Ice hockey is a fast paced contact sport which brings with it the potential for injury. As a governing body we take the prevention and treatment of injuries seriously. The following pages have been designed to provide important medical information to clubs, coaches, managers, parents, first aiders and athletes to minimise injury in our game.

Ice hockey should be a sport to enjoy, not a sport in which we worry about our athletes.

HEADCHECK is a campaign which launched in 2015 to raise the awareness of concussion in ice hockey. Concussion is a serious, life threatening injury which can take months to go and is common in ice hockey due to the contact. This was recently bought to media attention within ice hockey due to the long layoff with Sydney Crosby but all sports are now taking this injury more seriously.

All clubs are urged to follow the 5 S’s which mean a safe return for our players.

If you have any questions please feel free to contact Robyn Crebbin, Technical Director of Sport Injuries for the EIHA.

Click to Download Poster

Click to Download Poster


Concussion education in Ice hockey

The following page has been put together for players, parents, coaches and first aiders/medical professionals to use when dealing with concussion in ice hockey.

Concussion is a common problem in all contact sports not just in ice hockey. With recent high profile cases such as the Uruguayan player that was allowed to return to play after being knocked unconscious against England in the World Cup in Brazil, Tottenham goalkeeper Hugo Lloris who returned to play dazed after a clash with a player during a premier league game and an eleven month lay out for Olympic gold medallist Sydney Crosby due to concussion, it is no wonder that the way that sport manages concussion is in the limelight.

Ice hockey is a fast paced contact sport where the incidence of concussion is high. Although there is limited data to support the incidence of head injuries within the game in England, research that has been conducted in North America shows concussion rates range from 10-25% of all injuries.

Concussion as a topic and as an injury is not going away. It is up to us that are involved within the game to make sure that we manage it in the most appropriate way. It is no longer a ‘don’t worry about it, you can play on’ injury and you only have to look at the following two stories which show how badly it can go wrong:

Ben Robinson

14 year old rugby player that had suffered multiple blows to the head during a game but was allowed to play on. One of these occasions he even lost consciousness. He collapsed at the end of the game and died 2 days later in hospital.

Natasha Richardson (wife of Liam Neeson)

Fell whilst skiing in Canada. No initial signs and symptoms and was allowed to return back to her hotel. She was later admitted to hospital and died an hour later.

What is concussion?

Concussion is a complex process of the brain. It may be caused by a direct blow to the head, face and neck and can also be caused by a direct blow to anywhere else of the body. In 70-80% of cases concussion resolves within 7-10 days but some take longer. You only need to read the timeline for Crosby’s concussion symptoms to understand this. You must also know that concussions may take longer in children and adolescents.

What are the symptoms of concussion?

There is a common perception that you are only concussed if you have been knocked out unconscious. This is not the case and if any one or more of these symptoms are present after an incident then concussion should be suspected

– Nausea
– Vomiting
– Blurred vision/dizziness
– Headache
– Shock
– Memory loss
– Loss of consciousness
– Slowed reaction times
– Drowsiness
– Irritability
– Anger
– Emotional symptoms
– Feeling like in a fog
– Slurred speech

If anyone or more of these symptoms are present then a concussion should be suspected and you MUST remove the player from the ice. Players may not always tell you that they are experiencing symptoms and so if they are displaying any visual signs of concussion then you MUST remove them from the ice.

– Loss of consciousness or responsiveness
– Lying motionless on the ice/slow to get up
– Unsteady on feet/balance problems or falling over
– Grabbing/clutching of the head
– Dazed/blank/vacant look
– Confused/not aware of players of events

It is also useful to ask the player questions. Asking questions such as where do you live? What is your date of birth are not the best questions to ask as players tend to know the answers as they are ingrained in their long term memory. You need to be asking the following questions:

– What venue are we at today?
– Which period is it now?
– Who scored last in the game?
– What team did you play in the last game?
– Did you team win the last game?

Any athlete with suspected concussion should be IMMEDIATELY REMOVED FROM PLAY. They should not return to the ice, be left alone or left to drive home.

If is recommended that you refer the player to a medical professional for diagnosis and guidance about return to play.

What advice do I give to a player with concussion?

You must always give advice to someone who can look after the concussed athlete. Never let them go home on their own. Use the emergency contact on the medical screening form and contact their parent/guardian/friend/partner to explain that the player has had a suspected concussion and that they need to get checked out by a medical professional. A head injury form must be given to that person with information about what to do if there is any change in symptoms.

Never let a player go home on their own after a suspected concussion

How long do I need to monitor for?

You must monitor for symptoms for at least 24-48 hours. In the case of both Ben Robinson and Natasha Richardson they had symptoms after the time of the incident and both died. If any symptoms change then you MUST get them to hospital straight away.

For concussion we must follow the FIVE S’S

Understand what symptoms to look out for in order to help recognise a concussion
If suspected concussion then the player should be immediately removed from the game and sat on the bend
Ensure that the player is seen by an appropriate health professional e.g. Doctor, Graduate Sports Therapist, Chartered Physiotherapist
Stop all sport and rest.
Follow a SAFE return to play following the return to play guidelines

Most concussions in ice hockey will be simple concussions that will recover over a few days. For simple concussions the return to play will be quite rapid.
Return to play guidelines are as follows:
(1) No activity and the athlete must have complete rest. Once the player is asymptomatic (SCAT/DSST baselines are achieved and no symptoms experienced) then the player can commence to step 2
(2) Light aerobic exercise e.g. walking or stationary cycling. No resistance training
Symptom check
(3) Sports specific exercise e.g skating in ice hockey, progressive addition of resistance training
Symptom check
(4) Non contact training drills
Symptom check
(5) Full contact training after medical clearance
(6) Game play
Each stage should be documented in the injury notes and signed by the player (parent or guardian under 18) and the first aid. If symptoms are not clearing up after a few days then you must refer the player back to their doctor. Remember what has happened to Sydney Crosby. You can now download the HeadCheck changing room poster from the website. Please place on your changing rooms doors or for players and parents to see so that we can help educate people about concussion.

Documents to download

Head Injury

2018 IIHF Concussion Protocol
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Last UpdatedOctober 26, 2017

Concussion Recognition Tool 5
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Last UpdatedOctober 26, 2017

Sport Concussion Assessment Tool for children ages 5 to12 years
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Last UpdatedOctober 26, 2017

Sport Concussion Assessment Tool – 5th edition
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Last UpdatedOctober 26, 2017