Field hockey

Is field hockey safe?

Yes. Field hockey is one of the safest team sports for staying alive. The US National Center for Catastrophic Sport Injury Research (NCCSIR) has tracked school and college sport since 1982 and has not recorded a single traumatic death in field hockey. Three high-school girls died of exertional or medical causes in that time, a rate of 0.12 per 100,000 players a season.

What players do get is hurt by the ball and the stick. A hard ball struck or deflected at head height, a raised stick and a fall on an artificial pitch cause most of the serious injuries: broken fingers and hands, facial cuts, broken noses and concussions.

How we estimated the death risk

For US high-school girls, 0.12 deaths per 100,000 players a season is about 1.2 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary a season. A season of about 60 practices and games gives about 0.02 micromorts per session, comfortably among the lowest-risk sports we score.

The US data are almost all girls and women, because field hockey in American schools is mostly a girls' sport. Men play in large numbers in Europe, Asia and Oceania, and nobody has published a death rate for them. In other running team sports the main cause of death in young men is sudden cardiac death, which runs far higher in men than in women. On data from football, that points to about 0.1 to 0.2 micromorts a session for young men. We scored fatality risk between the two.

Where the injuries come from

The Netherlands, where field hockey is a mass sport, gives the best picture of serious injuries. In 2018, about 5,700 people went to an emergency department with a hockey injury. That is 0.11 visits per 1,000 hours played, against 0.074 for all sports combined, so hockey sends players to hospital about 50% more often than the average sport.

Of those emergency visits:

• 37% were caused by the ball and 18% by a stick;
• 39% were fractures and 27% bruises or grazes;
• broken hands and fingers were the single most common injury, at 21%;
• 28% counted as serious injuries, and men aged 35 to 54 had the highest rate of serious injury per hour played.

US surveillance shows the everyday picture. High-school girls lost time to injury at 1.73 per 1,000 practices and games and college women at 3.25. Muscle strains and bruises led, and games were about twice as risky as practice.

Head, face and eye injuries

In US college women's field hockey between 2004 and 2009, head, face and eye injuries ran at 0.94 per 1,000 practices and games. A raised ball caused 48% of them and a raised stick 22%. Concussions made up 43%, and 1 in 10 of these injuries ended the player's season.

Eye injuries are rare but can blind. That is why several US states made eyewear mandatory for high-school players. A study comparing states with and without a mandate found 0.47 head and face injuries per 1,000 exposures with eyewear against 0.69 without, and eye injuries five times more often without it, although that difference was not statistically certain with so few cases. There was no rise in concussions, which answers the worry that protected players play more recklessly.

The men's game is faster and harder. At the 2009 Men's Junior World Cup, a doctor on site recorded head and face injuries at 16 per 1,000 match hours, almost all from contact.

How to play more safely

1. Wear eye protection and a mouthguard. Goggles designed for field hockey cut head and face injuries; a mouthguard protects teeth from the ball and stick.
2. Wear a face mask when defending penalty corners. This is when a hard-struck ball is most likely to come at head height.
3. Protect your hands. Padded gloves, at least on the left hand, help against the most common fracture.
4. Do a structured warm-up. The Dutch federation and VeiligheidNL built an injury-prevention warm-up for hockey (Warming-Up Hockey, Start sterk!) around movement and stick skills.
5. Keep the ball and stick low. Umpires should enforce the rules on dangerous raised balls and high sticks, especially in youth and veterans' hockey.
6. Have a defibrillator at the club and players who know CPR.

How we scored it

Fatality risk (95) is very low, with the main uncertainty being unmeasured risk in men. Serious injury risk (60) is the weakest factor because fractures and head injuries from the ball and stick send players to hospital more often than in most sports. Controllability (70) is good: eyewear, masks and rules work. Rescue (88) is close at hand. Field hockey sits above basketball and ice hockey on our scale.