Medical Team Perspectives on Hand and Wrist Injuries in Elite Male and Female Ice Hockey Players

Medical Team Perspectives on Hand and Wrist Injuries in Elite Ice Hockey: A Cross-Sectional Survey Study in Male and Female Players

This is a cross-sectional survey study investigating how medical team staff in elite Swedish ice hockey perceive hand and wrist injuries in male and female players.

Hand and wrist injuries are common in ice hockey and can affect both performance and participation. While injury registries describe how often these injuries occur, less is known about how they are managed and prioritised in daily clinical practice, or whether there are differences in perception between medical teams working in male and female elite leagues.

In this study, physiotherapists and team physicians working in Swedish elite ice hockey (including SHL, HockeyAllsvenskan, and SDHL) will complete a structured questionnaire. The survey examines perceptions of injury frequency, underreporting, functional impact, clinical management strategies, and return-to-play decision-making related to hand and wrist injuries.

The aim is to better understand how medical teams experience and manage these injuries in real-world elite sport settings, and to identify potential gaps between epidemiological data and clinical practice. The study may help inform future injury prevention strategies, improve clinical decision-making, and support the development of more standardized management approaches in elite ice hockey.

No interventions or treatments are performed in this study.

Study Overview

• Status: Not yet recruiting
• Conditions: Injuries; Hand; Wrist; Ice Hockey; Medical Staff Perception

Detailed Description

This is a cross-sectional survey study designed to investigate how medical team staff in elite Swedish ice hockey perceive the burden, clinical relevance, and management of hand and wrist injuries in male and female players.

Hand and wrist injuries represent a substantial proportion of injuries in ice hockey and are known to affect both short-term performance and participation. While epidemiological data from injury surveillance systems and registry-based studies provide important information on incidence, injury type, and mechanisms, these data primarily reflect medically recorded or time-loss injuries. As a result, they may not fully capture ongoing symptoms, subclinical functional limitations, or injuries managed conservatively without formal reporting. This may create a gap between observed injury epidemiology and the clinical reality experienced by team medical staff.

To explore this gap, the study targets physiotherapists and physicians working within elite Swedish ice hockey organizations, including teams from the Swedish Hockey League (SHL), HockeyAllsvenskan, and the Swedish Women's Hockey League (SDHL). Participants will complete a structured 13-item questionnaire distributed during scheduled medical staff meetings. The questionnaire is completed anonymously and individually.

The survey includes domains addressing perceived frequency and severity of hand and wrist injuries, perceived underreporting of symptoms, functional consequences during training and competition, and clinical management strategies including rehabilitation approaches and return-to-play decision-making. Additional items explore perceived variability in practice and areas where improved clinical guidelines or standardized approaches may be needed.

Responses consist of categorical and ordinal variables and are analyzed descriptively. The study is exploratory in nature and aims to characterize patterns in clinical perception rather than test predefined hypotheses.

All data are collected at a single time point, and no follow-up assessments, interventions, or clinical procedures are performed. Data are fully anonymized, and no identifiable team- or individual-level information is recorded. The study is intended to complement existing epidemiological and registry-based research by providing insight into clinical decision-making and perception within elite ice hockey medical teams.

• Study Type: Observational
• Enrollment (Estimated): 50

Contacts and Locations

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

Study Locations

• Sweden
  • Dalarna County
    • Falun, Dalarna County, Sweden, 79182
      • Center for Clinical Research Dalarna, Uppsala University

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

Medical support staff are recruited from elite ice hockey organizations in Sweden, including teams competing in the Swedish Hockey League (SHL), HockeyAllsvenskan, and the Swedish Women's Hockey League (SDHL). The population includes individuals working in team-based medical and performance support roles such as physicians, physiotherapists, athletic trainers, and massage therapists. Participants are drawn from active staff lists within participating clubs and are invited to take part during scheduled medical or team staff meetings within the competitive season period.

Description

Inclusion Criteria:

• Physiotherapists working with elite ice hockey teams in Sweden (SHL, HockeyAllsvenskan, SDHL)
• Team physicians working with elite ice hockey teams in Sweden (SHL, HockeyAllsvenskan, SDHL)
• Massage therapists and sports massage practitioners working with elite ice hockey teams in Sweden
• Athletic trainers and performance staff involved in player health and injury management in elite ice hockey teams in Sweden
• Currently active in a medical or performance support role within a participating elite ice hockey team during the study period
• Able to understand and complete the questionnaire in Swedish or English Provides informed consent

Exclusion Criteria:

• Refusal to participate
• Not currently active in a medical, therapeutic, or performance support role within elite ice hockey during the study period

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Medical Team Staff in Elite Ice Hockey; Physiotherapists, physicians and other medical staff working with elite ice hockey teams in Sweden (SHL, HockeyAllsvenskan, SDHL) completing a cross-sectional survey on perceptions and management of hand and wrist injuries in ice hockey players.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Injury Burden Based on Time-Loss Ranking of Injury Locations	Ranking of injury locations based on perceived contribution to total time-loss in elite ice hockey, as reported by medical staff. Injury locations include head/face, shoulder, knee, groin, hand/wrist, and other specified regions. Unit of Measure: Ordinal ranking (1 = highest burden, 2 = second highest, 3 = third highest)	Baseline (cross-sectional survey at enrollment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency of Playing With Hand and Wrist Symptoms	Self-reported frequency of players participating in training or matches despite hand or wrist symptoms, as perceived by medical staff. Unit of Measure: 5-point ordinal scale: = Never; = Rarely; = Sometimes; = Often; = Very Often Higher scores indicate greater frequency of players participating while symptomatic.	Baseline (cross-sectional survey at enrollment)
Frequency of Hand and Wrist Symptoms Without Formal Diagnosis	Description: Self-reported frequency of observed hand and wrist symptoms in players that are not formally diagnosed, as perceived by medical staff. Unit of Measure: 5-point ordinal scale: = Never; = Rarely; = Sometimes; = Often; = Very Often Higher scores indicate greater frequency of symptoms occurring without formal diagnosis.	Baseline (cross-sectional survey at enrollment)
Perceived Extent of Underreporting of Hand and Wrist Injuries	Description: Self-reported perception of the extent to which hand and wrist injuries are underreported in elite ice hockey, as assessed by medical staff. Unit of Measure: 5-point ordinal scale: = Not at all; = To a small extent; = To a moderate extent; = To a large extent; = To a very large extent Higher scores indicate greater perceived underreporting.	Baseline (cross-sectional survey at enrollment)
Type of Hand and Wrist Problems Perceived as Underreported	Description: Type of hand and wrist injury or symptom most commonly perceived as being underreported in elite ice hockey, as reported by medical staff. Unit of Measure: Categorical (single choice): Fractures Ligament injuries Tendon or muscle injuries Non-specific pain or overuse Uncertain	Baseline (cross-sectional survey at enrollment)
Functional Impact of Hand and Wrist Injuries	Description: Functions most commonly perceived as affected by hand and wrist injuries in ice hockey players, as reported by medical staff. Unit of Measure: Categorical (multiple selection, up to 2 choices): Grip strength Stick handling Shooting Face-offs Physical play / board play	Baseline (cross-sectional survey at enrollment)
Consistency of Return-to-Play Decisions	Description: Self-reported consistency of return-to-play decisions for players with hand and wrist injuries, as perceived by medical staff. Unit of Measure: 5-point ordinal scale: = Very inconsistent; = Inconsistent; = Variable; = Consistent; = Very consistent Higher scores indicate greater consistency in return-to-play decision-making.	Baseline (cross-sectional survey at enrollment)
Presence of Standardized Management Approach for Hand and Wrist Injuries	Description: Whether a standardized approach is used for assessment and management of hand and wrist injuries within the team medical staff structure. Unit of Measure: Categorical (single choice): Yes No Partially	Baseline (cross-sectional survey at enrollment)
Perceived Performance Impact Ranking of Injury Locations	Ranking of injury locations based on perceived impact on player performance during participation despite symptoms, as reported by medical staff. Injury locations include head/face, shoulder, knee, groin, hand/wrist, and other specified regions. Unit of Measure: Ordinal ranking (1 = highest performance impact, 2 = second highest, 3 = third highest)	Baseline (cross-sectional survey at enrollment)
Frequency of Participation With Hand and Wrist Symptoms	Perceived frequency of players participating in training or matches while experiencing hand or wrist symptoms. Unit of Measure: 5-point ordinal scale: = Never; = Rarely; = Sometimes; = Often; = Very often Higher scores indicate greater frequency of participation while symptomatic.	Baseline (cross-sectional survey at enrollment)
Frequency of Hand and Wrist Symptoms Without Formal Diagnosis	Perceived frequency of hand and wrist symptoms in players that are not formally diagnosed by medical staff. Unit of Measure: 5-point ordinal scale: = Never; = Rarely; = Sometimes; = Often; = Very often Higher scores indicate greater frequency of symptoms occurring without formal diagnosis.	Baseline (cross-sectional survey at enrollment)

Collaborators and Investigators

• Sponsor: Dalarna County Council, Sweden
• Investigators: Principal Investigator: Daniel Muder, MD, PhD, Center 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.
• Gotlin MJ, Minhas SV, Buchalter DB, Feder OI, Alaia MJ, Jazrawi LM. Performance and Return to Sport After Hand, Wrist, and Forearm Fractures in the National Hockey League. Arthrosc Sports Med Rehabil. 2020 Sep 25;2(5):e505-e510. doi: 10.1016/j.asmr.2020.05.013. eCollection 2020 Oct.
• Tuominen M, Stuart MJ, Aubry M, Kannus P, Parkkari J. Injuries in men's international ice hockey: a 7-year study of the International Ice Hockey Federation Adult World Championship Tournaments and Olympic Winter Games. Br J Sports Med. 2015 Jan;49(1):30-6. doi: 10.1136/bjsports-2014-093688. Epub 2014 Oct 7.

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2026
• Primary Completion (Estimated): September 30, 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): June 5, 2026
• Last Update Submitted That Met QC Criteria: June 4, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: hand; wrist; cross-sectional survey; ice hockey; medical staff perception
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: EPM 2026-03227-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Any data shared with colleagues or collaborating researchers will be fully anonymized or pseudonymized to protect participant privacy in accordance with GDPR regulations. Data transfers will occur under strict confidentiality agreements, and all parties will adhere to applicable data protection laws to ensure the security and privacy of personal information. We will act in accordance with the ethical approval granted by the Swedish Ethical Review Authority (EPM) and comply with all relevant local policies regarding data protection.
• 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