Field Hockey Injury Risks Go Back 4,000 Years

By Dr. Eric W. Edmonds

The fall sports season is upon us, and it brings with it many of the most interesting, from the gladiator sports of football and boys’ water polo to the court-bound girls’ tennis and volleyball. However, one sport played in the autumn could consider its origins as ancient and unique: field hockey.

Contrary to our belief in America, this is a predominantly male sport for most of the world. The sport has a long history (perhaps 4,000 years) of development with an evolution from a simple “stick and ball” activity into the complex game that is played today. Yet, most of that history is a male-dominated activity that at times was quite brutal and at times was played on a field that was 750 feet long.

The modern game was an English design and spread to the commonwealth during the 19th century. It was played so often in the British Empire that the early Olympic history of men’s field hockey was dominated by India and Pakistan. But, in the U.S., the sport is predominantly a female sport.

Officially considered a non-contact sport, field hockey often results in injuries related to contact from another player, the stick or the ball. It is played in a semi-crouched position that places certain body parts at risk to get injured. Hand and wrist injuries from direct ball or stick contact are not uncommon, often resulting in finger fractures. The face is also at unique risk because of this body positioning and is often struck by the ball or an opponent’s stick. Many of these facial injuries are minor, but facial fractures, penetrating eye injuries and broken teeth have all been reported. Furthermore, concussions are not uncommon. Seven percent of all injuries sustained during field hockey competitions are concussion related.

Concussions should be given special consideration due to the significance of the injury. Dizziness and confusion are common symptoms, but otherwise unexplained headache, fatigue and difficulty concentrating may be symptoms of an unrecognized concussion.

The game is otherwise known for injuries to the ankle and knee. Ankle sprains are the most frequent injury in almost any sport, and field hockey is no exception. More than 15 percent of that sport’s injuries during participation are ankle sprains. Knee injuries are most often thigh muscle strains, but more significant injuries such as a tear of the anterior cruciate ligament are not uncommon.

Field hockey players are also prone to specific overuse injuries. Low-back pain and tendinitis of the hip, knee or ankle are very common, due to the semi-crouched position of play. Stress fractures of the foot can also result from the repetitive activity of play.

Some of the common injuries seen in field hockey can be prevented. An obvious choice is to wear appropriate protective gear such as a mouth guard and eye protection. But many of the acute injuries are difficult to prevent.

Dr. Eric W. Edmonds is a pediatric and adolescent orthopedic sports medicine specialist at Rady Children’s Hospital-San Diego and an assistant professor of orthopedics at UC San Diego. He can be reached at sports@rchsd.org.