© Springer International Publishing AG 2018Arthur Jason De Luigi (ed.)Adaptive Sports Medicinedoi.org/10.1007/978-3-319-56568-2_22
22. Ice Sled Hockey (Sledge Hockey Outside the United States)
Andrews Institute, Gulf Breeze, FL, USA
MedStar National Rehabilitation Network, Washington, DC, USA
KeywordsIce hockeyIce sled hockeySledge hockeyRulesEligibilityEquipmentInjuriesMedical management
Ice sled hockey was invented at a rehabilitation center in Stockholm, Sweden in the early 1960s by a motivated group of athletes who wanted to continue playing hockey after incurring physical disability . It was first exhibited at the Paralympic Winter Games in Sweden in 1976 and again at the 1988 Paralympics in Innsbruck . It became an official event at the 1994 Lillehammer Paralympics . Since then, the game has quickly become a popular sport for both children and adults.
Ice sled hockey is a sport played by males and females who have a lower body physical impairment. It is essentially a seated version of ice hockey for players whose impairments interfere with their ability to stand and skate. The players sit in double-blade sleds and propel with two shortened hockey sticks. The sticks are adapted with metal picks on the end, and players use the spike-end for propulsion and a blade-end for shooting the puck .
The structure of ice sled hockey is very similar to that of able-bodied ice hockey. There are six members of each team on the ice during play, one of whom is the goalie. The object of the game is to score on the opponent and to prevent the opponent from scoring. The game is played according to the Official Playing Rules of USA Hockey .
According to the IPC, there is only one sport class in ice sled hockey. Athletes must have an impairment in the lower part of their body that would prevent them from competing in able-bodied ice hockey. Thus, ice sled hockey players can exhibit a wide variety of mobility limitations including amputations, spinal cord injuries, spina bifida, and other permanent lower body impairments .
Non-disabled players are encouraged to participate in ice sled hockey. Leagues have developed guidelines for the non-disabled players. However, at the national and international level of Paralympic competition, participation is solely for athletes with impairments.
Companies specializing in prosthetics and orthotics create custom-made sleds that are designed to fit the body of each individual athlete. The materials used can vary. Cushioning may be added inside the sled to increase comfort and skin protection.
The sleds are generally between 0.6 and 1.2 m long and sit on top on two adjustable steel blades which are 3 mm wide . The sled must be high enough off of the ice in order to allow the puck to pass underneath. The players are strapped into the sleds during play.
Ice sled hockey players use two sticks during play. The sticks are equipped with a blade at one end and a pick at the other . As in able-bodied ice hockey, the blade is used for shooting; however, unlike able-bodied ice hockey, the sled hockey player must alternate between the blade and pick in order to provide self-propulsion down the ice. The material of the sticks can vary, but the stick cannot exceed 1 m in length, and the blade cannot exceed 25 cm (35 cm for goalies) .
For players unable to propel themselves, a push bar can be added to the sled. During play, a pusher can propel the sled for the player. Rules are in place to limit the pusher’s speed and impact on the game.
Medical Management of the Ice Sled Hockey Athlete
The medical management of the ice sled hockey athlete can be quite complex. It is imperative that the staff providing medical coverage be aware of the possible conditions and injuries associated with the sport. This includes identification and treatment of common illnesses, illnesses exclusive to the disabled athlete, and musculoskeletal and neurological injuries unique to the sport and equipment of ice sled hockey.
In any team setting or sporting event, one has to consider the possibility of common illness or infection affecting the athlete. Although not specific to ice sled hockey, the surveillance study conducted during the London 2012 Paralympic Games investigated the incidence and clinical characteristics of illness in athletes. In this surveillance study, infection was found to account for 40.8% of all illnesses in these athletes , highlighting the need for the medical team to thoroughly investigate early signs of infection in this population.
The most common type of infection present during the London 2012 Paralympic Games involved the upper respiratory tract. This type of infection tended to affect those athletes with intellectual impairment, visual impairment, cerebral palsy, and those falling into the Les Autres category. The majority of these infections (70%) were reported on the same day as the appearance of symptoms , allowing for prompt diagnosis and treatment.
Those with the greatest number of ailments at the London 2012 Paralympic Games were athletes with spinal cord injuries. In particular, these athletes tended to have issues involving the urinary tract as well as the skin and subcutaneous tissue. Notably, the majority of urinary tract infections were reported 1–2 days after clinical symptoms appeared; there was also an increase in the number of skin and subcutaneous infectious reported after the initial day of symptoms . Medical staff should recognize that athletes may be presenting with infections that have been manifesting for several days and to be mindful about rapid treatment. Additionally, athletes should be encouraged to report symptoms at the first sign of infection, as to avoid complications or spread infection to other athletes.