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Injuries in men’s international ice hockey: a 7-year study of the International Ice Hockey Federation Adult World Championship Tournaments and Olympic Winter Games.
The FIH Executive Board is the legislative body of the FIH. It meets three times a year and is made up of the President, the Chief Executive Officer and 14 members, five of which represent the Continental Federations and one that serves as the athletes' representative. Dr. Narinder DHRUV BATRA
PRESIDENT FIH President
Dr. Narinder DHRUV BATRA
➥ Dr. Batra was elected as FIH President at the 45th Congress in Dubai, United Arab Emirates in November 2016. He had been a member of the Executive Board since the 2014 FIH Congress in Marrakesh, Morocco and is the current President of the Indian Olympic Association (IOA). After his election as FIH President, Dr Batra stepped down from his roles as President of Hockey India (HI), Chairman of the Hockey India League (HIL) and Vice-President of the Asian Hockey Federation (AHF). In 2014, Dr. Batra was given the FIH President’s Award in recognition of his long and valuable services to hockey. In June 2019, Dr Batra was elected IOC Member. In May 2021, he was re-elected for a second term as FIH President. Dr. Batra’s favourite aspects of hockey are the speed and competitive nature of the game, stating that the sport always leaves you on the edge of your seat.
Thierry Weil
Chief Executive Officer
➥ With more than 35 years’ of experience as an executive leader and a proven track record working at the highest levels of sports administration on the global stage, French national Thierry Weil is multi-cultural, multi-national and multi-lingual leader. His strong international reputation in the highest echelons of the sports industry has been cemented thanks to his executive roles at two companies – Adidas Global and, most recently, Fédération Internationale de Football Association (FIFA). The former ‘Vice President, Global Football Sports’ at Adidas and 'Director of Marketing' at FIFA believes the values and respect within all levels of hockey are unique, whilst new international events, including the FIH Pro League and the Hockey Series, present exciting opportunities for the sport.
Mr. Seif EL DINE AHMED
Member | EGY (AfHF) | Term until 2023(Aug)
➥ Seif Ahmed was a member of Egypt’s national team in 1968 and has a long association with the sport as both an umpire and a technical official. He has been Treasurer and now President of the African Hockey Federation (AfHF) and is a former member of the Egyptian Olympic Committee. Seif was given the FIH President’s Award in 1999 and the FIH Order or Merit in 2002 in recognition of his long, distinguished and valuable services to hockey. He joined the FIH Executive Board in 2004. Seif loves the speed of the game as well as penalty corner set-plays.
Mr. Fumio OGURA
Member | JPN (AHF) | Term until 2023 (Feb)
➥ Elected on 22 February 2019 as the President of the Asian Hockey Federation (AHF) – therefore joining the FIH Executive Board as well -, Dato Fumio Ogura has been an international player and National Coach for Japan’s hockey team. He has been a long serving official of the Japanese Hockey Association (JHA) and also a core member of the AHF with more than 35 years of association with Asia’s hockey governing body. He has served FIH in various capacities; amongst others, he was member of the first FIH Development Committee and has served as the secretary of the FIH Development and Coaching Committee. Furthermore, Fumio Ogura is a Member of Olympic Council of Asia’s Rules Committee and the Deputy Executive Director, International Relations in charge of NOC & IPC Department for the Tokyo 2020 Olympic Games.
Ms. Marijke FLEUREN
Member | NED (EHF) | Term until 2023 (Aug)
➥ Marijke has been a member of the FIH Disciplinary, Competitions and Appointments Committees. She has been a Board Member and Vice President of the Royal Dutch Hockey Federation (KNHB) as well as being Vice President of the KNHB organizing committees. She was elected President of the European Hockey Federation (EHF) in 2011 - therefore joining the FIH Executive Board as well - and brings a wealth of knowledge to the Executive Board. Marijke’s favourite thing about hockey is that it is more than a sport; it is a lifestyle.
Ms. Clare PRIDEAUX
Member | AUS (OHF) | Term until 2023 (Apr)
➥ Clare won a silver medal at the 1990 FIH World Cup as a part of the Australian Women's team and has over 35 years leadership and high performance sport experience specialising in aligning strategy, values, people and performance. She was a Board member of Hockey Australia for nearly a decade serving as Vice President for over five years. Clare is a passionate coach and has a life long commitment to volunteering. She was elected President of Oceania Hockey Federation in March 2019, therefore joining the FIH Executive Board as well. She loves that hockey is team based and welcomes diversity - all ages, all genders, all cultures, all families - all welcome.
Mr. Alberto “Coco” BUDEISKY
Member | ARG (PAHF) | Term until 2021 (Aug)
➥ Alberto, also known as “Coco”, is a well-known face in Argentine and Pan American Hockey thanks to his tireless work in the region. He served on the FIH Competitions Committee before being elected President of the Pan American Hockey Federation (PAHF) in 2013, therefore joining the FIH Executive Board as well. He loves hockey’s ability to form healthy peer groups for young people, getting them involved in sporting activities from an early age.
Ms. Danae ANDRADA
Member | URU | Term until 2024 (Nov)
➥ The Pan-American Hockey Federation Executive Board Director, President of Uruguayan Hockey Federation and Director of the Uruguayan Sports Confederation has been involved in hockey for a number of years. Danae has been an FIH Executive Board member since 2016. Danae enjoys the skill and speed of hockey at all levels, from grassroots to elite teams.
Mr. Erik CORNELISSEN
Member | NED | Term until 2024 (Nov)
➥ President of the Royal Dutch Hockey Federation (KNHB) and Member of the FIH Risk and Compliance Committee. Erik has been an FIH Executive Board member since 2016. He is a valuable addition to the EB from one of the world’s most successful hockey nations. The sport’s excitement and passion as well as the global friendships it creates are the standout qualities of hockey for Erik.
Ms. Maureen CRAIG-ROUSSEAU
Member | TTO | Term until 2022 (Nov)
➥ Maureen has been an FIH Executive Board member since 2014 and has over 30 years experience serving the sport in various administrative roles. She is Director and Vice President of the Pan American Hockey Federation (PAHF), a past President of the Trinidad & Tobago Hockey Board (TTHB) and a hugely experienced Tournament Director and Technical Official. Maureen loves that hockey caters for athletes of all ages on a competitive level as well as being an all-inclusive family sport. Maureen was re-elected to the FIH Executive Board at the 46th FIH Congress in New Delhi, India.
Dr. Michael GREEN
Member | GER | Term until 2022 (Nov)
➥ A former national team member for Germany and player for Harvestehuder THC in Hamburg, Michael competed at two Olympic Games and was named FIH Player of the Year in 2002. Michael was, until November 2016, Chair of the FIH Athletes’ Committee. He has been an FIH Executive Board member since 2016. Michael loves that hockey is a dynamic and innovative sport that generates friendships across the globe. He was re-elected to the FIH Executive Board at the 46th Congress in New Delhi, India.
Mr. Tayyab IKRAM
Member | MAC | Term until 2024 (Nov)
➥ As a member of the International Olympic Committee Sport and Active Society Commission, the Association of National Olympic Committees Events Commission and the Athletes Commission and Coordination Commission of the Olympic Council of Asia, the CEO of the Asian Hockey Federation has a long association with hockey and international sport. Tayyab has been a member of the FIH Development and Coaching Committee, FIH High Performance Panel and is a FIH Master Coach. He has been an FIH Executive Board member since 2016. The former Pakistan and China Coach believes hockey is pioneering in its inclusivity and universality.
Ms. Hazel KENNEDY
Member | ZAM | Term until 2024 (Nov)
➥ As Secretary General of the National Olympic Committee of Zambia, President of the Zambia Hockey Association and a former Executive Board Member of the African Hockey Federation, Hazel has extensive experience in African sport. She has been an FIH Executive Board member since 2016. Her passion for hockey has been lifelong, with its health and social benefits her key attraction to the sport.
Ms. Elizabeth Safoa KING
Member | GHA | Term until 2022 (Nov)
➥ Elizabeth has a fine track record as a sports administrator and technical official in both her native Ghana and the Africa continent. She is Vice-President of the Ghana Hockey Association, and Treasurer of the Africa Hockey Federation (AfHF). Elizabeth served on the Women’s Commission for the Ghana Olympic Committee, which fights for female inclusion and participation at international events. Her contribution to the development of hockey in Ghana has been significant, playing a central role in the formation of a women’s hockey association with the aim to encourage women to play the sport. Elizabeth has been an FIH Executive Board member since 2018.
Mr. Shahbaz AHMAD
Member | PAK | Term until 2022 (Nov)
➥ Widely recognised as one of the greatest hockey players in the history of the sport, Shahbaz made over 300 appearances for Pakistan and was named player of the tournament at both the 1990 World Cup in Lahore and the 1994 World Cup in Sydney, where he captained the Green Shirts to the title. He also claimed an Olympic bronze medal at the Barcelona 1992 Games. He has been an FIH Executive Board member since 2018.
Mr. Rogier HOFMAN
Member | NED (Athletes) | Term until 2022 (Nov)
➥ Rogier Hofman enjoyed a stellar international career with the Netherlands, earning 212 caps over nine successful years between 2006 and 2016. The versatile attacker won gold medals at both the 2015 European Championships and 2012-13 Hockey World League Final, as well as silver medals at the London 2012 Olympic Games and the Hockey World Cup 2014. He joined the FIH Executive Board in 2018, as Representative of the Athletes. Away from the pitch, Rogier created, amongst others, the Sport Helpt Foundation, which gives seriously ill children the chance to meet top level athletes from their favourite sport.
ABSTRACT Background Information on ice hockey injuries at the international level is very limited. The aim of the study was to analyse the incidence, type, mechanism and severity of ice hockey injuries in men’s international ice hockey tournaments. Methods All the injuries in men’s International Ice Hockey Federation World Championship tournaments over a 7-year period were analysed using a strict definition of injury, standardised reporting strategies and an injury diagnosis made by a team physician. Results 528 injuries were recorded in games resulting in an injury rate of 14.2 per 1000 player-games (52.1/ 1000 player-game hours). Additionally, 27 injuries occurred during practice. For WC A-pool Tournaments and Olympic Winter Games (OWG) the injury rate was 16.3/1000 player-games (59.6/1000 player-game hours). Body checking, and stick and puck contact caused 60.7% of the injuries. The most common types of injuries were lacerations, sprains, contusions and fractures. A laceration was the most common facial injury and was typically caused by a stick.
The knee was the most frequently injured part of the lower body and the shoulder was the most common site of an upper body injury. Arenas with flexible boards and glass reduced the risk of injury by 29% (IRR 0.71, (95% CI 0.56 to 0.91)). Conclusions The incidence of injury during international ice hockey competition is relatively high. Arena characteristics, such as flexible boards and glass, appeared to reduce the risk of injury.
The International Ice Hockey Federation (IIHF), founded on 15 May 1908 in Paris, France, is the governing body of international ice hockey and inline hockey. The IIHF is comprised of 72 member associations, each of which is the national governing body for the sport of ice hockey. The IIHF also presides over ice hockey in the Olympic Games and the IIHF World Championships (WC) at all levels, that is, men, women, junior under-20, junior under-18 and women under-18. Each season, the IIHF, in collaboration with the local organising committee, runs Men’s WC in the six different categories. The teams are qualified to the divisions and groups according to IIHF World ranking. Ice hockey is also the biggest team sport in the Olympic Winter Games (OWG). Each ice hockey team typically consists of 22 players, including two wingers, one centre, two defencemen and a goalkeeper who are usually on the ice at the same time. The active playing time is three periods of 20 min each. In ice hockey, body contact is common and body checking is permitted in the men’s game.
Ice hockey is also associated with many other potential risk factors, such as unintended collisions, high velocity, rapid changes in direction and traumas from the boards, stick or puck. As a result, a wide variety of injuries ensue.1 Facial injuries and concussion have been reported in epidemiological studies at other levels of the sport including in the National Hockey League (NHL; USA and Canada).2 3 However, the risk, type, mechanism and severity of ice hockey injuries at the international elite level have not been well studied. The purpose of this study was to assess the incidence, nature, causes and severity of ice hockey injuries among IIHF men’s WC and Olympic Games between 2006 and 2013. METHODS During the seven ice hockey seasons between 2006–2007 and 2012–2013 (from 1 July 2006 to 30 June 2013) we registered, with permission from the IIHF, all ice hockey injuries from 32 men’s WC (seven WC Tournaments, seven WC Division (Div) I Grade (Gr) A Tournaments, seven WC Div I Gr B Tournaments, two WC Div II Gr A Tournaments, seven WC Div II Gr B Tournaments, two WC Div III Tournaments), one OWG (2010) and eight Olympic Qualification Tournaments. A total of 844 games were played in the 41 Tournaments by 303 Teams (6666 players).
A-pool level competitions consisted of 436 games in the eight tournaments played by 124 teams (2728 players). A Team Medical Personnel Meeting before each tournament allowed the IIHF medical supervisor (MS) to review the definition of the injury, game injury report form (GIR) and the injury report system form (IRS) with the individual team physicians (figure 1). The definition of an injury was made in accordance with accepted international ice hockey norms. An IRS was completed when one of the following criteria was observed: ▸ any injury sustained in a practice or a game that prevented the player from returning to the same practice or game; ▸ any injury sustained in a practice or a game that caused the player to miss a subsequent practice or game;
The team physician followed all the players on their team and reported all injuries to the MS using the GIR and IRS forms. Each injury required a separate IRS form and was reported only once. The GIR and IRS forms were both anonymous. The IIHF MS assigned to each championship was responsible for data collection. A GIR form was obtained from each team physician after every game to determine the number of injuries that satisfied the definition (figure 2). An IRS form was completed by the team physician for each individual injury. The IRS form detailed the period, location on ice, mechanism, anatomic location, severity and specific injury diagnosis. The anonymous forms were returned to the IIHF Medical Committee for insertion into a computer-based injury report system for ice hockey injuries (Medhockey). Injury rate (IR) was expressed as the number of injuries per 1000 ice hockey player-games and per 1000 player-game hours.
These two different injury rate definitions were used to allow comparison with other IIHF championships, hockey leagues and sports (football, soccer). The number of player-games was based on 22 players competing for each team in a game. The player exposure to injury was determined by collective playing time; that is, all the players of the team were participating in the game, had an impact in the game and were at risk for injury during every moment of the game event. When calculating the incidence all the players of the team were included in the denominator. The player-game injury rate was an average risk of one individual player per 1000 games (# injuries/# players (two teams)/# games×1000=injuries per 1000 player-games).
The injury rate for 1000 player-game hours was based on a 60 min active game with five players and a goalie per team on the ice at the same time (# injuries/# players on ice same time (two teams)/# games×1000=number of injuries per 1000 player-game hours). The given injury rates refer to game injuries only (practice injuries excluded). In the present study, the subgroup ‘flexible board and glass’ was collected from the tournaments where boards comparable to those of NHL were used. The more flexible boards and glass were developed to improve player safety.
To determine the association between the arena characteristics and occurrence of injuries, Poisson and Logistic regressions were used. Logistic regression was used when the number of the analysed injuries in each game was zero or one. In other statistical analyses, Poisson regression was applied to allow for several injuries per game. In these analyses, weighting with standardise active playing time was employed. Generalised estimating equations were used to determine association between the concussion and player position in A-pool tournaments. RESULTS Incidence of injuries During the study period, 528 injuries in 511 incidents were reported in 844 games. Additionally, 27 injuries occurred during the practices. The injury rate per 1000 ice hockey playergames was 14.2 for all men’s WC and the annual injury rate ranged between 12.2 (2011) and 17.5 (2008). For WC A-pool tournaments and OWG the injury rate was 16.3/1000 player Lower body injuries The knee was the most common lower body injury with 46.9% of the lower body injuries affecting the knee (men’s WC A-pool 49.4%).
The injury rate for knee injuries was 2.0/1000 playergames (men’s WC A-pool 2.3). Medial collateral ligament (MCL) sprain was the most common knee injury (56.6% of the knee injuries) and most of them were grade I injuries (51.2%). Meniscus tears comprised 14.5% and anterior cruciate ligament (ACL) disruption 10.5% of all knee injuries. Ankle and thigh injuries were the second and third most common lower body injuries. Upper body injuries The shoulder was the most common location for an upper body injury (49.6%; men’s WC A-pool=50%). The injury rate for shoulder injuries was 1.5/1000 player-games (men’s WC A-pool=1.7). Acromioclavicular (AC) joint sprain (50.9%) and glenohumeral joint injury (40.4%) were the most frequent diagnoses. The fingers (14.2%), wrist (10.8%) and hand (10.8%) injuries were in the second, third and fourth place in upper body injuries, respectively. Injury types by diagnosis The vast majority of injuries (92.8%) were acute in nature and this trend was consistent over the 7-year study period. Lacerations were the most common type of injury (26.1%). Sprains (21.8%) and contusions (15%) made up the next largest group.
A fracture was diagnosed in 14% (men’s WC A-pool=15.4%). The percentage of neurotrauma was 9.9% (men’s WC A-pool=11.5%; figure 5). Concussion Concussions accounted for a small yet clinically important number (n=52, 9.9%) of injuries in the championships. The injury rate of concussion was 1.4/1000 player-games in all men’s WC and 1.9 in men’s A-pool tournaments. The most common cause for concussion was check to the head (51.9%). A penalty was called in only 32.7% of the events that caused a concussion. For those players diagnosed with a concussion, 11.5% returned to play in the same game (men’s WC A-pool=5.6%). Estimated time loss was more than 3 weeks in 7.7% of the cases. The centre position had the highest risk of concussion, 25% (30.6% in men’s WC A-pool), the defence position, 20.2% (15.3% in men’s WC A-pool) and the wing position, 17.3% (19.4% in men’s WC A-pool).
The majority of concussions occurred during the first period (42.3%; 47.2% in men’s WC A-pool). Contact with the boards The majority of injuries occurred away from the boards (68.5%). This trend was apparent in all championships and was similar over the 7-year study period. Shoulder injuries were the most common (27.3%) resulting from contact with the boards (63.2%). The majority of concussions occurred without board contact (55.8%). Flexible boards and glass There was 29% lower risk of an injury at the arenas where flexible boards and glass were used compared to arenas with traditional boards and glass (IRR 0.71, (95% CI 0.56 to 0.91)). The A-pool WC tournaments that were played in arenas with flexible boards and glass had a shoulder injury rate of 0.9/1000 playergames as compared to 2.2/1000 player-games when traditional boards and glass were in place (IRR 0.36, (95% CI 0.15 to 0.90); figure 6). In addition to these significant findings, there were fewer concussions when flexible boards and glass were used instead of traditional boards and glass (OR 0.43, (95% CI 0.18 to 1.01)).
Also, there was a trend for a decrease in all other types of injuries at arenas with flexible boards and glass compared to arenas with traditional boards and glass (IRR 0.82, (95% CI 0.61 to 1.09)). Causes of injury The three most common causes of injuries were body checking (27.2%), and stick (21.1%) and puck (12.3%) contact. The majority of the injuries caused by stick were head injuries (76.9%). Penalties were assessed in 25.9% of stick injuries, 40% in checking to the head and 48.4% in hitting from behind injuries. Injury severity The majority of players who were injured returned to play within 1 week (53.8%); however, 14.5% of the injured players did not return for at least 3 weeks.
Player position, period and zone Injuries were equally distributed according to player position: wing players suffered 37% of all injuries (two wings per team), centre 18.4% (one centre per team) and defence 36.8% (two defences per team). The goalkeeper was the least injured in all the positions (3.5%) despite the fact that the goalkeeper is on the ice for the entire game. In the A-pool tournaments, the proportion of concussions sustained by centre was about twice that of defence and wing (OR 2.01, (95% CI 0.87 to 4.66)). The second period had the highest percentage of injured players
