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243 Spinal Cord Injuries were recorded by Canadian Hockey Players over the last 30 years,
that is equal to and average of 8 hockey players a year. 
(according to

How spinal injuries happen in hockey

The upper spinal column has a natural curve, which lends
flexibility to the head and neck when the head is held in a
normal " Heads Up" position (See illustration A).
But when the head is flexed (chin toward the chest), this
normal curve is removed, and the cervical spine becomes
straight, as illustration B demonstrates.
In this "head down position," when a player hits the boards
or a goal post head on, the head stops suddenly, but the body's
movement continues, compressing the spine. This force can
produce a shock greater than the neck's discs and muscles can
cushion, resulting in a fracture or break of one of more
vertebrae. And if one breaks, it can cause compression of the
spinal cord, resulting in paralysis below the level of the fracture.
According to research done among a wide range of hockey
players, almost all on-ice cervical spine injuries have been due
to the head being slightly flexed (head down) while making
head-on contact with the boards or goal post.
A player doesn’t have to be going at full speed for this to
happen — it can occur at walking speed.

So that's the basis for Rule One of Heads Up Hockey:

Heads Up — Don't Duck!

1. Charles H Tator, Spinal Injuries Due To Hockey.

Canadian Journal of Neurological Sciences; 11:34-41.

mass. medical logo

Heads Up, Don't Duck - A Program to Decrease the Risk of Spinal Cord Injuries

January 12, 2001

Most people do not relate playing ice hockey with spinal cord injuries in the neck -- they don’t happen often. But when a severe injury like a spinal cord injury does occur, the question is: What preventive measures could have been taken?




Can Prevention be Expected?

Prevention is usually possible, and should be the first thought in a player’s mind when entering the rink. Think of the countless hours spent skating, weight training, stretching, competing, and studying the sport, so the player can be prepared when the referee blows the first whistle at the start of the game. Knowing how to protect yourself against spinal cord injury is no different than knowing which goal to score against.

What Kind of Spinal Cord Injury Is Caused?

Cervical (neck) spinal cord injuries, though infrequent, can be devastating. These most often occur when a player lowers his head or tucks his chin to his chest, causing the vertebrae (bone segments of the spinal column that surround the spinal cord) to align in a straight line, and then collides head first into either another player, boards, or goal posts. This force (called axial compression) is transmitted to the aligned vertebrae, and, with minimal force, can result in the fracture, or breaking, of one of the cervical vertebrae. When the vertebra fractures, it can cause compression on the spinal cord, and it is this compression that results in paralysis.

It is rare that this injury occurs when the neck is in a normal or neutral position -- HEADS UP!

Is There Any Type of Protective Equipment?

At present, there is no protective equipment that a player can use to prevent a cervical spine injury. Helmets can protect a player from concussions but do not protect against cervical spinal cord injury.

The best form of protection is to be aware of the danger involved and keep your HEAD UP!

For copies of this brochure, please contact:
The Massachusetts Medical Society Department of Public Health and Education at (781) 434-7373.

Massachusetts Medical Society
Massachusetts Interscholastic Athletic Association (MIAA)
Massachusetts Hockey
New England Ice Skating Managers Association

                                          mass hockey logo                    miaa logo

Produced by the Massachusetts Medical Society in conjunction with Massachusetts Hockey.

This information may be duplicated for distribution w/out profit.

 Neck injuries occur when a player's head makes contact with the boards, goal posts, or with another
  player with the neck slightly flexed (chin near chest).  HEADS UP, hands up, DON'T DUCK! 
“Michigan Amateur Athletic Association”