All patients treated for a first-time anterior glenohumeral dislocation in Olmsted County, Minnesota, from 1970 through 1979 were identified. Of these 124 patients, 116 were available for study at a mean followup of 4.63 years (range 2 to 11). Of the 116 patients, 38 (33%) had recurrence of dislocation: 21 of the 32 (66%) patients less than 20 years old, 17 of the 43 (40%) patients 20 through 40 years old, and none of the 41 patients older than 40 years. Symptomatic instability remained a problem in 24 patients. Twenty-seven of 33 (82%) young athletes had recurrence of dislocation as compared with only 8 of 27 (30%) nonathletes of similar ages. Patients restricted from resuming sports participation for 6 weeks or more had significantly better results than those restricted for less than 6 weeks. The recurrence rate of dislocation is not as high as previously reported. However, the rate in athletes is much higher than that in nonathletes. Many patients continue to complain of symptomatic instability without actual redislocation. In our younger patients, we now advise immobilization for from 3 to 6 weeks, followed by extensive rehabilitation before return to athletic activity.

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Ice hockey is a fast-paced game involving both finesse and controlled aggression. Injuries are related to direct trauma (80%) and overuse (20%), with high puck velocities, aggressive stick use, and body checking (collisions) accounting for most of these. A participant can anticipate an injury after playing 7 to 100 hours of hockey, depending on his age, and most injuries are caused during the actual game rather than during practice. Although facial injuries are common, they are decreasing because of adequate use of helmets and masks. Conversely, cervical spine injuries are being reported more frequently. Injuries to the upper extremity include acromioclavicular joint dislocations, scaphoid fractures, and 'gamekeeper's thumb.' Injuries to the lower extremity predominantly involve soft tissue, with strains of the hip adductor, tears of the medial collateral ligament of the knee, and contusions of the thigh are common. Scientific studies have reduced injury by providing improved protective equipment, stricter rules and their enforcement, and effective training and conditioning.

Groin pain in athletes may be due to muscle strains, referral of pain from internal organs, and/or hernia. This study includes ten elite level hockey players unable to continue their careers due to groin pain. These patients did not present with the typical causes described above, including hernia. They were explored surgically and were found to have tears in the floor of the inguinal ring which were repaired either directly or with a synthetic mesh reinforcement (seven cases). All the patients have subsequently returned to hockey. Because these patients presented with symptoms similar to hernia, but did not have a hernia at the time of surgical exploration, they were considered to have a condition previously described as "sportsman's hernia".

Ice hockey is a team sport that has recently grown in popularity not only in the United States but also in Canada and Europe. With this increase in popularity has come a growing concern about the number and severity of injuries. The world literature on the biomechanics and physiology of ice hockey was reviewed in an attempt to evaluate the forces and mechanisms involved in the game. The influence of rule and equipment changes on injury patterns was particularly studied. Several studies on the epidemiology of injuries, providing data on the types of injuries and the mechanisms of those injuries, were analyzed to determine the conclusions that could be supported and those that require further study. Possible changes in the patterns and types of injury are outlined.