muscle, or if the limb becomes tensely swollen and the pain keeps rising instead of easing.

What helps

• Short cooling and a compression sleeve for pain in the first hours, then movement within a pain free range from day one
• Isometric holds in the first days, progressing to full range strengthening under load, since strength at long muscle length is what protects against reinjury
• Reintroduce speed work gradually before the first game, because most reinjuries happen in the first two weeks back
• Keep the rest of the body training, so the return is limited by the muscle and not by lost fitness
• Physiotherapy for a second strain in the same muscle, which usually means the first rehab was stopped too early

Hamstring Pull

The hamstrings run from the sitting bone to below the knee and work hardest while lengthening, when they slow the lower leg down before the foot lands. Skating loads them less than running does, so hockey hamstring injuries often happen in dryland sprinting or when a leg is forced back during a fall or a check. Biceps femoris near the tendon is the usual site.

Symptoms

• Sudden pain at the back of the thigh during a sprint or a slip
• Pain when you straighten the knee with the hip bent
• Tenderness along a line in the muscle rather than one small point
• Bruising behind the knee after a couple of days
• Difficulty in the first stride and in decelerating

How serious it is: Grades 1 to 3 apply as for other strains. What matters most for the timeline is location: a tear near the sitting bone or involving the tendon takes considerably longer than one in the muscle belly, and a complete avulsion at the sitting bone is a surgical injury.

Typical time out: Two to six weeks for a grade 1 injury and six to twelve weeks for a grade 2. Injuries at the tendon near the sitting bone often need three months or more, and after surgical reattachment of an avulsion the return is measured in months, not weeks.

See a doctor if: Get it examined if you cannot sit comfortably on that side, if there is a gap you can feel near the sitting bone, or if the back of the thigh is numb, which suggests the sciatic nerve is irritated.

What helps

• Nordic hamstring curls or a comparable eccentric program, which is the single best supported measure against both first and repeat hamstring injuries
• Strengthening at long muscle length, for example Romanian deadlifts and the single leg version, rather than only short range curls
• A staged running progression off the ice before returning to full skating
• Hip and trunk strength work, since the hamstring compensates for a weak hip extension pattern
• Do not return on the first pain free day: reinjury risk is highest in the first two weeks back

Facial Injuries

The face takes direct impacts from pucks, high sticks, elbows and the ice. The result is cuts to the eyebrow, lip and cheek, fractures of the nose, the cheekbone or the orbital floor around the eye, and broken or knocked out teeth. Full cages and full shields remove most of these, so the injuries cluster in players wearing a half visor or none.

Symptoms

• Bleeding cut on the eyebrow, lip or chin after a stick or puck
• Nose visibly bent, blocked, or bleeding heavily
• Double vision or numbness on the cheek and upper lip, which suggests an orbital or cheekbone fracture
• Teeth that feel out of line when you bite together
• A loose, cracked or missing tooth

How serious it is: A cut through skin alone is minor. Fractures around the eye, a jaw that no longer bites together correctly and any injury with double vision are serious and are handled by a maxillofacial or eye specialist. For teeth, the deciding factor is time: a knocked out permanent tooth has a good chance of surviving if it is put back within the first hour and a poor one after that.

Typical time out: A stitched cut costs a few days to two weeks. A nasal fracture usually means two to four weeks and a protective cage on return, while an orbital or cheekbone fracture means four to eight weeks and often a period without contact after surgery. Dental work may not cost ice time at all but needs follow up for months.

See a doctor if: Go to hospital the same day for double vision, numbness of the cheek, a bite that no longer meets, clear fluid running from the nose, or a nosebleed that will not stop.

What helps

• Pressure and clean rinsing of the cut first, then closure within hours to limit scarring and infection
• A knocked out tooth handled by the crown only, rinsed briefly, and either put straight back in the socket or kept in milk on the way to the dentist
• Assessment for concussion after any blow strong enough to break facial bone, since the two travel together
• Full cage or full shield on return, and long term for youth and recreational players, as it is the measure that prevents these injuries rather than treats them
• A custom fitted mouthguard, which also protects the teeth and jaw joint far better than a boil and bite version

Hip Injuries

The skating stance keeps the hip deeply flexed and turned out, and repeating that position drives the rim of the socket against the neck of the thigh bone. Over years this femoroacetabular impingement can fray the labrum, the cartilage ring that seals the socket, and it is unusually common in hockey players, particularly goaltenders. Acute injuries add hip flexor strains and, after a hard fall, a fracture or labral tear.

Symptoms

• Deep pain in the front of the hip or groin, often shown by cupping the hand in a C around the joint
• Pain and stiffness after sitting for a long time, for example on a bus trip
• Clicking, catching or a locking sensation when you rotate the hip
• Difficulty getting into a deep skating stance or, for goalies, into the butterfly
• Pain when you pull the knee toward the chest and turn it inward

How serious it is: A hip flexor strain settles like any muscle strain. Impingement and labral problems are the chronic end: mild while they only limit deep positions, severe when they hurt in daily life and stiffen the joint, at which point the discussion moves toward arthroscopic surgery.

Typical time out: A hip flexor strain costs two to six weeks. Impingement and labral pain managed with rehabilitation needs three to six months of consistent work, and hip arthroscopy means four to six months before full hockey, occasionally longer for goaltenders because of the demands of the butterfly position.

See a doctor if: See a doctor if the hip cannot be moved passively without severe pain, if you cannot bear weight after a fall, or if groin pain comes with fever or night pain at rest.

What helps

• Gluteal and deep hip rotator strengthening, which shifts load away from the front of the joint
• Trunk and pelvis control work, since a pelvis that tips forward deepens the impingement in every stride
• Manage load and reduce the number of repetitions in the deepest positions during a flare, especially for goaltenders
• A structured physiotherapy trial of at least three months before considering arthroscopy, because many players improve without surgery
• MRI with contrast or a specialist referral if catching and deep pain persist despite that program

Broken Collarbone

The clavicle is the strut that holds the shoulder out from the chest, and it sits directly under the skin with almost no padding. It breaks when a player lands on the point of the shoulder after a check or goes into the boards shoulder first, and the middle third is the usual site because that is where the bone is thinnest and most curved.

Symptoms

• A crack or snap felt at the moment of impact, then sharp pain over the collarbone
• Holding the arm against the body and supporting the elbow with the other hand
• A visible bump or step in the line of the bone
• Pain on any attempt to lift the arm away from the body
• Grinding felt under the skin when the shoulder moves

How serious it is: The key questions are whether the bone ends have shifted and whether the fracture is in one piece or several. Undisplaced fractures heal reliably in a sling, while a shortened, badly displaced or multi fragment fracture, or one that has pierced toward the skin, is usually plated to avoid a non union.

Typical time out: Six to twelve weeks for an undisplaced fracture treated in a sling, with a return to contact only once the bone is no longer tender and imaging shows healing. Plated fractures allow movement earlier but still need roughly three to four months before body checking, and healing is slower in smokers and in fractures with several fragments.

See a doctor if: Go to hospital straight away if the skin over the bone is tented, white or broken, if the arm or hand is numb or cold, or if you become short of breath, since the lung sits directly underneath.

What helps

• A simple sling for comfort, usually for two to four weeks, and elbow and hand movement from the first days
• Shoulder movement started as the pain allows and guided by follow up x rays, rather than waiting until the sling comes off
• Rotator cuff and scapular strengthening once the bone is healing, because the shoulder stiffens quickly in a sling
• A surgical opinion for a fracture that is clearly displaced or shortened, particularly in a player who wants to return to contact
• No contact until the doctor confirms bone healing, since a refracture in the same season is the common avoidable setback

Olecranon Bursitis

The olecranon bursa is a thin fluid sac over the point of the elbow that lets the skin glide over the bone. Falling onto the elbow on hard ice, or repeated contact through a worn or poorly positioned elbow pad, makes it bleed and fill, so a soft swelling the size of a golf ball appears at the back of the elbow. The bursa can also become infected through a small skin break, which changes the treatment completely.

Symptoms

• A soft, squashy swelling right on the point of the elbow
• Surprisingly little pain for the size of the lump, unless it is infected
• Discomfort leaning on the elbow or on the boards
• Full bending is limited by the swelling rather than by pain
• Redness, heat and increasing pain if it becomes infected

How serious it is: The mild form is a painless fluid swelling that resolves on its own. The important distinction is between a simple bursa and an infected one: fever, spreading redness, marked warmth and pain on any movement point to infection, which needs antibiotics and sometimes drainage.

Typical time out: Usually no time off at all if it is only a swelling, with a padded elbow for a few weeks. A bursa that keeps refilling can take four to eight weeks to settle, and an infected bursa means one to three weeks off plus antibiotics, occasionally longer if it needs surgical removal.

See a doctor if: See a doctor the same day if the elbow is red, hot and increasingly painful, or if you have a fever, because an infected bursa needs treatment rather than observation.

What helps

• Protect the elbow with a proper fitting pad and add a compression sleeve for a few weeks
• Avoid leaning on the elbow at the desk and on the bench, which is what keeps it refilling
• Short cooling for pain in the first days if the swelling is fresh and tender
• Draining it only when necessary, since aspiration often has to be repeated and carries an infection risk
• Prompt medical review for any warmth or redness rather than waiting to see

Low Back Strain and Facet Joint Irritation

The skating posture holds the trunk bent forward for long periods, which loads the muscles along the spine and the discs, and the rotation of shooting and turning loads the small facet joints at the back of the vertebrae. Pain is usually a strain of the muscles and their attachments plus irritation of those joints, and less often disc related pain that radiates into the leg. Goaltenders and defensemen carry the most of it because of the time spent in a low crouch.

Symptoms

• A band of ache across the low back that is worse after a game than during
• Stiffness getting out of bed or standing up after sitting
• Pain on arching backward or twisting toward one side
• A spot beside the spine that feels tight and tender to press
• Pain running down the back of the leg past the knee if a nerve is involved

How serious it is: Mild means pain that limits some movements but settles within days and never travels below the knee. Severe means pain that radiates down the leg with numbness or weakness, or back pain in a young player that is worse on arching back, which raises the question of a stress fracture in the vertebral arch.

Typical time out: A simple strain costs one to three weeks with modified load rather than complete rest. Nerve related pain typically takes six to twelve weeks to settle, and a stress fracture of the vertebral arch in an adolescent means around three months of restricted activity, which is why persistent back pain in a young player should not just be trained through.

See a doctor if: Seek urgent care for numbness around the groin or saddle area, loss of bladder or bowel control, progressive leg weakness, or back pain with fever.

What helps

• Keep moving and stay at reduced load rather than lying flat, since bed rest slows recovery
• Trunk endurance and hip mobility work, because a stiff hip forces the low back to supply the rotation
• Correct the dryland program: heavy loaded spinal flexion and twisting on top of a hockey week is a common trigger
• Gluteal and hamstring strengthening so the hips rather than the back drive extension
• Imaging and a medical opinion for pain radiating into the leg beyond six weeks, or for any young player with back pain that is worse on arching backward

Neck Stinger (Brachial Plexus Injury)

A stinger happens when a check drives the shoulder down while the head is pushed to the opposite side, stretching the brachial plexus, the bundle of nerves that runs from the neck into the arm. The nerve is not cut, it is stretched or compressed, so the burning and weakness usually pass quickly. The same mechanism with the head down and the crown taking the impact is what causes far more serious cervical spine injuries, which is why every neck symptom is treated seriously on the ice.

Symptoms

• A burning or electric feeling shooting from the neck down one arm to the hand
• The arm feeling dead and heavy for seconds to minutes
• Weakness lifting the arm or gripping right after the hit
• Symptoms in one arm only, which is what separates a stinger from a spinal cord injury
• Neck stiffness in the days afterward

How serious it is: The mild form clears in seconds to minutes with no lasting weakness. It counts as severe when weakness persists beyond a few minutes, when it recurs repeatedly through a season, or when both arms or the legs are affected, which is a spinal cord emergency and not a stinger.

Typical time out: A single stinger that clears completely within minutes with normal strength often costs no time beyond that shift. Persistent weakness means at least two to six weeks and a medical assessment, and repeated stingers can mean a season out while the neck is investigated and strengthened.

See a doctor if: Call for emergency help and do not move the player if symptoms are in both arms or in the legs, if there is neck pain in the midline with numbness, or if the player cannot move properly after the hit.

What helps

• Off the ice until strength in the arm is fully normal on testing, not just until the burning stops
• Neck and upper back strengthening, especially the muscles that stabilize the shoulder blade
• Coaching on keeping the head up and never taking contact with the crown of the helmet, which is the mechanism behind catastrophic neck injuries
• Correctly fitted shoulder pads that actually cover the top of the trapezius
• Medical assessment with imaging after a second or third stinger in a season

Finger Fracture and Joint Sprain

A slash, a puck to the glove or a finger caught in a jersey during a fight loads the small bones of the finger and the ligaments beside the middle joint. The result is either a fracture of the phalanx, often with rotation, or a sprain of the collateral ligaments and the volar plate at the middle joint, which swells for months even when nothing is broken. A finger that crosses over its neighbor when you make a fist is a rotated fracture and needs correcting.

Symptoms

• Immediate swelling of one finger that makes the glove tight
• Pain on pressing the side of the joint
• The finger crossing over its neighbor when you curl the hand
• Inability to fully straighten the finger
• A joint that stays thickened and stiff long after the pain has gone

How serious it is: A stable sprain can be buddy taped and played on. A fracture that is angled, rotated, involves the joint surface or has an associated tendon avulsion belongs with a hand specialist, because a badly healed finger fracture permanently limits grip.

Typical time out: Often no time off at all with a buddy taped sprain inside a glove. A stable fracture takes three to six weeks before contact and a fracture needing wires or a plate six to twelve weeks, with stiffness lingering well beyond that.

See a doctor if: Get an x ray if the finger looks crooked or crosses its neighbor when you make a fist, if you cannot straighten the tip actively, or if the skin over the joint is broken.

What helps

• Buddy tape to the neighboring finger for stable sprains and start moving early
• X ray for any deformity or rotation rather than assuming it is just jammed
• Daily gentle bending and straightening from the first week, since finger joints stiffen faster than almost any other joint
• A hand therapist for a joint still stiff after four weeks
• Accept that visible swelling of the joint can persist for six to twelve months even after a good recovery

Thumb Ulnar Collateral Ligament Sprain

The ulnar collateral ligament runs along the inner side of the base of the thumb and stops it being levered outward. In hockey it tears when the thumb is caught on the stick or the ice during a fall, or when an opponent’s stick forces the thumb sideways. Without that ligament the pinch grip between thumb and index finger is unstable, which affects far more than the sport.

Symptoms

• Pain and swelling at the web between thumb and index finger
• Weak pinch, for example turning a key or holding a mug
• The thumb feeling loose or as if it will bend too far sideways
• Bruising at the base of the thumb after a day
• Pain when you push the thumb outward

How serious it is: Grades 1 to 3 apply, from a stretched ligament to a complete tear. The important variant is when the torn end flips above an intervening layer of tissue, which prevents healing and always requires surgery, so a clearly unstable thumb should not simply be splinted and forgotten.

Typical time out: A grade 1 or 2 sprain costs three to six weeks in a thumb splint, and hockey can often be resumed earlier inside a glove with the thumb protected. A surgically repaired complete tear means roughly six to twelve weeks before contact, with grip strength returning over several months.

See a doctor if: See a doctor within a few days if the thumb clearly opens up sideways compared to the other hand or if pinch grip is markedly weak, since a complete tear treated late does badly.

What helps

• A thumb spica splint early, with an examination once the initial swelling has settled
• An x ray to rule out a fracture where the ligament pulls a bone fragment off
• Hand therapy for pinch and grip strengthening once the ligament is protected
• Surgical opinion for any thumb that tests unstable, rather than a wait and see approach
• A well fitting glove with an intact thumb, and taping the thumb for the first months back

Scalp Laceration and Skull Contusion

The scalp has a rich blood supply and sits directly on bone, so a puck, a stick or a skate blade that gets past the helmet edge produces a cut that bleeds heavily and looks worse than it usually is. The same impact bruises the underlying periosteum, the sensitive layer covering the skull, leaving a tender lump for weeks. Every one of these blows also raises the question of concussion or, rarely, a skull fracture.

Symptoms

• Heavy bleeding from a cut on the head, often soaking through a towel
• A firm tender lump on the skull that lasts for days to weeks
• Local headache right at the point of impact
• Bruising spreading down toward the eye over the following days
• Any concussion symptoms alongside it, such as feeling dazed or nauseous

How serious it is: A cut through the scalp alone is minor once it is closed. It becomes serious when there is a depression you can feel in the bone, when bruising appears behind the ear or around both eyes, or when any concussion or neurological symptom is present, which turns a skin problem into a head injury.

Typical time out: A closed scalp cut usually costs a few days to two weeks, mainly to protect the wound. If a concussion is diagnosed, the concussion protocol sets the timeline instead, which means at least one to four weeks and a stepwise return.

See a doctor if: Go to hospital immediately for a dent you can feel in the skull, clear fluid or blood from the nose or ear, increasing drowsiness, repeated vomiting or worsening headache.

What helps

• Firm pressure directly on the cut, since scalp bleeding almost always stops with sustained pressure
• Closure with staples or sutures within hours for anything that gapes
• Screening for concussion regardless of how small the cut is
• Short cooling of the bruised lump for pain, and letting it resolve on its own over several weeks
• Check helmet fit and the position of the visor, since these cuts often follow a helmet that sits too far back

Lace Bite (Anterior Foot and Ankle Tendon Irritation)

Lace bite is irritation of the tibialis anterior tendon and the tissue over it where the tongue of the skate and the top laces press on the front of the ankle and foot. Stiff new boots, laces pulled hard at the top and a tongue that has flattened over time concentrate pressure on a spot with almost no padding between skin and tendon. It is a pressure problem, not a training injury, which is why it responds to changing the skate rather than to rest alone.

Symptoms

• A burning or sharp pain across the front of the ankle inside the skate
• Pain that builds within minutes on the ice and disappears once the skate is off
• A tender, sometimes slightly swollen area over the front of the ankle
• A visible lace pattern or redness on the skin after skating
• Pain pulling the foot upward against resistance in more advanced cases

How serious it is: Mild lace bite is skin and soft tissue irritation that settles within a day. It counts as severe when the tendon itself is inflamed and hurts when you lift the foot even out of the skate, or when a hard lump forms over the bone, which can be a bony spur reacting to years of pressure.

Typical time out: Usually no time off, because it resolves within days once the pressure is removed. Tendon inflammation that has been ignored for months can need two to six weeks of reduced skating, and a bony lump that keeps rubbing may need a specialist opinion.

See a doctor if: See a doctor if the front of the ankle hurts when walking barefoot, if you cannot lift the foot properly, or if a hard lump on the bone keeps growing.

What helps

• Add a gel pad or a folded felt pad over the tender spot under the tongue, which fixes most cases directly
• Skip the top eyelet or lace the top section loosely instead of pulling it tight
• Have the boot heat molded and the tongue checked, since a collapsed tongue is the usual cause
• Give new skates a proper break in period rather than jumping straight into full sessions
• See a physiotherapist if pain persists out of the skate, because that means the tendon is involved

Rib Contusion and Fracture

A check into the boards, a fall onto an opponent’s knee or a puck taken to the side compresses the chest wall. The result is either a bruise of the rib and the muscles between the ribs, or a fracture of a rib, most often at the side where the curve is greatest. Because the ribs move with every breath, the injury is felt constantly, and the concern is less the bone itself than what lies underneath.

Symptoms

• Sharp pain on breathing in deeply, coughing, sneezing or laughing
• A precise painful point on the rib that hurts when pressed
• Pain rolling over in bed and getting up from lying down
• Shallow breathing because a full breath hurts
• Pain on trunk rotation, for example on a shot

How serious it is: A contusion or an undisplaced single rib fracture is painful but not dangerous. Multiple broken ribs, breathlessness, coughing blood or pain in the left upper abdomen after a hit are the serious end, since they point to injury of the lung, spleen or kidney.

Typical time out: A contusion costs one to three weeks. A single rib fracture usually needs three to six weeks before contact and often longer before shooting feels normal, because the muscles between the ribs pull on the healing bone with every rotation.

See a doctor if: Get emergency assessment for shortness of breath, coughing up blood, dizziness, or pain in the upper abdomen or radiating to the shoulder tip after a hit to the flank.

What helps

• Enough pain relief to allow deep breathing, since shallow breathing after a rib injury is what leads to chest infections
• Deliberate deep breaths and a supported cough several times a day
• Short cooling for local pain in the first days, without strapping the chest, as binding the ribs restricts breathing
• Gradual return to rotation and shooting, in that order, only after coughing is painless
• Medical review for any breathlessness or for pain that is still severe after two weeks

Metacarpal Fracture

The metacarpals are the five long bones in the palm. They break in hockey from a direct slash across the back of the hand, from a puck, or from punching during a fight, in which case the neck of the little finger metacarpal is the classic site. The glove protects against cuts but transmits a hard blow, so a hand that swells across the back after a slash is treated as a fracture until it is imaged.

Symptoms

• Swelling and bruising across the back of the hand rather than one finger
• A knuckle that has sunk or disappeared when you make a fist
• Pain on gripping the stick and on pushing through the hand
• The affected finger crossing over its neighbor when you curl the hand
• Pain when you press along the bone in the palm

How serious it is: The deciding factors are angulation, rotation and whether the joint surface is involved. A small angle at the neck of the little finger metacarpal is tolerated well, while rotation of any degree is not, since it makes the finger cross over its neighbor permanently and blocks a full grip.

Typical time out: Four to eight weeks for a stable fracture treated in a cast or splint, with a return to skating without contact often possible earlier. Fractures fixed with wires or a plate take six to twelve weeks before full contact, and grip strength usually takes another month or two to normalize.

See a doctor if: Get an x ray if a knuckle has disappeared, if the finger rotates, or if there is a wound over the knuckle from a tooth, which needs antibiotics because of the infection risk.

What helps

• Splint the hand and get it x rayed within a day or two rather than playing on it
• Keep the fingers moving in the splint as far as allowed, because a stiff hand is the main long term problem
• Hand therapy for grip and range of motion once the fracture is stable
• Return with the hand protected in the glove and progress from stick handling to shooting to battles
• A hand surgeon’s opinion for any rotated or joint involving fracture

Toe Fracture

Blocking a shot puts a puck onto the toe cap at high speed, and although the skate boot spreads the force, the toes underneath can still fracture, most often the great toe or the fifth toe. Skate boots that have gone soft at the toe box, plus a hard slap shot, are the usual combination. The bone heals reliably; the practical problem is that a stiff boot presses on the swollen foot.

Symptoms

• Immediate severe pain in the toe after blocking a shot
• Swelling and dark bruising, sometimes under the toenail
• Pain when pushing off in the stride
• A toe that looks bent or sits at a different angle than the other side
• Pain that continues when walking barefoot, not only in the skate

How serious it is: Most toe fractures are undisplaced and heal without intervention. It becomes serious when the great toe is fractured through the joint, when the toe is clearly deformed, or when blood collects painfully under the nail and needs releasing.

Typical time out: Two to four weeks for a lesser toe and three to six weeks for the great toe, which carries more of the push off load. A fracture involving the joint of the great toe or one requiring fixation means six to ten weeks, and the limit is often boot comfort rather than bone healing.

See a doctor if: Get it seen if the toe is visibly crooked, if the skin is broken, or if pressure under the nail is severe, since a bent toe healed in that position causes lasting problems in a tight boot.

What helps

• X ray for the great toe or for any deformity, since it is worth confirming there
• Buddy tape a lesser toe to its neighbor with a pad between them
• A stiff soled shoe for walking in the first weeks to limit toe bending
• Return to skating when the boot can be laced without pain, starting with skating before shooting and battling
• Consider a boot with an intact toe cap and shot blockers, since a softened toe box is often the reason it broke

Shin Contusion and Periosteal Bruising

The front of the shin bone has only skin and a thin sensitive membrane, the periosteum, over it, so a puck or a stick that lands above, below or beside the shin guard bruises the bone surface directly. The pain is out of proportion to the visible injury and lasts longer than a muscle bruise because the periosteum is densely supplied with nerves. A hard blow to the same area can also cause a fracture of the tibia, which is why persistent point tenderness is checked.

Symptoms

• Intense, immediate pain after a puck or stick to the shin
• A tender lump on the bone that stays for weeks
• Pain when anything touches the spot, including the shin guard
• Bruising that tracks down toward the ankle over several days
• Pain on pushing off in the stride if the spot is near the top of the shin

How serious it is: The usual form is a painful bruise that fades over two to six weeks and needs nothing more than padding. It is serious when weight bearing is not possible, when the calf becomes tensely swollen with pain that keeps rising, or when a specific point on the bone stays sharply tender for more than two weeks, all of which need a doctor.

Typical time out: Usually a few days to two weeks, mostly limited by tolerating the shin guard. A tibial fracture is a different matter entirely, with six to twelve weeks at minimum and months if it is surgically fixed.

See a doctor if: Seek urgent care if you cannot bear weight, if the lower leg becomes tightly swollen with severe and increasing pain, or if there is numbness in the foot, since pressure inside the muscle compartment is an emergency.

What helps

• Short cooling and a compression sleeve for pain in the first hours
• An extra pad or a doughnut shaped pad over the tender point inside the shin guard
• Keep skating within pain limits rather than resting completely, since it is a local bruise and not a training injury
• Check that the shin guard actually covers the knee to the boot without a gap, which is where these blows land
• X ray if pressing one specific point on the bone still causes sharp pain after two weeks

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 Ice Hockey

• Play in leagues that keep body checking out of youth hockey for as long as possible. Removing checking from Pee Wee play in Canada cut game injuries in half and concussions by roughly two thirds in 11 and 12 year olds, which is a bigger effect than any training program achieves.
• Build adductor strength before the season and keep it through it. Hip adduction strength is the clearest modifiable factor behind groin injuries in hockey, and a simple Copenhagen adduction progression twice a week covers it.
• Wear a full cage or full shield, especially in youth and recreational hockey, and use a custom fitted mouthguard. Facial cuts, orbital fractures and broken teeth almost all belong to players wearing a half visor.
• Coach and enforce head up contact. Hitting from behind, targeting the head and taking impact on the crown of the helmet are the mechanisms behind concussions and the rare catastrophic neck injuries, and rule enforcement changes them more than equipment does.
• Manage the load across the whole week, including dryland, and treat the first weeks back after a break as the highest risk period. Most overuse and groin problems appear when volume jumps after time off.
• Check equipment fit rather than owning it: skates heat molded with an intact tongue, shoulder pads that cover the top of the trapezius, shin guards without a gap at the boot, and gloves with an intact cuff and thumb.

When to Stop and Get Medical Help

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

• Any suspected head injury with loss of consciousness, repeated vomiting, a seizure, growing drowsiness or a headache that keeps worsening.
• Neck pain in the midline after a hit, or numbness, tingling or weakness in both arms or in the legs. Do not move the player and call emergency services.
• A visibly deformed limb or joint, a bone end pressing against or through the skin, or a joint that cannot be moved at all.
• Inability to bear weight for more than a few steps after an ankle, knee or leg injury.
• Numbness, a cold or pale hand or foot, or a limb that becomes tensely swollen with pain that keeps increasing rather than easing.
• A deep cut that will not stop bleeding under firm pressure, any cut on the neck, or breathlessness, coughing blood or upper abdominal pain after a blow to the chest or flank.

Sources

• Epidemiology of Injuries in National Collegiate Athletic Association Men’s Ice Hockey, Journal of Athletic Training (2021)
• Boltz et al., Journal of Athletic Training 2021 (NCAA Injury Surveillance Program)
• The risk of injury associated with body checking among Pee Wee ice hockey players, British Journal of Sports Medicine (2017)

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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