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Ice hockey and skiing injuries: ski boots, skates and what each sport does to a body

Skiing injuries and ice hockey injuries are not one subject, and the first thing this page does is tell you which of the two sports you are in. Across the series gathered in one clinical review, the knee accounts for 27 to 41 percent of skiing injuries, with the thumb ligament in the top five of four separate series; across five seasons of college men's ice hockey in the United States the three biggest regions were the shoulder at 16.13 percent, the head or face at 15.20 percent and the hip or groin at 12.10 percent, with the knee fifth at 9.16 percent. The two sports share no body region at the top of their lists, which is why the pages under this one are split by sport rather than by body part. The published rates cannot be compared either, because the two sports count in different units, so a figure from one of them is not a figure for the other. Two things on snow or ice do not wait: chest pain, pressure or tightness that does not ease quickly with rest needs emergency services, and a knock to the head means coming off the ice or the snow at once whatever the helmet did, with emergency services if any of the head injury warning lines on this page apply, and assessment by a healthcare professional or NHS 111 within 24 hours, and no play inside those 24 hours, even when none of those lines apply.

Warning signs, and when to get help

What each sport asks of your body

These two sports sit on one page because people ask about them in the same week of the year. The answer splits almost immediately. On snow, your foot and lower leg are clamped into a boot, you are moving fast, and most of what happens to you happens without anyone else touching you. On ice you are also moving fast, but you are sharing a rink with five other bodies, a board, a puck and a stick, and the thing that hurts you is usually one of them.

That difference shows up in the equipment research as well as in the injury lists. Boot and binding systems were built around the shin, and they worked: in a prospective series at two Vermont areas, the adult tibial fracture rate fell 89 percent between 1972 and 1994 while adult cruciate ligament injuries rose 280 percent over the same span, and the overall injury rate fell 43 percent (Deibert and colleagues, 1998). Read together, those three numbers say the pattern moved up the leg while the total came down, which is our reading of the trend rather than something that study set out to test. The 2019 clinical review of alpine skiing says the same thing from the engineering side: binding systems were designed and refined to protect the tibia, and were never designed to protect the knee from sprains (Davey and colleagues, 2019).

Hockey has no equivalent story, because the forces come from outside. In five seasons of college men's play in the United States, 46.76 percent of competition injuries came from contact with another player, while practice injuries were mostly contact with apparatus at 29.59 percent, non-contact at 24.65 percent and overuse at 10.36 percent (Boltz and colleagues, 2021). One sport is a falling sport. The other is a collision sport with a training-load problem underneath it.

What are the most common skiing injuries?

The knee, by a distance. Pulling together the series it tabulates, the 2019 review puts knee injury at 27 to 41 percent of all skiing injuries, with the upper limb at about 14 percent and the head and neck at about 13 percent (Davey and colleagues, 2019). The same review reports the ligament on the inner side of the thumb knuckle as the commonest hand injury in the sport, and it appeared in the top five of four independent series it tabulates. Those two, the knee and the thumb, are most of what a ski clinic sees.

The mechanisms are published in enough detail to recognize yourself in them. Three account for about three quarters of ski knee injuries: a knee driven inward with the lower leg turning out, the backward inside-edge fall known as the phantom foot, and the knee forced straight past straight. Collisions make up a very small share, 2.2 percent of those ski knee injuries, and that figure covers running into a stationary object as well as into another skier (Shea and colleagues, 2014, as reported by Davey and colleagues, 2019). The review flags its own weakness there, because those shares rest on injured skiers remembering a fall that took a fraction of a second. The individual percentages, and what each one feels like, are on ski and hockey knee injury.

Two things the data does not say, and that get said anyway. It does not say that difficult terrain is where this happens: across 107,540 injury reports from 29 western Canadian resorts, most injuries came from falls on marked green or easiest terrain, day-ticket holders were the most injured customer type, and 12.8 percent needed emergency transport (Dickson and Terwiel, 2021). Those reports cover skiers and snowboarders together, so read them as a figure for the hill rather than for skiers alone. And it does not say you are safe at the severe end because you are a careful skier. A single winter of acute orthopedic admissions at one hospital in southern New Zealand took in 88 patients with 92 injuries over 129 days, 23 of them with spinal injuries including one fatal burst fracture of a neck vertebra, and 32 of those admissions were visitors from Australia (Burgess and Namazie, 2011). That is an inpatient series, so every figure in it describes the worst end of the sport, and it counted 52 snowboarders against 36 skiers, so the admissions are not a skiing figure either.

What are the most common ice hockey injuries?

A different list, in a different order. Across 2014-15 to 2018-19 in college men's ice hockey in the United States, the most injured body parts were the shoulder at 16.13 percent, the head or face at 15.20 percent and the hip or groin at 12.10 percent, with the knee fifth at 9.16 percent, and the overall rate was 7.65 injuries per 1000 athlete exposures with 43.1 percent of injuries costing at least a day (Boltz and colleagues, 2021). The commonest specific diagnoses were concussion at 9.61 percent, a sprain of the joint at the top of the shoulder at 7.3 percent and a medial collateral ligament tear in the knee at 3.7 percent.

Head injury is the one part of that list this page does not handle. It is the single commonest specific diagnosis in the hockey data, and in skiing the 2019 review describes brain injury as the most common severe traumatic injury and the one with the highest fatality prevalence. Both belong with the warning lines at the foot of this page and with concussion recovery and return to activity, which is written for exactly that decision. One thing from that page belongs here as well, because it is decided at the rink or on the hill and not later: nobody goes back on the ice, the snow, training or a PE lesson within 24 hours of a suspected concussion, and the UK grassroots guidance asks for every suspected concussion to be assessed by a healthcare professional, or through NHS 111, within 24 hours, with emergency services if any of the head injury warning lines below apply.

The timescale after that catches people out. The same guidance allows a return to any sport carrying a head injury risk only after a graduated return program, and sets no return to competition before 21 days from the injury; the NHS puts the same point as no contact sport for at least 3 weeks. For a skier or a hockey player that is usually the rest of the trip, or several weeks of the season, rather than a day off.

Two other injuries on that list have their own pages. A shoulder that came out of its socket belongs with shoulder dislocation, and a wrist that took a fall with wrist sprain or wrist fracture rehab.

The hip and groin story in hockey is bigger than the time-loss figures show: among 329 Swedish professional men, 53.2 percent reported a hip or groin problem in the previous season, and 48 percent of all 329, not 48 percent of the affected ones, had problems which never cost them a day on the ice (Wörner, Thorborg and Eek, 2020). That is half the sport's commonest training problem sitting outside any time-loss count.

One paper does compare the two sports, a German language review of knee injuries in snow and ice sports. Its English abstract reports the knee as the most commonly affected region in alpine skiing and snowboarding, and in third place in ice hockey (Rauch, 2022). It also says prevention is achievable through targeted training and through the equipment and its adjustment, and for the training half it points at the Swedish ski high school result and at a football meta-analysis rather than at anything measured in recreational skiing (Rauch, 2022). The training section below sets out what that evidence covers and what it does not.

Does it happen in practice or in games?

In hockey the answer changes the whole picture. The hip or groin was the most prevalent region in practice injuries at 19.72 percent and only 8.77 percent of competition injuries, while the shoulder and the head or face both roughly doubled going the other way, from practice to competition (Boltz and colleagues, 2021). The rate in games is much higher overall, at a competition to practice rate ratio of 6.54 with a 95 percent confidence interval of 6.08 to 7.04.

That gives a player two places to look. If your problem is the groin, look at your training week, because that is where it is being built; the detail is on hockey groin injury. If it is the shoulder, the head or a knee that took a hit, look at games and contact.

Skiing has no practice and games split, but it has an equivalent one. The injury that puts you in a clinic at the end of a holiday week is usually not the one dramatic crash; it is a fall like all the others, on easy ground, on a good day, in the afternoon.

Can you train to prevent this?

For skiing the evidence is thin rather than absent, and the difference matters. A systematic review of physical therapy recommendations for injury prevention in alpine skiing searched three databases, included 10 studies and reported that it had found no evidence-based program for physical preparation published in the previous ten years, recommending instead that the field borrow from other non-contact sports whose mechanisms look similar (Kresal and colleagues, 2022). Its population is competitive alpine ski racers, not holiday skiers, which matters when you read its conclusion.

Two skiing-specific results sit either side of that review, and neither is a randomized trial. Swedish ski high school students given two seasons of a core stability and neuromuscular program had 12 cruciate injuries among 305 skiers, 3.9 percent, against 35 among the 431 students of the five earlier seasons who served as controls, 8.1 percent (Westin and colleagues, 2020). Those are competitive adolescent racers and the comparison is with earlier years rather than a parallel control group.

The other result is 31 years old and is not an exercise study at all: on-slope staff at 20 ski areas were trained to recognize and avoid two knee injury mechanisms, and serious knee sprains fell 62 percent among trained patrollers and instructors against the two previous seasons, with no fall at the 22 untrained areas (Ettlinger and colleagues, 1995). Those are people who ski every working day. Nobody has tested either approach in recreational skiers, who are most of the people reading this, so getting fit before a trip is worth doing on its general merits rather than as a measured shield. The 2019 review adds that formal ski lessons, by contrast, have not been shown to reduce the likelihood of injury (Davey and colleagues, 2019).

Hockey has one thread of prevention evidence and it is about the adductors. On a single National Hockey League team, 33 of 58 players who screened as at risk on preseason adductor strength were given a 6 week strengthening program, and adductor strains fell from 11 in the two seasons before to 3 in the two seasons after (Tyler and colleagues, 2002). One team, no randomization, no control team. Promising, not proven. A clinical commentary on physical therapy for hockey players sets out the wider thinking, including position and age effects and a model for prevention, and it is written for a clinician more than for a reader (Wolfinger and Davenport, 2016).

Be suspicious of any page that hands you a figure from football or handball and presents it as skiing evidence. Borrowed numbers can be useful, but only when they name the sport they were measured in.

Does protective equipment work?

Some of it, measurably. The Auckland meta-analysis of 55 pooled studies puts helmets against head injury at an odds ratio of 0.58 with a 90 percent confidence interval of 0.51 to 0.66, and wrist guards against wrist injury in snowboarders at 0.33 with an interval of 0.23 to 0.47 (Hume and colleagues, 2015). Note the population on the second one: snowboarders, who fall onto their hands because they have no poles to hold.

The same analysis is as useful for what raises risk. Being a beginner came out at an odds ratio of 2.72 for skiers and 2.66 for snowboarders, renting equipment at 2.58 with a 90 percent interval of 1.98 to 3.37, and poor visibility at 2.69. Those are the unglamorous ones, and two of the three are decisions you make before you leave the hire shop, not skills you build over a season.

What no readable source supports is the idea that a binding, of any design, protects your knee. The 2019 review says it was never designed to, and that the forces which rupture a cruciate ligament can happen without the binding releasing (Davey and colleagues, 2019). Getting your bindings checked and adjusted is still worth doing, and that review sets out the trial evidence behind it, all of which is about the lower leg. For the shin, in other words, and not for the ligaments. The detail, including the boot sole and rented ski findings, is on ski and hockey knee injury.

Which of these pages is yours

Three pages sit under this one. They divide by what happened, not by sport alone.

A sore or torn inner thigh, in hockey or on skates, goes to hockey groin injury, and the exercise program behind it is groin strain. A knee that twisted, gave way or swelled goes to ski and hockey knee injury, which sorts out which ligament and links the program for each, including MCL sprain. A thumb forced away from the hand in a fall, with or without a pole in it, goes to ski pole thumb injury, and the diagnosis and the splint weeks are on skier's thumb.

Two more routes that sit outside those three. An older recreational skier building strength and balance before a trip will get more from strong and steady for older adults than from anything on this page. And when you are deciding whether you are ready to go back after any of these, the return to sport test battery sets out the tests clinicians actually use, which beats judging it by how the limb feels on a Tuesday.

When to see a physio

Two weeks of the same complaint is the usual trigger, and two situations do not wait that long. A knee that swelled within a few hours of a twist or a fall, or that felt a pop, is an emergency department visit that day rather than an appointment, and so is a knee that felt as though it slipped out of place and went back; the warning lines below set out both, including not driving yourself. A thumb that feels loose or cannot hold anything between thumb and index finger is checked the same day as well, whatever you plan to do with the rest of the week.

For everything slower, bring the week with you. How many days you skied or skated, what changed, what you were doing when it started, and whether the problem turns up during the session or after it. A physiotherapist will spend most of a first appointment watching you move, not scanning you. In both of these sports the useful conversation is about the return: what has to be painless, at what intensity, before the next step.

Two of the warning lines below are not musculoskeletal at all, and they lead the list for a reason. In the slope fatality data the 2019 review gathers, acute cardiac events accounted for more than half of all deaths once medical as well as traumatic causes were counted, and brain trauma was the commonest cause of the deaths due to injury (Davey and colleagues, 2019). The warning signs come first, at whatever speed each line sets.

In this topic

Related exercise programs

Warning signs

Get emergency help now

  • Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
  • Emergency: if you faint while exercising, call emergency services, even if you feel fine again quickly.
  • Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
  • Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. Nobody should try to lift you off the floor, and nobody should pull you up by the arms: being hauled upright can move a broken bone that has not slipped yet and can make an injured neck or back worse. Someone helping should call for help, keep you warm and stay with you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
  • Emergency: you fell and cannot remember the fall or how it happened. Go to an emergency department straight away, and do not drive yourself. You may have blacked out or hit your head without knowing it.
  • Emergency: after a puck, a stick, a ski pole, a collision or a fall to the face, any change to your sight, severe pain in the eye, a headache or finding light hard to bear, feeling sick or being sick, an eye you cannot move or keep open, or blood or pus coming from the eye. The same applies if something has pierced the eye or hit it at high speed, or if a strong chemical has gone into it. Go to an emergency department or call emergency services straight away, and do not drive yourself.
  • Emergency: after a knock to the head, being very drowsy or finding it hard to keep your eyes open, confusion, a fit (seizure), new weakness or numbness anywhere in your body, new trouble understanding, speaking, walking or keeping your balance, new problems seeing or hearing, clear fluid coming from your ears or nose, bleeding from your ears or bruising behind them, a black eye when your eye was not hit, a dent in your head or a wound with something stuck in it, or a change in behavior. Call emergency services straight away. These can be signs of an injury to the brain.
  • Emergency: a knock to the head in a high-energy accident, even if you feel completely well. That means a fall from a height of more than 1 meter (about 3 feet) or more than 5 stairs, a crash at high speed, a car that rolled over, being thrown from a vehicle, being hit by a vehicle while walking or cycling, a bike crash, an accident on a quad bike or similar motorized vehicle, a fall from a horse, a diving accident, or any other heavy, fast impact to the head. Call emergency services straight away, without waiting to see how you feel. A high-energy head injury is a reason for emergency assessment on its own, with no symptoms needed.
  • Emergency: after a knock to the head, you were knocked out, even for a moment, you cannot remember what happened just before or after, you have had a headache ever since, or you are being sick (vomiting). The same applies, even if you feel fine, if you take medicine that thins your blood, other than aspirin on its own, have a bleeding or clotting condition, have had brain surgery in the past, or had been drinking alcohol or taking drugs when it happened. Go to an emergency department straight away, and do not drive yourself.
  • Emergency: severe neck pain after a knock to the head, whatever the fall or the knock was like. Keep still and call emergency services, and do not let anyone move you until someone trained has checked your neck. If the neck pain only starts later and nobody has checked your neck since, go to an emergency department straight away, and do not drive yourself.
  • Emergency: after a knock to the head, swelling, a deep cut or severe pain at the exact spot that was hit. Call emergency services or go to an emergency department straight away, and do not drive yourself. These can be signs of a broken skull.
  • Emergency: the shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or the pain is severe after a fall or an injury. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.
  • Emergency: your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
  • Emergency: after a fall or a knock, a wrist, hand or arm that has changed shape or sits at an odd angle, that goes numb, tingles or has pins and needles, that turns pale, blue or cold, that has a bone showing through the skin, or that has a cut bleeding heavily. Go to an emergency department straight away, or call emergency services, and do not drive yourself. Do not try to straighten the arm or push the bone back yourself.
  • Emergency: after an injury, a finger or thumb that points at an odd angle, looks blue or feels numb, or has a cut with bone showing or poking out. Go to an emergency department straight away, and do not drive yourself. The finger may be broken.
  • Emergency: the knee became very swollen very quickly, within a few hours of a twist, fall or blow, or you felt a pop or snap. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance. A knee that fills up that fast has usually bled inside the joint, which can come from a torn ligament, a kneecap that slipped out or a break, so it needs checking before you play again.
  • Emergency: the whole knee, not just the kneecap, felt as though it slid or shifted right out of place at the moment of injury, even if it went back straight away, or the knee now feels loose or wobbly in more than one direction. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance. A knee that comes out of place and goes back can tear several ligaments at the same time and can damage the artery or the nerve behind the knee. That damage is not always obvious at first, and the knee can look almost normal, so it is checked in hospital on the day rather than worked out at home.
  • Emergency: numbness, tingling or altered feeling around or under your genitals, between your inner thighs, or around your bottom (anus), for example it feels different when you wipe after using the toilet. Call emergency services or go to an emergency department straight away, and do not drive yourself. This can be a sign of pressure on the bundle of nerves at the base of the spine (cauda equina syndrome), which needs emergency treatment.
  • Emergency: you find it hard to start peeing, cannot pee, cannot feel yourself peeing or cannot control when you pee, or you do not notice when you need to poo or cannot control when you poo, and this is not normal for you. The same applies to a new change in how your genitals feel during sex, new trouble getting or keeping an erection, new trouble ejaculating, or new trouble reaching orgasm. Call emergency services or go to an emergency department straight away, and do not drive yourself. These can also be signs of cauda equina syndrome.
  • Emergency: sciatica in both legs, or pain, tingling, numbness or weakness in both legs. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away, and do not drive yourself.
  • Emergency: back or leg pain that started after a serious accident, such as a car crash or a fall from a height, or back pain with chest pain. Call emergency services. If the pain started straight after the accident, keep still while you wait.
  • Emergency: the ankle or foot looks deformed or out of place, you heard a crack when you were injured, or the foot is numb, tingling, cold, pale or blue. Go to an emergency department straight away, and do not drive yourself.

Get help today

  • Same day: you have had a knock to the head and you take aspirin on its own, without any of the emergency signs above. Get medical advice the same day. Aspirin on its own is the only blood thinning medicine left out of the emergency line above, and the NHS still asks anybody taking a medicine that thins the blood to get urgent advice after a head injury.
  • Same day: a sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
  • Same day: after a fall or a knock, a wrist, hand or arm that is very painful, that you cannot use because of the pain, that is badly swollen or bruised, or that is very stiff or hard to move, with no change of shape, no numbness or tingling, no pale, blue or cold skin, no bone showing and no cut that is bleeding heavily. Get it checked the same day at an urgent care center or an emergency department, and do not exercise that arm until it has been seen. A fall onto an outstretched hand often breaks a bone near the wrist, and an X-ray is the only way to be sure.
  • Same day: you cannot walk or put weight on the leg, whether or not there was a fall or injury, or you have very bad knee pain after a fall or injury, or very bad knee pain that came on suddenly with no injury at all. Get medical advice the same day.
  • Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
  • Same day: the pain is there at night or at rest and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Book an appointment

  • Within a day or two: the pain is there at night or at rest and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
  • Within a few days: the pain is there at night or at rest and keeps getting worse. See your doctor within a few days.

Common questions

Is skiing more dangerous than ice hockey?

Nobody can answer that from the published numbers, and the reason is arithmetic, not a gap in the research. Skiing counts injuries against time spent on the hill: 2.79 per 1000 skier days at two Vermont areas between 1981 and 1994, and an average of 2.24 per 1000 skier days across 29 western Canadian resorts over the decade to 2017-18, from 107,540 injury reports that count skiers and snowboarders together (Deibert and colleagues, 1998; Dickson and Terwiel, 2021). College men's ice hockey in the United States counts against athlete exposures, where one exposure is one player in one practice or one game, and recorded 7.65 injuries per 1000 of them (Boltz and colleagues, 2021). A skier day and an athlete exposure are not the same quantity of anything, so putting 2.24 next to 7.65 produces a sentence that sounds like a comparison and is not one. What the data does say about each sport separately is on this page.

Do ski helmets work?

For head injury, yes, and the effect is one of the better measured things in snow sports. A meta-analysis from an Auckland group pooled 55 studies and put helmet use against head injury at an odds ratio of 0.58, with a 90 percent confidence interval of 0.51 to 0.66, which it rated 99 percent most likely beneficial (Hume and colleagues, 2015); the unusual 90 percent intervals are how that paper reports, not a typing slip. The 2019 clinical review adds that helmets reduce both how often head injuries happen and how bad they are, with no sign that wearers take more risks or hurt their necks more, and that around 80 percent of skiers and snowboarders and 89 percent of minors were wearing one in the 2016-17 United States season (Davey and colleagues, 2019). The honest other half: the same review records that deaths on the slopes have not fallen as helmet use has risen, because the crashes that kill exceed what any helmet can absorb. So wear one for the concussion and the skull, and do not treat it as cover for skiing faster.

Do ski bindings protect your knee?

No, and the documents that address it directly are blunt about why. Ski boot binding systems were designed and refined around the shin, and they have cut tibial shaft fractures, boot-top bruising and ankle injuries; the same review states plainly that these changes were never designed to protect the knee from sprains, and that the forces that rupture a cruciate ligament can be generated without a normally functioning binding releasing at all (Davey and colleagues, 2019). One thing worth doing anyway: that review reports more than 75 percent of the equipment involved in lower leg injuries did not meet the relevant standards, and a randomized trial of having bindings checked and adjusted to normal shop practice reduced lower limb equipment-related injuries. Get the binding checked, for the shin. Claims that a particular binding brand cuts knee injuries by a given percentage are not on this page, because we could not get to the studies behind the figures in circulation, and a number we cannot check is not a number to act on.

Which injuries happen in practice and which in games?

In ice hockey the whole profile flips between the two. Across five seasons of college men's play, the hip or groin was the most prevalent region in practice at 19.72 percent of practice injuries and only 8.77 percent of competition injuries, while the shoulder ran at 18.65 percent in competition against 10.36 percent in practice and the head or face at 17.36 percent against 10.26 percent (Boltz and colleagues, 2021). The mechanisms follow: 46.76 percent of competition injuries came from player contact, while practice injuries were 29.59 percent contact with apparatus, 24.65 percent non-contact and 10.36 percent overuse. The rate itself is far higher in games, at a competition to practice rate ratio of 6.54 with a 95 percent confidence interval of 6.08 to 7.04. So the groin is mostly what skating does to you, and the shoulder and head are mostly what other players do to you.

References

  1. Davey A, Endres NK, Johnson RJ, Shealy JE. Alpine Skiing Injuries. Sports Health. 2019;11(1):18-26. https://doi.org/10.1177/1941738118813051
  2. Shea KG, Archibald-Seiffer N, Murdock E, Grimm NL, Jacobs JC Jr, Willick S, Van Houten H. Knee Injuries in Downhill Skiers: A 6-Year Survey Study. Orthopaedic Journal of Sports Medicine. 2014;2(1):2325967113519741. https://doi.org/10.1177/2325967113519741
  3. Boltz AJ, Nedimyer AK, Chandran A, Robison HJ, Collins CL, Morris SN. Epidemiology of Injuries in National Collegiate Athletic Association Men's Ice Hockey: 2014-2015 Through 2018-2019. Journal of Athletic Training. 2021;56(7):703-710. https://doi.org/10.4085/1062-6050-611-20
  4. Rauch A. Wintersportverletzungen am Kniegelenk (Knee injuries in winter sports). Orthopadie (Heidelberg). 2022;51(11):870-881. https://doi.org/10.1007/s00132-022-04317-7
  5. Hume PA, Lorimer AV, Griffiths PC, Carlson I, Lamont M. Recreational Snow-Sports Injury Risk Factors and Countermeasures: A Meta-Analysis Review and Haddon Matrix Evaluation. Sports Medicine. 2015;45(8):1175-1190. https://doi.org/10.1007/s40279-015-0334-7
  6. Dickson TJ, Terwiel FA. Injury trends in alpine skiing and a snowboarding over the decade 2008-09 to 2017-18. Journal of Science and Medicine in Sport. 2021;24(10):1055-1060. https://doi.org/10.1016/j.jsams.2020.12.001
  7. Deibert MC, Aronsson DD, Johnson RJ, Ettlinger CF, Shealy JE. Skiing injuries in children, adolescents, and adults. Journal of Bone and Joint Surgery (American Volume). 1998;80(1):25-32. PMID 9469305. https://pubmed.ncbi.nlm.nih.gov/9469305/
  8. Burgess AG, Namazie R. Serious ski and snowboard injuries in southern New Zealand requiring acute orthopaedic admission and treatment during winter 2009. New Zealand Medical Journal. 2011;124(1328):89-97. PMID 21475343. https://pubmed.ncbi.nlm.nih.gov/21475343/
  9. Wörner T, Thorborg K, Eek F. High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position. Knee Surgery, Sports Traumatology, Arthroscopy. 2020;28(7):2302-2308. https://doi.org/10.1007/s00167-019-05787-7
  10. Kresal F, Bračun Š, Tönig L, Amon M. Physical therapy recommendations for injury prevention in alpine skiing. Annales Kinesiologiae. 2022;12(1):43-55. https://doi.org/10.35469/ak.2021.320
  11. Ettlinger CF, Johnson RJ, Shealy JE. A method to help reduce the risk of serious knee sprains incurred in alpine skiing. American Journal of Sports Medicine. 1995;23(5):531-537. https://doi.org/10.1177/036354659502300503
  12. Westin M, Harringe ML, Engstrom B, Alricsson M, Werner S. Prevention of Anterior Cruciate Ligament Injuries in Competitive Adolescent Alpine Skiers. Frontiers in Sports and Active Living. 2020;2:11. https://doi.org/10.3389/fspor.2020.00011
  13. Tyler TF, Nicholas SJ, Campbell RJ, Donellan S, McHugh MP. The effectiveness of a preseason exercise program to prevent adductor muscle strains in professional ice hockey players. American Journal of Sports Medicine. 2002;30(5):680-683. https://doi.org/10.1177/03635465020300050801
  14. Wolfinger CR, Davenport TE. Physical therapy management of ice hockey athletes: from the rink to the clinic and back. International Journal of Sports Physical Therapy. 2016;11(3):482-495. PMID 27274432. https://pmc.ncbi.nlm.nih.gov/articles/PMC4886814/
  15. NHS. Chest pain. Page last reviewed 8 August 2023. https://www.nhs.uk/symptoms/chest-pain/
  16. NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/
  17. NHS. Eye injuries. Page last reviewed 12 March 2026. https://www.nhs.uk/conditions/eye-injuries/
  18. NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
  19. National Institute for Health and Care Excellence (NICE). Head injury: assessment and early management. NICE guideline NG232. Published 18 May 2023. https://www.nice.org.uk/guidance/ng232
  20. Sport and Recreation Alliance and UK Government. UK concussion guidelines for non-elite (grassroots) sport. Published 2023, updated November 2024. https://sportandrecreation.org.uk/campaigns-and-policy/concussion/concussion-guidelines-for-grassroots-sport-html-version
  21. NHS. Dislocated shoulder. Page last reviewed 16 September 2026. https://www.nhs.uk/conditions/dislocated-shoulder/
  22. NHS. Broken arm or wrist. Page last reviewed 26 May 2023. https://www.nhs.uk/conditions/broken-arm-or-wrist/
  23. NHS. Broken finger. Page last reviewed 20 November 2025. https://www.nhs.uk/conditions/broken-finger/
  24. NHS. Knee pain. Page last reviewed 21 December 2023. https://www.nhs.uk/symptoms/knee-pain/
  25. NHS. Back pain. Page last reviewed 5 March 2026. https://www.nhs.uk/conditions/back-pain/
  26. NHS. Sciatica. Page last reviewed 3 December 2024. https://www.nhs.uk/conditions/sciatica/
  27. NHS. Sprains and strains. Page last reviewed 23 April 2024. https://www.nhs.uk/conditions/sprains-and-strains/
  28. NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/

Written and checked by the PocketPhysio editorial team. Last updated 2026-11-06.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.