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Clinical Research | Field Hockey Injuries

Clinical Research

Aye for an eye?
By Gary Brown| NCAA.org

College field hockey stares down a protective-equipment issue

The collegiate field hockey community is weighing whether a recommendation to require protective eyewear is good for the game. Citing increased rates of injuries to the face and head, the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports is recommending that NCAA field hockey work toward requiring players to wear protective eyewear in the near future.The eyewear requirement was implemented at the high school level last year. That action, combined now with the suggestion from the NCAA’s primary health and safety board, is prompting a broader discussion at the collegiate, national and international levels.The competitive-safeguards committee based its recommendation on NCAA data showing that 25 percent of all injuries in field hockey competitions occur to the head and face, with 28 percent of those being from contact with the ball and another 16 percent because of contact with the stick. Although rare, 8 percent of head injuries involve the eye (eye injuries include eyelid lacerations, corneal abrasions, orbital fractures, soft tissue contusion and others).

“We’re trying to mitigate data we’ve seen from our Injury-Surveillance System indicating that eye injuries are a potential risk in field hockey,” said Jeff Anderson, chair of the committee and director of sports medicine at the University of Connecticut. “Those data, along with the action the high schools took, prompted us to suggest that eyewear eventually be mandatory.” The original request from Anderson’s committee last summer was for the requirement to be in place by next season, but feedback and presentations from researchers and equipment experts at the committee’s most recent meeting in December prompted the group to delay the effective date of the proposal until additional testing can be done on the eyewear currently available to ensure it is appropriate for the collegiate game.
All three of the NCAA’s divisional championships committees are aware of the recommendation and have referred the matter to the respective field hockey committees, which in turn are soliciting feedback from coaches and other constituents.The early returns indicate support for enhancing player safety where appropriate, but many coaches worry that the eyewear designed to protect their players actually puts them more at risk.

Click Here to read full report from NCAA

Head injuries common in women’s field hockey
Reuters Health (Source: Clinical Journal of Sports Medicine, September 2008) NEW YORK | Fri Oct 17, 2008 3:08pm EDT

Injuries to the head and face are fairly common in women’s field hockey,
raising the question of whether players need more protective gear,
according to researchers.

In a study of six Division I college field hockey teams, researchers found that of 253 athletes followed
for two seasons, 22.5 percent suffered an injury to the head or face — including lacerations, bruises,
concussions and broken facial bones. Most of the injuries — 89 percent — were the result of a player
being struck by a field hockey stick or ball.

The findings are a “concern,” the researchers report
in the Clinical Journal of Sports Medicine, because
such injuries can be serious — potentially causing long-term
problems such as post-concussive syndrome or vision loss.
“Prevention measures, including better protective equipment for
the head and face, may help reduce future head and facial
injuries in these athletes,” write Dr. C. Daniel Hendrickson
and his colleagues at the University of Michigan Athletics in Ann Arbor.

Women’s field hockey has been steadily increasing in
popularity since the 1980s, the researchers note.
Some experts, they add, have argued that rule changes made
10 years ago, intended to make the game faster-paced
and higher-scoring, have increased players’ risk of injury.
To investigate college-level injury rates,
Hendrickson’s team followed six Division I teams over
two field hockey seasons.

Among the 253 athletes in the study, there were 62 head
and facial injuries during that time.Lacerations and bruising
accounted for more than half of the injuries, while
18 percent were concussions and 13 percent involved

broken facial bones. Broken or displaced teeth accounted for
6 percent of the injuries.Experts already recommend
that field hockey players wear custom-fitted mouth guards
to protect against dental injuries. There have also
been calls for college field hockey to follow the example
of collegiate lacrosse, which requires players to
use protective eyewear, Hendrickson and his colleagues point out.

The current findings, the researchers add, raise the question
of whether more-substantial protective gear, such as
the full facial protection worn in ice hockey, might be necessary.

“Although mandating protective equipment might meet resistance,”
they write, “the potential benefits seem to support
further study of this issue.”

Click Here to read full report from Clinical Journal of Sports Medicine, September 2008

Novel Field Hockey Facial Impact Protection
Thayer School of Engineering, Dartmouth College 2011

Team: Maxwell Bogren ’10, Kyle Betts ’10, Heather Kluk ’11, Katharine Gulemi ’11

Sponsor: Dr. Angela Ranzini
, Technical Advisor: Jeremy Murray
, Faculty Advisor: Richard Greenwald

Current field hockey safety gear fails to adequately protect the head and face from impact injuries.
A novel form of protection is needed. The group developed a facemask design and produced a testable prototype.

Tests involving ball-and-stick impacts were implemented on
the state-of-the-art protective sports masks and the prototypes.
Additional video analysis data was used to augment
theoretical analysis on the impact situations. Materials research
and testing was conducted to determine appropriate shell
and padding materials. User specifications were developed through
focus group discussion with field hockey athletes.

The group created two advanced “form, fit, and function” prototypes:
a contoured modular mask and a hockey-style mask. These prototype
designs relied on user specifications, such as optimal vision
and comfort, without sacrificing protection. Field hockey players
from Dartmouth practiced while wearing the masks and provided
constructive feedback. From the physical and user testing results,
one ultimate design has been recommended for future production.

Click Here to go to the article page

The Mechanisms and Prevention of Sports Eye Injuries
By Paul F. Vinger, M.D.
Clinical Professor of Ophthalmology, Tufts University School of Medicine
Associate Surgeon in Ophthalmology, Honorary Staff, Mass. Eye and Ear Infirmary

Street, floor, rink, and in-line roller hockey
Testing as to the actual energy levels in these sports has not
been done, but total eye and face protection would be
achieved with an ice hockey full-face mask mounted on a helmet.
This combination should be required for all participants.
Street and floor hockey are played outdoors or in the school
gymnasium using either regulation or lighter-weight hockey
sticks and a plastic puck or a tennis ball. Face and head protection
are rarely worn, even by the goalie. In 1.5 school years 10
of 400 players sustained an eye injury. 454 One player, who was
wearing a helmet, but no facemask, lost an eye when struck
with the blade of a plastic hockey stick. 455
Rink hockey is played with rink (quad) skates and a lightweight
(155g, 7-8 cm diameter ball. Face protection is mandated
for the goalie, but not for the other players.
In-line roller hockey is similar to ice hockey and is usually
played in a rink with a hard rubber puck that has ballbearings
or bumps to limit surface friction. Helmets with face-masks are

Field hockey
Injuries to the head and face are common in field hockey.
The field hockey ball (diameter 7.13-7.5 cm; 156-163 g), which
is extremely hard and can be driven at a velocity in excess of
50 mph by high school girls, has caused an almost fatal
epidural hemorrhage from a fractured skull to a Massachusetts
high-school player. Of the 14 serious injuries to women playing
field hockey at California State University in Long Beach

from 1976 to 1979, 4 involved the head and face (3 cerebral
concussions and 1 severe cheek contusion with neuropathy of
the seventh nerve that lasted several months). 456 Tooth injuries
in field hockey have increased, prompting the Big Ten
athletic rules committee to mandate mouthguards for female
collegiate athletes in 1982.A 1996 survey of Delaware, Massachusetts,
Missouri, New Hampshire, Ohio and Rhode Island
reported 160 occurrences of head injuries in 5,070 players. Fifteen
of these injuries involved the eye, 10 the eyelids, and 19
the eyebrow. Field hockey eye injuries tend to be severe and
include ruptured globes from impact with the stick. 19, 458 The
risk of an eye injury over an eight-year career is approximately
4% (Table3). Head, face, eye, and teeth injuries could be eliminated
with helmets and faceguards, which are mandatory for
goalies but forbidden to other US players. Eye injuries can be
reduced or eliminated with eyewear conforming to ASTM
F2713 for field hockey. Thus far, field hockey officials have no
adequate explanation as to why the ball must be so very hard,
and why helmets and full-face guards are not permitted to
players other than the goalie.

Click Here to read full research paper

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