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.
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
50
Center for Clinical Research Dalarna, Uppsala University
Falun, Dalarna County, Sweden
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)
Time frame: Baseline (cross-sectional survey at enrollment)
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: 1. = Never 2. = Rarely 3. = Sometimes 4. = Often 5. = Very Often Higher scores indicate greater frequency of players participating while symptomatic.
Time frame: 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: 1. = Never 2. = Rarely 3. = Sometimes 4. = Often 5. = Very Often Higher scores indicate greater frequency of symptoms occurring without formal diagnosis.
Time frame: 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: 1. = Not at all 2. = To a small extent 3. = To a moderate extent 4. = To a large extent 5. = To a very large extent Higher scores indicate greater perceived underreporting.
Time frame: 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
Time frame: 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
Time frame: 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: 1. = Very inconsistent 2. = Inconsistent 3. = Variable 4. = Consistent 5. = Very consistent Higher scores indicate greater consistency in return-to-play decision-making.
Time frame: 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
Time frame: 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)
Time frame: 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: 1. = Never 2. = Rarely 3. = Sometimes 4. = Often 5. = Very often Higher scores indicate greater frequency of participation while symptomatic.
Time frame: 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: 1. = Never 2. = Rarely 3. = Sometimes 4. = Often 5. = Very often Higher scores indicate greater frequency of symptoms occurring without formal diagnosis.
Time frame: Baseline (cross-sectional survey at enrollment)
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