Dr. Michael Clarfield - physician for the Toronto Maple Leafs
For over 2 decades, Dr. Clarfield has helped athletes recover from sports injuries both at the professional level and at the minor levels. Hockey, more specifically, has been a major focus in his life and Dr. Clarfield still enjoys playing the game. He coaches his son’s hockey team in Toronto and it is at the arena that The Hockey Source met Dr. Clarfield for a chat, one Saturday morning at 7:00 AM.
THS: Where is the first place someone should go to get checked after an injury?
DMC: There are a couple things.
- For severe injuries you may need x-rays and possibly surgery so you definitely want to visit a hospital. Depending on the severity of the injury, you might even go to an emergency room.
- Where you live might determine where you go. If you’re in a rural city you may only be able to attend your family doctor’s office or local clinic.
THS: What is the most common injury for hockey?
DMC: I have noticed that concussions and groin injuries are the most common. The primary reason is that the younger aged players and officials seem to ignore proper training on the core of the body - the mid-section.
THS: What is the most important thing in assessing an injury?
DMC: In the case of players, parents need to know their child. They need to understand and be attentive to when their child is physically hurt, requiring medical treatment and when they are emotionally hurt and require to be understood.
THS: How does one avoid injuries?
DMC: By the age of 13 or 14, players especially should start focusing their training to improving their mid-core strength. Stomach and lower back connect the upper and lower body.
THS: Why is it such a big deal for players to tell their coaches of an injury?
DMC: There is a fear of not getting ice time. There is a fear of being considered not tough. For players at the older ages of 12 and up, there is a fine line between playing hurt and playing with an injury. Playing hurt could be with a bruise and only time will heal. There will be no movement or general strength affected. Playing with an injury runs the risk of doing more damage. A good example is a concussion. There is a bruise to the brain and it needs to heal. If a player comes back too soon, there is more than just tissue damage.
THS: Are bruises something to worry about?
DMC: Most bruises are only the blood coming to the surface of the skin. Deep bruising is always a concern. An example would be a quad contusion, where there is bruising deep in the quadracept muscle of the thigh.
THS: How does a coach know when an injury is physical or emotional?
DMC: Obvious physical injuries leave marks like cuts, or abrasions. A good rule of thumb is when a player goes down, a coach should be concerned.
THS: How does one judge the severity of an injury?
DMC: When a players says he can’t skate, that is a good sign that there is something not right. It is always better to err on the side of caution.
THS: What is the most important thing to do when there is an injury in hockey?
DMC: Anybody involved should have an emergency action plan. They need to have a step by step set of tasks that need to be done when there is an injury. In answer to your question, remaining calm is the key. This way you can think clearly and take action on what you have in your plan.
THS: How important is time?
DMC: It is key and again depending on the type of injury – if it is a neck injury for example, it is imperative to assess quickly.
THS: How important is getting an injury looked at afterwards?
DMC: Don’t be afraid to get an injury looked at by a qualified physician. You will find out how bad the injury is and know how to get it healed. It might simply be rest.
THS: Can a player or official come back too soon?
DMC: Yes. They should have a doctor clearance before they return to the ice. They should be following steps of progression like doing off-ice, then practice and lastly game situations.
THS: Who should decide when a player can come back?
DMC: A doctor. Follow the plan of progressions I said.
THS: What is the best way to overcome an injury?
DMC: Rest. The length is dependant of the severity.
THS: Cold or heat? Which one should be used on an injury and why?
DMC: Cold. Basic acronym to use is PRICE - Protect the injury, Rest, Ice the area, Compress the area, Elevate to limit the blood flow to the injured area. By applying ice, you constrict the blood flow to that part of the body.
THS: What do you suggest to a player who wants to play but is not 100%?
DMC: Talk to a qualified physician. Don’t hide the symptoms and allow him or her to do a thorough assessment.
THS: How does one get involved in sports medecine?
DMC: You need to know what you want to get into. There are so many roles, such as therapist, doctors of course and exercise trainers.
THS: What do you recommend for someone who wants to get into this but does not have the college or university background?
DMC: This is a complex field, so start taking courses, increase your educational knowledge. For starters, take first aid courses and slowly look into more in-depth training.
THS: What are your overall thoughts on injuries and recovery for players and officials?
DMC: For coaches, trainers and managers, make sure you have an emergency action plan. Know where you are going to go once an injury happens. Make sure you get good advice and if you are giving the assessment, then give good advice.
THS: Dr Clarfield, thank you for your time today. We appreciate your support with The Hockey Source.
DMC: You’re welcome. Great job on the website.
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