Ice hockey neck cuts, the rare injury with a five-minute clock
Key takeaways · 9 min read
- Skate cuts are rare: in US college games they caused 0.11 time-loss injuries per 1,000 athlete-exposures, against 7.36 for player contact.
- A cut carotid artery can lead to critical blood loss within about five minutes, so the first minutes on the ice decide the outcome.
- Cases cluster around falls, tangles near the net and boards, and players low on the ice; at NHL level wrists and legs are cut more often than necks.
- In a 2015 lab test 13 of 14 neck guard models held at moderate force, but almost all failed at 600 newtons. The NHL now requires cut level A5.
On 7 December 2024 Cole Cusitar, the 35-year-old captain of the Churchbridge Imperials in Saskatchewan’s Sask East Hockey League, fell to the ice after a faceoff. Another player’s skate blade opened a gash under his jaw, about half an inch from his jugular vein. He was not wearing a neck guard. He needed surgery and 80 stitches, and was out of hospital within days. His team then decided that every player would wear one.
Doctors fear these cuts because of the clock. The common carotid artery carries about 395 millilitres of blood a minute, and a 2024 review for the American Orthopaedic Society for Sports Medicine notes that losing more than 40% of the body’s blood, with failing vital signs, can follow within five minutes of a cut to it. Among patients who reach hospital with penetrating injuries to the neck arteries, from any cause, a study it cites found 26% died.
This article covers what a skate blade does to a neck, who gets cut and in what situations, what laboratory tests of neck guards, wrist guards and socks actually show, why nobody has yet shown that mandates save lives, and why the answer is a guard worn properly and a rehearsed emergency plan rather than giving up the game.
What a skate blade does to a neck
Skate cuts are among the rarest ways to get hurt in hockey. Over ten seasons of US college injury surveillance, contact with a skate caused 22 of the men’s injuries that kept a player out for at least a day, about 1% of those with a recorded cause. In games the rate was 0.11 per 1,000 athlete-exposures, against 7.36 for contact with another player. High school boys recorded three skate injuries in six seasons.
Where college hockey injuries come from
Time-loss injuries per 1,000 athlete-exposures in NCAA men’s ice hockey games, 2004–05 to 2013–14, by mechanism. An exposure is one player taking part in one game.
Source: Lynall et al., Journal of Athletic Training 53(12):1129 (2018), NCAA Injury Surveillance Program. Injuries counted only if they restricted play for 24 hours or more.
The neck is where rarity stops being reassuring. The middle of the neck holds the carotid arteries, the jugular veins and the airway close under the skin. A 1996 report described three amateur players cut there by skates; two died, one from blood flooding the airway and one from bleeding from the main neck vessels. None of the three was wearing a neck protector.
Most neck cuts are far less serious. When Mayo Clinic researchers surveyed 26,342 USA Hockey members and interviewed 33 players who reported one, 61% of the wounds had needed only a bandage. The same survey found that 27% of those cut had been wearing neck protection at the time. Its headline prevalence figure, and the catastrophic registry counts, are in our earlier article on hockey injuries and body checking.
How bad a neck cut gets
Selected figures on severity. The hospital figures cover penetrating injuries to the neck arteries from any cause, not only sport.
Sources: Stuart et al., Clinical Journal of Sport Medicine (2009); DiBartolomeo et al., as cited by Murray and Chambers, AOSSM Sports Medicine Update (Winter 2024).
Where the risk concentrates
No registry records the situations in which necks are cut, so the pattern comes from cases. On 22 March 1989 the Buffalo goaltender Clint Malarchuk was in his crease when St Louis forward Steve Tuttle was flipped upside down in front of him; Tuttle’s skate cut Malarchuk’s jugular vein, and he needed 300 stitches. In February 2008 Richard Zednik’s carotid artery was nearly severed by the skate of a Florida teammate, Olli Jokinen. Both survived after emergency vascular repair.
The common thread is a body on or near the ice with a blade rising beside it. Cusitar had fallen after a faceoff. In 2009 an Ontario junior official, Kevin Brown, was cut under his chinstrap while separating two fighting players who fell to the ice. Goaltenders work in the crowded crease, and the NHL’s new neck-guard rule names them alongside skaters. These are anecdotes, not rates, but they point to falls, tangles near the net and boards, and anyone low on the ice.
Skate cuts in part of one NHL season
Skate lacerations reported in the 2019–20 NHL season in the 14 weeks before the COVID-19 suspension, by body part. Six in total.
Source: Murray and Chambers, AOSSM Sports Medicine Update (Winter 2024), citing a New York Times report.
At the elite level the wrists and legs are cut more often than the neck. The wrist sits exposed between glove cuff and elbow pad, and a blade can reach the tendons there. Just above the skate, a boot-top cut can damage tendons, nerves and vessels through a small skin wound, and a 2016 review warned that players who fold the skate tongue down expose more of the lower leg. It suggested cut-resistant socks.
What has been measured to work
The most quoted test came from a Mayo Clinic team in 2015. Researchers mounted 46 samples of 14 neck guard models on a neck surrogate, with foam underneath to show any cut through, and drew a sharpened skate blade across them at five metres a second. Under loads up to 300 newtons, every model but one held. At 600 newtons, every guard failed except one model and one of three samples of another. Guards made with Spectra fibre did best.
Two further findings matter in practice. A blade striking at 45 degrees cut more easily than one at 90, because the contact area is smaller. And visible damage on a guard did not reliably show how much protection was left. Canada certifies neck guards to the BNQ 9415-370 standard, first published in 1996 and reaffirmed in 2026, which tests protection against skate blades within a defined zone; an international version, ISO 10256-5, reached draft stage in 2025.
The 2015 skate-blade laboratory test
Neck guards tested on a laceration machine with a neck surrogate, blade speed 5 m/s. Load is the force pressing the blade on the guard.
Source: Loyd et al., Clinical Journal of Sport Medicine 25(3):254 (2015). The 600 N condition was designed as a more severe simulation.
The NHL chose a different yardstick. From the 2026–27 season, players without NHL games must wear a neck guard rated at least A5 on the ANSI/ISEA cut scale, in games and warm-ups, and may not roll, tape or cut it. The scale comes from a machine that pulls a straight blade across fabric under rising weight; A5 means at least 2,200 grams to cut through. Europe uses the same machine under ISO 13997.
What a cut level means
ANSI/ISEA 105 cut levels: grams of load on the test blade needed to cut through the material on a tomodynamometer (ASTM F2992). The NHL minimum for new players is A5.
Sources: Ansell, Understanding ANSI/ISEA 105 (2016); NHL Rule 9.8 as reported by The Hockey News, 15 September 2026. A glove-test rating is not a measure of a falling player’s skate.
None of this proves guards save lives. Lab loads are not the measured force of a player landing on a blade, and 27% of cut players in the US survey were already wearing protection. Neck guards are tested only for cuts: in a 2025 puck test, one of three guards cut the impact force by 39%, the others by 4% to 6%. Every guard tested on 46 teenage players reduced neck movement. The only public comparison of cut-resistant hockey socks we found was a 2025 high-school project with six samples.
Why the answer is not to stop playing
A cut that can turn critical in minutes is decided by what happens on the ice. The AOSSM review sets out the first steps: for a carotid wound, block the cut with a single finger rather than squeezing the whole artery, which risks a stroke; pack a jugular wound to slow the bleeding; use a tourniquet on a limb; keep the pressure on in the ambulance. In every case the next step is an immediate transfer to hospital by the emergency services.
The NHL’s emergency plan requires three doctors at every game, two ambulances and defibrillators in each arena. Community hockey cannot match that, so a written plan is the substitute: who calls the ambulance, who opens the gate, who meets the crew at the door, and where the first-aid kit is. At a hearing in April 2026, the coroner said paramedics who treated Adam Johnson had to climb over barriers because no one could guide them onto the ice.
Wearing the guard properly matters as much as owning one: rolled down, taped back or loose, it leaves bare the strip it was made to cover. A full mask, a cut-resistant wrist sleeve and a sock under a raised skate tongue close the other gaps. The rules have moved faster than the evidence. England, USA Hockey and now the NHL require guards, and in May 2026 NCAA committees proposed neck, wrist and ankle protection for 2027–28. Leagues should count cuts before and after.
Questions people ask
Do neck guards stop skate cuts?
In laboratory tests most guards resist a skate blade at moderate force, and some fail at high force. In a US survey, 27% of players who had been cut were wearing one. No study has yet measured how many deaths guards prevent.
What does cut level A5 mean?
It is a rating on the ANSI/ISEA scale: the material needs at least 2,200 grams of load on a test blade to cut through. The NHL requires it for new players’ neck guards from 2026–27.
What should you do if a player’s neck is cut on the ice?
Call the emergency services at once and press on the wound. A sports-medicine review advises blocking a carotid wound with one finger, packing a jugular wound and keeping pressure on until hospital. A rink emergency plan should say who guides paramedics onto the ice.
Are goalies at higher risk?
There are no rates by position. Goalies work in the crowded crease, and one of the best-known cases, Clint Malarchuk in 1989, happened there. The NHL’s new rule covers goaltenders as well as skaters.
Should children wear cut-resistant socks and wrist guards?
They are cheap, and NCAA rules committees have proposed wrist and ankle protection for college players. The published testing is thin, so choose products with a stated cut rating and keep the skate tongue up so the sock is covered.
The short version
- Skate cuts are rare: in US college games they caused 0.11 time-loss injuries per 1,000 athlete-exposures, against 7.36 for player contact.
- A cut carotid artery can lead to critical blood loss within about five minutes, so the first minutes on the ice decide the outcome.
- Cases cluster around falls, tangles near the net and boards, and players low on the ice; at NHL level wrists and legs are cut more often than necks.
- In a 2015 lab test 13 of 14 neck guard models held at moderate force, but almost all failed at 600 newtons. The NHL now requires cut level A5.
- No study yet shows mandates prevent deaths. Wear the guard properly, cover wrists and boot tops, and rehearse a rink emergency plan.
This is a summary of published research, not medical advice. For a cut that will not stop bleeding, call the emergency services immediately and keep firm pressure on the wound. For questions about protective equipment or recovery from an injury, talk to a doctor, physiotherapist or athletic trainer.
Further reading: Murray and Chambers, AOSSM Sports Medicine Update (Winter 2024), for on-ice management of skate lacerations. Loyd et al., Clinical Journal of Sport Medicine (2015), for the skate-blade test of neck guards. Morrissette et al., American Journal of Sports Medicine (2026), for a review of neck guard mandates.
- The Emergency, Thomas Fisher (2022). A Chicago emergency physician’s year on the front line, a reminder of how much depends on the minutes before hospital.
- The Data Detective, Tim Harford (2021). Ten rules for reading statistics, useful when a frightening case and a tiny injury rate point different ways.
- The Art of Uncertainty, David Spiegelhalter (2024). A Cambridge statistician on rare risks and acting before the evidence is complete, as hockey did with neck guards.
Sources
- Lynall RC, Mihalik JP, Pierpoint LA, et al. The first decade of web-based sports injury surveillance: descriptive epidemiology of injuries in US high school boys’ ice hockey (2008–2009 through 2013–2014) and NCAA men’s and women’s ice hockey (2004–2005 through 2013–2014). Journal of Athletic Training 53(12):1129 (2018).
- Murray JC, Chambers CC. The cutting edge: a deeper look at skate blade lacerations in hockey. AOSSM Sports Medicine Update, Winter 2024.
- Stuart MJ, Link AA, Smith AM, et al. Skate blade neck lacerations: a survey and case follow-up. Clinical Journal of Sport Medicine (2009), doi:10.1097/JSM.0b013e3181c0aaa4.
- Vergis A, Räsänen T, Hernefalk L. Neck injuries from skate blades in ice hockey: a report of three cases. Scandinavian Journal of Medicine & Science in Sports (1996), doi:10.1111/j.1600-0838.1996.tb00106.x.
- Malarchuk can relate to Zednik’s injury. The Spokesman-Review (Associated Press), 13 February 2008.
- Medicine Hat News, report on Cole Cusitar’s skate injury, 9 December 2024; Sask. hockey player recovering after near fatal skate accident during game. CTV News Regina, December 2024.
- Report: Jr. C official in critical condition after being cut by skate. The Hockey News, 30 December 2009.
- Popkin CA, Schulz B, Park CN, et al. Evaluation, management and prevention of lower extremity youth ice hockey injuries. Open Access Journal of Sports Medicine 7 (2016).
- Loyd AM, Berglund LJ, Twardowski CP, et al. The most cut-resistant neck guard for preventing lacerations to the neck. Clinical Journal of Sport Medicine 25(3):254–259 (2015), doi:10.1097/JSM.0000000000000121.
- Standards Council of Canada. CAN/BNQ 9415-370/2013 (R 2026), Neck protectors for hockey players; BNQ notice of intent, Protective equipment for use in ice hockey – Part 5: Neck laceration protectors (ISO 10256-5).
- DIN EN ISO 10256-5:2025-09 (draft), Protective equipment for use in ice hockey – Part 5: Neck laceration protectors, doi:10.31030/3639175.
- Ansell. Understanding ANSI/ISEA 105. White paper (2016).
- Which Sharks prospects aren’t affected by the new neckguard regulations. The Hockey News, 15 September 2026.
- Brewer C, Quenneville CE. Development of a novel test surrogate for evaluating material protection against hockey puck impacts to the neck and clavicle. (2025), doi:10.1177/17543371251379539.
- Krause DA, Stuart MJ, Erickson LN, et al. Influence of neck laceration protectors on cervical range of motion. Clinical Journal of Sport Medicine (2017), doi:10.1097/JSM.0000000000000320.
- Lugaila D, Grundish N. A systematic study of cut-resistant socks for hockey players. Journal of Emerging Investigators (2025), doi:10.59720/24-357.
- Sprecher MH. New NCAA ice hockey throat protection rule could hit events as soon as fall. Sports Destination Management, 22 May 2026.
- Morrissette CR, Borchers C, Margarucci K, et al. Neck lacerations in ice hockey: a current concepts review from on-ice treatment to prevention. American Journal of Sports Medicine (2026), doi:10.1177/03635465251380851.
- “Chaotic scene” at Sheffield Steelers game in which player Adam Johnson received fatal neck cut – inquest. The Star (Sheffield), 28 April 2026.
