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Face Mask Makes Difference on the Ice

Protection works for amateur hockey players, study finds

MONDAY, Feb. 11, 2002 (HealthDayNews) -- Each year, hockey players go blind because of nasty collisions with pucks, sticks and elbows.

New research now suggests their best defense is a face mask, which protects the eyes and doesn't cause the neck injuries and concussions some experts had feared.

Of the 282 amateur hockey players studied, not one who wore a full or partial face mask suffered an eye injury.

"The most important thing to realize is that if you don't wear a face mask, you have a seven times greater risk of facial injuries and a nearly five times greater risk of injuring your eye," says Dr. Michael Stuart, the study's co-author and co-director of the Mayo Clinic Sports Medicine Center.

Stuart and his colleagues studied face masks to settle a long-standing debate over their worth. Many hockey players choose to wear no face mask or only a partial face mask.

"Some people feel that players who are better protected are more reckless and take more risks," Stuart says. "They may use their head as a weapon, or engage in other possible dangerous activities."

In addition, some people have worried that full face masks could make the neck and head more vulnerable to injury.

On the other hand, cuts to the face are the most common injuries in amateur hockey, Stuart says. Many are caused during "high-sticking," in which players raise their sticks against each other in violation of the rules.

"There's a lot of contact," Stuart says. "Even without violating the existing rules, you can injure your head and face."

From 1997 to 1998, researchers studied players from the U.S. Hockey League, an amateur organization made up of college-age men. The league has 13 teams in the Midwest, from Minnesota to Oklahoma, and it is hockey's equivalent of college basketball or football.

Players who wore no facial protection suffered 159 injuries per 1,000 hours played. That number dropped to 73.5 for players wearing partial protection and 23.2 for those with full protection.

No players with full or partial facial protection suffered neck injuries, and those with no protection actually had more concussions, although researchers didn't consider the difference significant.

The findings appear in the January/February 2002 issue of the American Journal of Sports Medicine.

Although the study was not the only factor in its decision, the U.S. Hockey League recently decreed that all players will wear full face masks unless they are over 18 and sign a waiver, Stuart says.

Not everyone is a fan of facial protection. Many players in the National Hockey League (NHL) continue to avoid face masks, even though there have been cases of blindness because of injuries on the ice, Stuart says.

The NHL actually bans the use of full face masks, he says. They are forbidden unless a player gets a medical excuse.

"I would assume it's because (the NHL) does not wish to give players an unfair advantage by allowing them to wear more protection than others," he says.

However, he adds, the use of partial masks has grown among NHL players.

The U.S. Hockey League has made a wise decision, says Dr. Paul Stricker, a pediatrician who specializes in sports medicine at Scripps Clinic in San Diego.

Similar studies are sometimes ignored or never done "because of pressure from those who think adding more protective gear might change the way the game is played," he notes.

What To Do

Learn about the differences in risk between full and partial face masks in this primer from the University of Minnesota.

Learn about the history of face-mask regulations from the Canadian Safety Council.

SOURCES: Interviews with Michael Stuart, M.D., co-director, Mayo Clinic Sports Medicine Center, Rochester, Minn.; Paul Stricker, M.D., pediatrician, Scripps Clinic, San Diego; January/February 2002 American Journal of Sports Medicine
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