Q: I took a slapshot to the inside of my right foot during a game just over four weeks ago. I went to the emergency department that night for X-rays and was told there were no broken bones. After almost a month, I can finally walk normally. However, it still hurts to get my foot in my skate, making it almost impossible to play. How long is my foot going to hurt? Is there anything I can do to protect my foot from getting injured by another shot?
– John W., Minnetonka, Minn.
A: John, foot and ankle injuries are taking players off the ice in record numbers and injury reports in junior, collegiate, and professional hockey leagues support this. Certainly, hockey skates getting hit by slapshots is not a new phenomenon. First, I would like to discuss why we are seeing an increase in foot and ankle injuries because of this.
Today’s hockey skates are lighter than ever with the goal of improving performance and maximizing speed on the ice. Different from the heavy leather skates of years past, today’s skates are made of a much lighter composite material and manufacturers use less material to build the skate, particularly in the front (tongue area) and sidewalls. Skaters may glide across the ice much faster without the extra weight, but this comes at a cost. The foot and ankle are not as well protected, making this area of the body vulnerable, particularly from a high velocity puck.
Taking a slapshot directly to the skate can certainly hurt—A LOT. Most commonly, blocking a shot with your skate results in a bone bruise that can take many weeks to heal. It is not uncommon for initial X-rays to appear negative for a fracture. However, in cases of persistent pain, especially if the injured player is unable to bear weight on the affected foot/ankle, it becomes necessary to evaluate with more advanced imaging techniques, such as an MRI or CT scan. These imaging tests can identify small fractures that are easily missed on X-rays. Generally speaking, it is important for a player to obtain evaluation by an orthopedic surgeon, ideally a foot and ankle specialist, when initial X-rays are negative but pain persists in daily life outside of hockey for more than 2-3 weeks.
Once a fracture has been ruled out, there are a few things I recommend for managing pain when putting a bruised foot back in a skate. It is helpful to be taking a daily anti-inflammatory medication, such as ibuprofen or naproxen, and making sure it is taken at least two hours before hitting the ice. There is also a role for topical gels which can be applied directly to the spot on the foot where it hurts prior to sliding on the skate. I recommend either Voltaren or BioFreeze gel, both of which can be purchased over the counter.
A player should also avoid putting the injured foot into a very cold skate. For example, skates taken straight out of a car that has been parked outside on a January day in Minnesota. Warming the skate before putting it on will make the experience much less painful.
One last tip that may help is the use of an ankle sleeve, such as the Bunga Boot Bumper™, which provides additional cushioning for the injured foot.
To decrease the risk of repeat injury by the force of another slapshot, I would consider looking into an external skate protector. There are a couple of commercially available products that can be purchased and placed on the exterior of the skate to provide impact protection. They are lightweight and will minimize any damage to the foot that may occur if a player is struck by another high-velocity puck.