Spine Check: Common Back Injuries in Hockey

Few people would dispute that hockey is one of the roughest team sports. With the possible exception of football and rugby, it’s difficult to imagine a game in which players take such a beating, whether from body checking, getting slammed into the wall, or falling hard on the ice – and that’s not even considering all the fist fights!

The bottom line is that there are plenty of ways to get hurt playing hockey. And while back and neck injuries are not nearly as common in the game as head, leg and shoulder trauma, both recreational and pro players do encounter them on a regular basis. So with the NHL season now well underway and our own hometown (ECHL) Orlando Solar Bears out to a 4-2 start, we thought it might be a good time to address some spinal injuries that are most commonly associated with hockey.

The scariest spine injuries in hockey are cervical fractures.

By far the most serious hockey-related spine injuries are those impacting the cervical (or neck) vertebrae. A player whose head hits the wall at a high rate of speed with his neck fully flexed can incur a cervical fracture, causing severe trauma to the spinal cord and putting him at risk for paralysis from the neck down.

Bone fractures in the neck primarily occur in the C5 and C6 vertebrae. Sadly, younger players can be susceptible to these types of injuries when the bones and muscles in their neck and torso are less fully developed than those in their arms and legs. It’s therefore extremely important for players in competitive leagues to work on strengthening their neck muscles as part of their daily workouts.

Thankfully, the incidence of all spinal cord injuries in both youth and pro hockey is relatively rare, and appears to be on the decline due to stiffer penalties, improved player education and precautionary efforts like the STOP program for juniors (where a bright red STOP sign on the back of players’ jerseys reminds others not to hit someone from behind).

Lower back pain, simple muscle strains and herniated disks are among the most frequently encountered injuries in hockey, and can potentially lead to something more serious.

The largest number of back injuries in hockey occur in the lumbar, or lower, spinal region. This is because of the forward-leaning posture and repetitive extension of the lower spine that’s required for skating, as well as the rotational stresses and excessive loading on the lumbar disks when a player accelerates quickly, shoots the puck, reaches out to block a play, or falls awkwardly after being hit. The best way to reduce the likelihood of such injuries is by thoroughly stretching and strengthening the hip flexors, hamstrings, and low back, abdominal and gluteal muscles ahead of each game and practice. Our Back to Basics videos provide several stretches aimed at these muscle groups.

One common reason for low back pain in hockey players (and many other athletes) is a condition known as spondylolysis, which is a stress fracture of one or more vertebrae in the lumbar region. Both stress fractures and herniated disks may stem from repeated collisions with other players, sudden and violent twisting maneuvers, and frequent hard falls that are not unlike the trauma football players experience on the gridiron. Read more about herniated disks in football here.A herniated disk may press on a spinal nerve, causing shooting sciatic pain down the hips, buttocks and legs. And over time, the cumulative impacts of such lower back injuries may cause the disks to start breaking down in a condition known as degenerative disk disease.

The NHL’s current injury list includes at least five players with significant back injuries.

Most teams don’t give specifics about their players’ injuries – either listing them as “undisclosed” or in such general terms as “upper body” or “lower body” issues – so it’s tough to know just how many NHL players are sidelined with back injuries at any given time. But a recent peek at the NHL injury chart showed at least five major players with back problems that are keeping them on the bench, including Dennis Seidenberg of the Boston Bruins, Brad Richards of the Detroit Red Wings, Chris Phillips of the Ottawa Senators, Nathan Horton of the Toronto Maple Leafs and Grant Clitsome of the Winnipeg Jets.

Among these players, Horton’s situation appears especially grievous. Diagnosed with severe degenerative disk disease in several of his lower vertebrae, the 30-year-old has been experiencing debilitating pain that’s kept him off the ice since April of 2014. While surgery may be able to relieve his pain, Horton has been told that the extensive spinal fusion and lumbar stabilization procedure required in his case (with up to four levels of fusion and placement of a titanium rod) probably won’t allow his return to pro-level play.

Preventing injuries in hockey means practicing the basics, but may also require a certain amount of luck.

If you know someone who’s a serious hockey player, chances are they will never sustain a serious and debilitating back injury. But it’s important to remember that repeated muscle strains, body blows and seemingly minor injuries can have a cumulative impact on the spine. Taking the proper precautions such as wearing the appropriate protective equipment, strengthening one’s core and neck muscles, and properly warming up prior to play can significantly lessen the likelihood of both pros and amateurs sustaining preventable spinal injuries.

If chronic neck or back pain is keeping you on the sidelines, it’s time to consult a medical expert like Dr. Chetan Patel at the Spine Health Institute in Altamonte Springs, Fla. He and his team of multidisciplinary specialists combine advanced diagnostics and conservative treatment plans to effectively resolve many patients’ longstanding back problems through targeted exercises, physical therapy, pain management injections and minimally invasive surgical procedures. Call our patient care coordinator at Home Call407-303-5452 or click on the Book Online button at the top of this page.

References

The Hockey Doc: Low back pain (n.d.). Retrieved from LetsPlayHockey.com: http://www.letsplayhockey.com/online-edition/hockey-doc/1420-the-hockey-doc-low-back-pain1.html

Spinal injuries due to hockey (2/11/1984). Abstract retrieved from PubMed.gov/U.S. National Library of Medicine: http://www.ncbi.nlm.nih.gov/pubmed/6704792

On Thin Ice: How YOU Can Prevent Ice Hockey Injuries (n.d.). Retrieved from ProfessionalPT.com: http://www.professionalpt.com/thin-ice-can-prevent-ice-hockey-injuries/

Hockey culture must change if concussion problem to be solved (2/19/2012). Retrieved from TheStar.com:http://www.thestar.com/sports/hockey/2012/02/19/hockey_culture_must_change_if_concussion_problem_to_be_solved.html

Nathan Horton’s career could be over due to back injury (10/21/2014). Retrieved from Yahoo! Sports: http://sports.yahoo.com/blogs/nhl-puck-daddy/nathan-horton-s-career-could-be-over-due-to-back-injury-000839222.html

NHL Injury Report (n.d.). Retrieved from Rotoworld.com: http://www.rotoworld.com/teams/injuries/nhl/all/