Injuries are unavoidable in a sport where elite athletes are armed with sticks and placed on ice skates. Hockey players, regardless of position, assume a level of injury risk every time they hit the ice. As a result, anyone willing to take on the challenge of fantasy hockey has to assume that someone on their roster will inevitably be injured. However, recognizing injuries and properly managing them when they do eventually occur can give an owner a sizeable advantage in winning their league.
The NHL insures this is no easy task. In 2008, the league changed the way each team discloses an injury. While clubs are still required to report whether an injured player will miss time, they do not have to provide specifics regarding the injury. It’s believed that this approach protects the player from having the affected area targeted upon their return. As a result, injury information is often vague and limited to a general region like “upper” or “lower” body. Still, familiarizing yourself with basic injury terminology can help you decipher some of the mystery surrounding certain ailments.
Sprains and Strains
These two injuries are prevalent in today's game, and the injured structure can be deduced when a club includes one of these descriptors in their report.
A strain occurs to muscle tissue, including muscles and tendons. These injuries can be slow to heal and become recurring issues if the player returns before the area is completely healed. Lower extremity strains -- especially those to the groin, hamstring and calf -- can be particularly problematic because they impact the individual’s ability to skate with speed and precision.
A sprain involves connective tissues, specifically ligaments. Ligaments are the scotch tape of the body, connecting bone to bone while providing additional stability. When overloaded and pushed past their yield point, ligaments are sprained leaving the affected joint compromised and unstable. Each joint of the body, including the shoulder, ankle, and knee, are susceptible to sprains while playing hockey.
Both sprains and strains are often assigned grades based on the severity of the damage sustained. A Grade 1 injury is considered the least severe. These injuries are often referred to as minor injuries and are marked by micro tearing of the tissue with little to no loss of function for the injured athlete. Grade 2 injuries are considered more moderate and often referred to as partial tears as fibers of the involved structure are damaged. Grade 3 injuries are the most severe and generally result in loss of stability and function. These types of injuries can be called complete tears or ruptures. Generally speaking, the recovery window is longer as the grade of the injury increases.
Back injuries are another frequently injured area in hockey. Unfortunately, teams can also make things difficult to read by providing symptoms disguised as diagnoses. Back tightness, soreness, and spasms are not injuries but instead the result of an underlying problem. These symptoms tend to suggest an injury involving a muscle or muscles, but can occur with more significant ailments. Combat this ambiguity by focusing on any additional information provided. For example, if the pain reportedly extends into the hip or lower extremity, or information regarding a potential nerve problem is revealed, then the issue could be linked to a more problematic disc injury.
Concussions and Facial Fractures
Concussions remain the hot topic in sports medicine and hockey is no exception. While the league has attempted to address the issue with various rule changes, concussions remain a far too common occurrence. A concussion is an injury to the brain, often following a blow to the head. The accompanying symptoms vary from person to person but can include headaches, blurry vision, amnesia, sensitivity to light and nausea. If an NHL player exhibits any of these symptoms following a direct or indirect blow to the head, they are to be removed from the game or practice and properly evaluated.
If a concussion is diagnosed, the individual must complete a gradual return to play protocol. This protocol includes a complete recovery from all concussion-related symptoms, clearance from a consulting neurologist, and a return to previously measured neurocognitive function. Every concussion is unique, therefore, there is no standard period that a player will be withheld from play following the injury. Things get even more serious if the player has a history of concussions. The effects of concussions are cumulative, meaning they build with each subsequent injury. This can result in more significant, longer-lasting symptoms and a lengthier recovery window. Pittsburgh’s Sidney Crosby has become the most prominent NHL player to endure multiple concussions.
Concussions aren’t the only head injury suffered by hockey players. Sticks and pucks routinely find their way up into the face of players resulting in fractures of the various bones of the skull. The skull is comprised of two primary parts: the neurocranium which houses the brain, and the facial skeleton. The facial skeleton is comprised of 14 interconnected bones, including the routinely fractured nasal bone. The orbit, or eye socket, is also vulnerable to injury and is made up of bones from both the neurocranium and the facial skeleton. The orbit includes the upper jaw (maxilla), the forehead (frontal bone), and the cheekbone. The severity of facial fracture depends on multiple aspects, including size of the fracture, whether the affected bone or bones have moved following impact, and any associated soft tissue and/or muscle damage. Surgery is often required if the involved bone or bones have become displaced or significant damage to the eyeball has occurred. Recovery time following a facial fracture often depends on the necessity of surgical intervention.
Shoulder injuries The shoulder is one of the more frequently injured areas in hockey but it’s a more complex joint than most people realize. The glenohumeral (GH) joint forms the ball and socket joint of the shoulder and is the area most commonly associated with the shoulder. The GH joint is formed between the head of the upper arm bone (the humerus) and the glenoid fossa of the scapula (shoulder blade). Injuries involving the alignment of the GH joint are referred to as subluxations (partial dislocation) or dislocations.
However, the shoulder is more than just a ball and socket and includes several other joints and articulations. One of these joints, the acromioclavicular (AC) joint, is routinely injured by NHL players. The AC joint is situated where the clavicle (collarbone) connects to a bony process on the shoulder blade known as the acromion. The AC joint act as a strut, allowing the arm to be raised overhead. It is stabilized by two ligaments that are susceptible to injury when the tip of the acromion is forcibly pushed downward following a direct blow or collision. Injuries to the AC joint are often referred to as a separated shoulder. Unfortunately, players that suffer a moderate to severe AC joint sprain often report residual symptoms upon their return, making this an impactful injury. Collarbone injuries, including fractures, are another frequent ailment in hockey and can take weeks to mend
The violent nature of hockey makes injuries inescapable. However, the methodical fantasy owner will understand basic medical terminology and be equipped to appropriately manage an injury when one inevitably occurs. Don’t let the enigmatic nature of NHL injury reports limit your approach and be quick to recognize subtle clues that can help you make informed decisions regarding your roster.