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Removal of An Injured Ice Hockey Player's Helmet May Lead to Serious Neck and Spine Injuries, Researchers Caution at the Annual Meeting of the American Orthopaedic Society for Sports Medicine
June 20, 1999-Traverse City, Michigan-Over the past twenty years, the annual incidence of hockey related spinal injuries has increased markedly. The most common injury is to the cervical spine, which can result in paralysis or even death.
In a research study presented here today at the Annual Meeting of the American Orthopaedic Society for Sports Medicine, Robert J. Broxterman, MS, ATC, and co-researchers Robert F. LaPrade, MD, Kent Schnetzler, MS and Eric Wendland of the University of Minnesota in Minneapolis, Minnesota, urged that the helmets of downed players should not be removed.
"Removal of the helmet increases the extension of the cervical spine, which may cause or exacerbate an existing injury," Broxterman said. "Our study indicates that this lordosis, or backward extension, greatly increases and puts the player at greater risk for a more serious injury."
Ten adult male volunteers, ages 18 to 28, with no previous history of cervical spine injuries, were enrolled in the study. Each subject was fitted with an appropriately sized ice hockey helmet and shoulder pads. All subjects were immobilized in a supine position to a standard spine backboard to secure the head in a neutral position. Images of each volunteer's spine were taken with computerized tomography scout scans with the subjects wearing no protective equipment, wearing a helmet and shoulder pads and wearing shoulder pads and no helmet.
When the helmet was removed and the volunteer was wearing only shoulder pads, a significant increase in backward extension was seen. This extension was not evident when the volunteer was wearing both a helmet and shoulder pads. This is similar to research that has been done with football players and led to the AOSSM developing guidelines on football helmet removal in 1996. In hockey players, however, the extension occurs in an area of the spine where the majority of cervical spine injuries happen.
The researchers urge the universal adoption of a policy of immobilization of all injured hockey players in all circumstances until a cervical spine injury has been ruled out.
The American Orthopaedic Society for Sports Medicine (AOSSM) is an international medical specialty association of allied health professionals and physicians, primarily orthopaedic surgeons, who have demonstrated a significant and long-term commitment to sports medicine. The AOSSM promotes and supports education and research programs in sports medicine, including those concerned with physical fitness, as well as programs designed to advance our knowledge in the recognition, treatment, rehabilitation and prevention of athletic injuries.
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Editor's Note: Black and White photos of Robert Broxterman and volunteers are available that show him assisting a player off the ice and a player properly strapped to a back board.
AOSSM's Football Helmet Removal Guidelines are available upon request.
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