Prevalence and Functional Impact of Hand and Wrist Symptoms in Ice Hockey Players

Prevalence and Functional Impact of Hand and Wrist Symptoms in Ice Hockey Players: A Cross-Sectional Survey Study

Ice hockey places high physical demands on the hands and wrists due to frequent shooting, passing, and physical contact. This study aims to understand how common hand and wrist pain or symptoms are among ice hockey players in Sweden, and how these symptoms affect training, participation, and performance.

Players from different competitive levels (elite, junior, and amateur) and both sexes will complete a structured questionnaire based on the validated Oslo Sports Trauma Research Centre (OSTRC) tool, along with questions about pain intensity, symptom characteristics, and functional impact.

The goal is to describe the prevalence and severity of hand and wrist symptoms across different groups of players and to identify potential differences between sex, playing level, and position. No treatment or intervention is involved.

Study Overview

• Status: Not yet recruiting
• Conditions: Overuse Injury; Hand; Wrist; Ice Hockey Players

Detailed Description

This cross-sectional observational survey study investigates the prevalence, severity, and functional impact of hand and wrist symptoms among ice hockey players in Sweden. Ice hockey is characterized by high mechanical loading of the upper extremities due to repeated stick handling, shooting, passing, and frequent body contact, which may result in both acute injuries and chronic or overuse-related symptoms affecting the hand and wrist.

Despite the recognized importance of upper-limb function in ice hockey performance, the burden of non-time-loss symptoms remains poorly described in epidemiological injury surveillance systems. Traditional injury registries primarily capture time-loss injuries and may therefore underestimate the true functional impact of hand and wrist complaints that do not necessarily result in absence from play.

To address this gap, players from multiple competitive levels-including elite, junior elite, and amateur ice hockey teams in Sweden-will complete a structured questionnaire during the competitive or pre-season period. The survey is based on the validated Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire, supplemented with additional items capturing pain intensity (numeric rating scale), symptom characteristics (location, duration, and triggers), and perceived impact on training, participation, and performance.

The study population includes both male and female athletes across different competitive tiers, allowing stratified analyses by sex, playing level, and playing position. The primary objective is to estimate the prevalence of hand and wrist symptoms, while secondary objectives include quantifying symptom severity and functional consequences, as well as exploring associations with player characteristics such as age, playing experience, and prior injury history.

All data are collected at a single time point, and no interventions or treatments are administered as part of the study. The results are intended to improve understanding of the functional burden of hand and wrist symptoms in ice hockey and to inform future injury prevention, load management, and rehabilitation strategies.

• Study Type: Observational
• Enrollment (Estimated): 800

Contacts and Locations

• Study Contact: Name: Daniel Muder, MD, PhD; Phone Number: +46722027596; Email: danielmuder@email.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Active male and female ice hockey players recruited from Swedish ice hockey teams across elite, junior elite, and amateur levels. Teams are selected from professional leagues (SHL and SDHL), second-tier leagues (HockeyAllsvenskan and NDHL where applicable), junior U18/U20 teams, and amateur clubs. Participants are drawn from active rosters during the competitive season or pre-season period and complete a structured questionnaire assessing hand and wrist symptoms, pain, and functional impact.

Description

Inclusion Criteria:

• Active ice hockey players currently registered on a participating team roster in Sweden.
• Male or female players competing at elite, junior elite, or amateur level.
• Participation in one of the included competition levels during the current season.
• Able to understand and complete the questionnaire.
• Provides written informed consent.

Exclusion Criteria:

• Declines participation.
• Inability to complete the survey due to language barriers or cognitive limitations.
• Acute severe upper-limb injury at time of data collection preventing meaningful survey completion, if deemed necessary for context-specific exclusion.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Ice Hockey Players; Active male and female ice hockey players from elite, junior, and amateur teams in Sweden participating in a cross-sectional survey assessing hand and wrist symptoms.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of Hand and Wrist Pain Under Load in Ice Hockey Players	Proportion of ice hockey players reporting hand or wrist pain occurring during hockey-specific load-bearing activities (e.g., shooting, stick handling, body contact), assessed using a structured cross-sectional survey including OSTRC-based symptom items. Unit of Measure: Percentage of participants (%)	Baseline (cross-sectional survey at enrollment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Severity of Hand and Wrist Symptoms in Ice Hockey Players	Overall severity of hand and wrist symptoms during hockey participation, assessed using a structured questionnaire based on OSTRC overuse injury principles and a 0-10 numeric rating scale for pain intensity. Unit of Measure: OSTRC-based severity score (ordinal scale) Numeric Rating Scale (0-10), where 0 = no pain and 10 = worst imaginable pain (higher score = worse outcome)	Baseline (cross-sectional survey at enrollment)
Functional Impact of Hand and Wrist Symptoms on Participation and Performance	Self-reported impact of hand and wrist symptoms on participation in training and competition, training volume, and on-ice performance, assessed using structured OSTRC-based items. Unit of Measure: Ordinal scale responses (5-level categories) assessing: participation limitation training reduction performance impairment Higher scores indicate greater functional impact.	Baseline (cross-sectional survey at enrollment)
Characteristics of Hand and Wrist Pain in Ice Hockey Players	Distribution and pattern of self-reported hand and wrist pain during hockey participation, including anatomical location, triggering actions, and duration of symptoms. Unit of Measure: Categorical responses (multiple response options), including: anatomical location (e.g., radial wrist, ulnar wrist, fingers, thumb) triggering mechanisms (e.g., shooting, stick handling, body contact) symptom duration (e.g., during activity, minutes, hours, persistent) Results will be reported as frequencies and percentages.	Baseline (cross-sectional survey at enrollment)
History of Hand and Wrist Injuries and Associated Characteristics in Ice Hockey Players	Self-reported history of prior hand and wrist injuries, including injury type, timing, and current treatment status, as potential background factors associated with current symptom burden. Unit of Measure: Categorical variables reported as frequencies and percentages, including: presence of previous hand/wrist injury (yes/no) injury type (e.g., fracture, ligament injury, tendon injury) timing of most recent injury (year) current treatment status (yes/no; type of treatment)	Baseline (cross-sectional survey at enrollment)
Clinical Management and Reporting Behaviour Related to Hand and Wrist Symptoms in Ice Hockey Players	Self-reported clinical management strategies and reporting behaviour related to hand and wrist symptoms, including communication with medical staff, reasons for non-reporting, return-to-play modifications, and use of protective or symptomatic treatments during participation. Unit of Measure: Categorical responses reported as frequencies and percentages, including: reporting to medical staff (yes/no) reasons for non-reporting changes in playing style due to symptoms (yes/no) use of protective measures or treatments (e.g., tape, brace, medication)	Baseline (cross-sectional survey at enrollment)

Collaborators and Investigators

• Sponsor: Dalarna County Council, Sweden
• Investigators: Principal Investigator: Daniel Muder, MD, PhD, Centre for Clinical Research Dalarna, Uppsala University, Sweden

Publications and helpful links

General Publications

• Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med. 2013 May;47(8):495-502. doi: 10.1136/bjsports-2012-091524. Epub 2012 Oct 4.
• Worner T, Kauppinen S, Eek F. Injury patterns in Swedish elite female and male ice hockey - A cross-sectional comparison of past-season's injuries. Phys Ther Sport. 2024 Jan;65:83-89. doi: 10.1016/j.ptsp.2023.12.001. Epub 2023 Dec 8.
• Aman M, Forssblad M, Henriksson-Larsen K. Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data. Scand J Med Sci Sports. 2016 Apr;26(4):451-62. doi: 10.1111/sms.12462. Epub 2015 Apr 8.

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: April 30, 2026
• First Submitted That Met QC Criteria: May 10, 2026
• First Posted (Actual): May 14, 2026

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 22, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: ice hockey, hand and wrist symptoms, OSTRC questionnaire, sports injuries, cross-sectional survey
• Additional Relevant MeSH Terms: Wounds and Injuries; Sprains and Strains; Athletic Injuries; Cumulative Trauma Disorders
• Other Study ID Numbers: 2026-02210-01A

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Individual participant data (IPD) including de-identified questionnaire responses will be shared. This includes OSTRC-derived symptom and severity scores, pain intensity ratings (NRS), reported symptom characteristics (location, duration, triggers), and functional impact on training, participation, and performance, as well as basic demographic and playing characteristics such as age, sex, playing position, playing level, years of experience, dominant hand, and prior hand/wrist injury history.
• IPD Sharing Time Frame: From the publication of the protocol and for 10 years thereafter.
• IPD Sharing Access Criteria: Access to individual participant data is typically restricted to authorized researchers involved in the study or approved collaborators under strict confidentiality and data protection agreements.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No