Why are Knee Injuries Common in Ice Hockey?

Due to the fast-paced nature of this sport, as well as the ability for one to “catch an edge” on a crack in the ice, ice hockey players do have a risk of tearing structures within their knee that do require surgery. If one twists their knee and feels a pop or feels an injury and has it swell up right away, one has to be concerned that there may be more ominous problems going on inside the knee and should make sure that they get it checked out immediately.

What is the Common Knee Injury in Ice Hockey?

One of the most common injuries that an ice hockey player sustains is a tear of the medial collateral ligament (MCL). The MCL is the inside of the knee. MCL tears can occur both from contact and noncontact mechanisms. If the MCL is torn off the femur, there is a good chance that this will go on to heal without any problems. However, if the knee wobbles open when stressed when it is out straight or if it tears off the tibia and retracts above the hamstring tendons, there is a much higher risk that these MCL tears will not heal. Therefore, obtaining an evaluation to determine the type and location of a MCL tear is very important. In most circumstances, a period of bracing and the use of a stationary bike, which has been shown to accelerate the healing of an MCL tear, would be indicated.   The time off from an MCL tear depends upon the grade of the tear. A minor tear with no gapping, called a grade 1 tear, commonly takes 1-2 weeks to improve and allow one to return back to full on-ice activities. A grade 2 tear, where there is some gapping but there is still some ligament intact, usually takes about 3-4 weeks to heal. A complete MCL tear, called a grade 3 tear, usually takes around 6 weeks or slightly longer to heal sufficiently to return back to on-ice activities without any limitations. These numbers are for MCL tears that occur in isolation. If they occur with other injuries or with an ACL tear, that is a different story and the treatment would likely differ.

ACL Injuries in Ice Hockey Players

If one twists and turns on the ice and catches an edge and feels a pop and their knee slip, one has to be concerned about tearing their ACL. ACL tears can occur in ice hockey from catching an edge, being in contact with an opponent during a check, or when one hits the board. The ACL itself has a very good blood supply, and when one tears their ACL, the knee often swells up with blood within a short period of time, usually within the first 24 hours after injury. Therefore, if one does have significant swelling with an ice hockey injury, one has to be concerned about their ACL being torn and should be seen by a specialist. In addition, if one feels a pop when they have a knee injury, this is a bone bruise, and bone bruises most commonly occur with an ACL tear for ice hockey players. Due to the high risk of the development of arthritis, cartilage problems, or meniscus tears, we generally recommend that most ice hockey players undergo an ACL reconstruction at the time of injury and do not try to play through the season with their ACL tear.

Other Knee Injuries in Ice Hockey Players

Other ice hockey injuries that can occur include tears of the meniscus, kneecap dislocations, and less common injuries like tears of the PCL or LCL.

In all of these instances, if there is swelling, which indicates there is blood in the knee, a pop, which usually indicates that there is a bone bruise in the knee with a high likelihood of a substantial injury, or if the knee feels unstable when initially walking on it, one really needs to get checked out by a physician who is familiar with these type of injuries to ensure that there is not an injury that would affect one’s ability to continue to play the sport, both in the short term and the long term.

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