The Minnesota Department of Health guidance for resuming youth sports requires masking, even during strenuous exercise. Guidance about masking from MDH emphasizes there is no evidence wearing a mask is harmful in regards to oxygen consumption and exercise performance. The effect of wearing masks while playing hockey on the risk of falls and collision is not mentioned or referenced by MDH, despite the serious consequences of concussion and spinal cord injury in the event of a collision. The American Academy of Pediatrics COVID-19 Interim Guidance: Return to Sports mentions concerns about masks contributing to falls and injury in cheer sports and gymnastics “because the covering may get caught on objects and become a choking hazard or accidently impair vision.”
Visual information from the lower visual field is needed to avoid obstacles and prevent falls. Clear vision is necessary to maintain balance. Recent case reports from the ophthalmology literature have found inferior visual field defects due to slightly ill-fitting medical masks worn by patients undergoing visual field testing for glaucoma. It is highly likely and alarming that a hockey player wearing a helmet and skating at high speed will experience face mask movement and subsequent visual impairment caused by lower field defect or accidental coverage of the eyes. Hot breath mixing with cold rink air causes condensation to form on the eyelashes and brow resulting in obscured vision from watery eyes and/or fogging of lenses or face shield.
MDH has approved two masks that attach to the lower half of the helmet cage. Masks that touch the bridge of the nose and attach to the helmet likely reduce peripheral vision at ground level. Full-face firefighter masks with a similar design were found to reduce inferior peripheral vision by 28 degrees.
Playing hockey carries the risk of concussion and spinal cord injury, which can be mitigated by heads-up positioning. Wearing a face covering or a mask attached to the helmet reduces the visual clues and clarity needed to prevent falls and collisions. I respectfully request that Gov. Walz rescind the unsafe hockey face mask mandate immediately.
Maria K. Poirier, M.D., is a hockey mom, safety advocate and physician. She lives in Rochester.