The Sport of the Frozen Four

GO DU PIONEERS: 3-2 victory in FROZEN FOUR against Michigan team with 13 NHL draft picks. 4/7/22

I saw the University of Denver Pioneers play and win many times with great players (Magnuson) and coaches (Armstrong) as an undergraduate at DU. It was one of my inspirations to sub-specialize in lower extremity sports medicine with a Fellowship from the AAPSM (American Academy of Podiatric Sports Medicine).

Ice hockey is played at a pace that makes it impossible to fully protect yourself from foot and ankle injuries. Because of the speed and intensity of the game, foot and ankle injuries are common often the result of an impact with a fast moving puck, a slip on the ice or being hit by a stick. Although hockey skates provides a fair amount of support and stability for the foot and ankle, high speeds and rapid directional changes that occur while skating place the foot and ankle at risk for injury. Perhaps the most common hockey injury is the high ankle sprain. These sprains are caused when ankles roll outward, causing connecting ligaments to stretch or even tear. Because high ankle sprains most often occur when the foot is twisted outwards and twisting or turning maneuvers are common in hockey, recurrent tearing of this area can occur and this together with poor blood supply to the area can delay or slow down the rate of healing.

Lace bite, also known as skate bite, is another common hockey injury. This condition is caused by "hot spots" created by too much pressure from stiff hockey skates where a skate tongue has not been broken in well, or in old skates which have old and inflexible skate tongues. An inflexible skate tongue puts extra pressure in the upper foot and lower ankle and its tendons. The ankle and foot will swell and become painful. The repeated motion of these tendons rubbing against a tight skate tongue can cause inflammation of the main tendon, and eventually, tendinitis. Pressure on the top of the foot from skates that are too tight can contribute to an entrapment neuropathy or pinched nerve. Entrapment neuropathy symptoms include pain on the top of the foot, accompanied by numbness and tingling in the first and second toe with symptoms similar to lace bite.

The act of skating itself may result in a variety of injures. Sharp blades can cause cuts. Metatarsal and navicular stress fractures can occur and become chronic. Underlying structural deformities such a bunions, contracted digits or hammertoes, plantar fasciitis or excessive tightness or tendinitis of the Achilles tendon can worsen. Pre-existing conditions such as diabetes and those involving the circulatory or nervous system can contribute to problems and should be medically monitored.

While it is impossible to eliminate all risk of injury in any sport especially such a physical sport as ice hockey, awareness and preventative measures can reduce injuries on the ice and keep the excitement of ice hockey safe for the players and enjoyable for the fans at all levels of play.

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