Association of Training and Game Loads to Injury Risk in Junior Male Elite Ice Hockey Players: A Prospective Cohort Study.

Background: Training and game loads are potential risk factors of injury in junior elite ice hockey, but the association of training and game loads to injuries is unknown. Purpose: To investigate the association of chronic training and game loads to injury risk in junior male elite ice hockey players. Study Design: Cohort study; Level of evidence, 2. Methods: In this prospective cohort study, we monitored all health problems among 159 male junior ice hockey players (mean age, 16 years; range, 15-19 years) at sports-specific high schools during the 2018-2019 school year. Players reported their health problems every week using the Oslo Sports Trauma Research Center Overuse Questionnaire on Health Problems (OSTRC-H2). The number of training sessions and games was reported for 33 weeks. We calculated the previous 2-week difference in training/game loads as well as the cumulative training/game loads of the previous 2, 3, 4, and 6 weeks and explored potential associations between training/game loads and injury risk using mixed-effects logistic regression. Results: The players reported 133 acute injuries, 75 overuse injuries, and 162 illnesses in total, and an average of 8.8 (SD ±3.9) training sessions and 0.9 (SD ± 1.1) games per week. We found no association between the difference of the two previous weeks or the previous 2- 3- and 4-week cumulative, training or game load and acute injuries, nor the difference of the two previous weeks, or the previous 4- and 6-week cumulative, training or game load and overuse injuries (OR, ∼1.0; P > .05 in all models). Conclusion: In the current study of junior elite ice hockey players, there was no evidence of an association between cumulative exposure to training/game loads and injury risk.

Association Between Preseason Fitness Level and Risk of Injury or Illness in Male Elite Ice Hockey Players: A Prospective Cohort Study.

BACKGROUND: Little is known about the association between physical fitness and the risk of injury or illness in ice hockey. The least-fit players may be more prone to injury and illness. PURPOSE: To examine the association between preseason fitness level and injury or illness risk among elite ice hockey players during the regular season. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 133 male ice hockey players in the GET League (the premier professional league in Norway) completed 8 different exercises (40-m sprint, countermovement jump, 3000-m run, squat, bench press, chin-ups, brutal bench, and box jump) at the annual 1-day preseason testing combine. During the 2017-2018 competitive season, the players reported all health problems (acute injuries, overuse injuries, and illnesses) weekly (31 weeks) using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. RESULTS: Overall, the players reported 191 acute injuries, 82 overuse injuries, and 132 illnesses. The least-fit tercile of players did not report more health problems (mean, 3.0; 95% CI, 2.2-3.8) compared with the most-fit (mean, 3.4; 95% CI, 2.6-4.2) or the medium-fit (mean, 2.7; 95% CI, 1.9-3.5) players. The most-fit players reported more substantial health problems (mean, 2.0; 95% CI, 1.6-2.5) compared with the medium-fit (mean, 1.3; 95% CI, 0.8 -1.8) and least-fit (mean, 1.8; 95% CI, 1.3-2.3) (P = .02) players. There was no association between low physical fitness and number of health problems when comparing the least-fit tercile of the players with the rest of the cohort (P > .05); however, there was an association between low physical fitness and greater severity of all health problems when comparing the least-fit tercile of players to the rest of the cohort after adjusting for time on ice per game, playing position, and age (P = .02). CONCLUSION: Low physical fitness was not associated with increased rate of injury or illness but was associated with greater severity of all health problems after adjusting for time on ice per game, playing position, and age.

Prevalence and Burden of Self-Reported Health Problems in Junior Male Elite Ice Hockey Players: A 44-Week Prospective Cohort Study.

BACKGROUND: Little is known about the burden of overuse injuries and illnesses in junior elite ice hockey. PURPOSE: To describe the prevalence and burden of all health problems in junior male elite ice hockey players in Norway during 1 school year. STUDY DESIGN: Descriptive epidemiological study. METHODS: A total of 206 junior male ice hockey players (mean age, 17 years; range, 15-20 years) attending specialized sports academy high schools in Norway reported all health problems, acute injuries, overuse injuries, and illnesses, weekly during the 2018-2019 school year (44 weeks). The players self-reported injuries and illnesses using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. RESULTS: Of the players included, 25% (95% CI, 23%-27%) reported at least 1 health problem at any given time, while 16% (95% CI, 14%-17%) experienced health problems with a substantial negative effect on training and performance. Of the total burden of health problems, acute injuries accounted for 44%, overuse injuries 31%, and illnesses 25%. For acute injuries, the greatest burden was caused by injuries to the ankle, knee, and hand, whereas for overuse injuries the most burdensome location was the hip/groin and knee. CONCLUSION: This study documented that while acute injuries did represent the greatest problem among junior elite ice hockey players, overuse injuries, especially to the knee and hip/groin, also had a substantial effect.

Prevalence and Burden of Health Problems in Male Elite Ice Hockey Players: A Prospective Study in the Norwegian Professional League.

BACKGROUND: As previous epidemiological studies in elite ice hockey have focused on acute time-loss injuries, little is known about the burden of overuse injuries and illnesses in ice hockey. PURPOSE: To report the prevalence and burden of all health problems in male professional ice hockey players in Norway during a single competitive season. STUDY DESIGN: Descriptive epidemiological study. METHODS: A total of 225 male ice hockey players in the GET League (the premier professional league) in Norway reported all health problems (acute injuries, overuse injuries, and illnesses) during the 2017-2018 competitive season. Players reported all injuries and illnesses for 31 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems. RESULTS: At any given time, 40% (95% CI, 37%-43%) of players reported symptoms from an injury or illness, and 20% (95% CI, 19%-22%) experienced health problems with a substantial negative impact on training and performance. Acute injuries represented the greatest incidence, prevalence, and burden (defined as the cross-product of severity and incidence). The most burdensome acute injuries were to the head/face, shoulder/clavicle, knee, and ankle. The most burdensome overuse injuries were to the knee, lumbar spine, and hip/groin. CONCLUSION: This registration captured a greater burden from overuse injuries than traditional injury registration, but acute injuries did represent a major problem. These data provide guidance in the development of prevention programs for both acute and overuse injuries, which should focus on the lumbar spine, hip/groin, and knee.