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Ice Hockey injury prevention for girls.

Speed and falls make concussion the top concern, with hip and groin strains close behind.

Concussion

Among the most common injuries in girls' ice hockey.1

Remove

Any suspected concussion means removal from play the same day.2

10 min

Off-ice warm-up for hips, trunk, and balance.

Girls' ice hockey has high concussion rates even without body checking, due to falls, collisions, and boards. Recognition and removal from play are critical.

The skating stride loads the adductors and hip flexors; building hip and groin strength may help, though prevention trials in female players are still lacking.

College surveillance data show female athletes report concussions at higher rates than male athletes in comparable sports and can take longer to return. Every coach, parent, and player should know the signs and follow a graded return.

Injury profile

What actually injures ice hockey players

Concussion

Most common serious injury

Mechanism: Falls, collisions, and boards.

Female-specific: Female athletes may report more symptoms and longer recovery.1,2

Adductor/groin strain

Common

Mechanism: Skating push-off.

Female-specific: Hip strength work is sensible; female-specific prevention evidence is limited.

Shoulder injury

Common

Mechanism: Falls onto the shoulder or into boards.

Female-specific: Well-fitted shoulder pads matter.

MCL sprain

Common knee injury

Mechanism: Valgus force in falls and collisions.

Female-specific: Most heal without surgery with guided rehab.

Female physiology

Why the risk is different for girls

These factors change what prevention has to address — they are not reasons to train girls less.

Remove when in doubt

Any suspected concussion means removal from play and clinician evaluation before a graded return.2

Graded return protects the brain

After a concussion, return follows staged steps from symptom-limited activity to full contact, moving on only when symptoms stay settled. Contact comes last and needs clinician clearance.2,1

Energy availability comes before every other adaptation

When an athlete does not eat enough to cover the energy her training burns, the body downregulates the systems it treats as optional first — menstrual function, bone remodeling, immune response, and tissue repair. The IOC calls this Relative Energy Deficiency in Sport (REDs), and it raises bone stress injury and soft-tissue injury risk independent of how good her mechanics are. Amenorrhea (no period for three or more months) in an athlete is a clinical finding, not a convenience.

Puberty changes the machine mid-season

The adolescent growth spurt lengthens the levers (femur, tibia) faster than the neuromuscular system recalibrates, and in girls the strength gain that accompanies growth is smaller than in boys. The result is a two- to three-year window of reduced dynamic knee control, wider dynamic valgus on landing, and higher relative injury risk. Programming should get more — not less — landing and single-leg work through this window.

Menstrual-cycle phase is a variable, not a taboo

Hormonal fluctuation across the cycle affects laxity, neuromuscular control, thermoregulation, and perceived exertion, and prospective data in international footballers found injury incidence differed by cycle phase. The practical action is not to restrict training but to track: a simple cycle log next to load data lets athletes and staff see patterns and adjust intensity, hydration, and fueling.

10 minutes warm-up

The protocol, block by block

Run off-ice before every practice and game.

3:00

Block 1 of 4

Dynamic warm-up

Jog, leg swings, hip openers.

  • Full range
  • Easy pace
Screening

What to check, and when to escalate

Baseline concussion history

Record prior concussions preseason.

Red flag: Multiple or recent concussions — clinician review.

Adductor squeeze

Compare squeeze strength side to side.

Red flag: Pain or clear weakness.

Single-leg balance

30-second balance each leg.

Red flag: Clear asymmetry.

Training load

Load rules that prevent overuse

  • Remove any player with a suspected concussion the same day — no same-day return.
  • Build ice time gradually early season.
  • Include adductor strength twice weekly.
  • Follow graded return-to-sport after concussion.

Gear & equipment

  • Certified helmet with full cage
  • Fitted mouthguard
  • Properly sized shoulder pads
  • Neck guard
Return to play

Stages, not dates

Progression is criteria-based and clinician-led. A calendar date is not a clearance.

Stage 1 of 5

1. Symptom-limited activity

Daily activities without worsening symptoms.

FAQ

Questions coaches and parents ask

Removing body checking lowers risk, but falls and collisions still cause concussions. Recognition and removal protocols remain essential.

References

Every claim, sourced

2 peer-reviewed sources. Each links to its PubMed record so you can read the original.

  1. 1

    Covassin T, Moran R, Elbin RJ. Sex differences in reported concussion injury rates and time loss from participation: an update of the National Collegiate Athletic Association Injury Surveillance Program from 2004-2005 through 2008-2009. J Athl Train. 2016;51(3):189-194.

    PubMed 26950073
  2. 2

    Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695-711.

    PubMed 37316210
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