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Injury Risk to IIHF Ice Hockey Referees and Linesmen

2021 Congress Paper Abstracts

Injury Risk to IIHF Ice Hockey Referees and Linesmen

Charles A. Popkin, MD, UNITED STATES Ajay S Padaki, MD, UNITED STATES Andrew Rogers, UNITED STATES David P Trofa, MD, UNITED STATES T. Sean Lynch, MD, UNITED STATES Markku Tuominen , MD, PhD, FINLAND Michael J. Stuart, MD, UNITED STATES

Columbia University, New York, New York, UNITED STATES

2021 Congress   Abstract Presentation   6 minutes   Not yet rated


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Summary: Officials in ice hockey play a crucial role in providing a safe environment in this intrinsically hazardous sport, however, there is no current literature examining the injury profile for hockey referees and linesmen.


Ice hockey officials have not been given the same attention as the players by the sports medicine community. The unique demands of the job expose them to considerable orthopedic injuries.

Hypothesis/Purpose: The purpose of the study was to quantify and analyze musculoskeletal injuries reported by International Ice Hockey Federation (IIHF) officials.

Study Design: Descriptive Epidemiology Study


A 61 question survey tool designed by an interdisciplinary team was used to evaluate musculoskeletal injuries experienced by ice hockey officials during competition and training. The questionnaire was distributed to IIHF referees and linesmen at their Annual Winter Meeting in 2020.


264 ice hockey officials completed the survey. 52% were linesmen, 45% were referees and 3% identified as both. Respondents were 72% male and 28% female with a mean age of of 31.1 years. Officiating experience averaged 11.4 years, including 6.3 years with the IIHF. A total of 295 injuries were reported by more than 55% of the officials. Injuries occurred more frequently in games compared to training, resulting in a mean of 24.4 days off work. The most common injuries involved the wrist and hand (n=64, 21%), concussions (n=58, 20%) and the knee (n= 47, 16%). Wrist and hand trauma included 23 fractures, 16 contusions, 8 lacerations, 5 tendon injuries and 5 dislocations.

Knee and shoulder injury were most likely to require surgery (p<.001). Thirty officials underwent surgery from an acute knee injury (10.4%). Injury prevention was effective for risk reduction (p = 0.04) Referees and linesmen who worked year-round had more total injuries than those who took time off (p = 0.03).


The majority of ice hockey officials experience musculoskeletal injuries during their career. We support the IIHF recommendation to add officials to their Injury Reporting System. The risk of trauma to the wrist and hand could be possibly be reduced by equipment modifications including protective gloves. Greater emphasis should be placed on injury prevention programs and officials can be encouraged to intermittently take time away from the ice.

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