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Musculoskeletal and Sports Medicine

Utilizing Dynamic Pressure Mapping in a Team USA Para Ice Hockey Athlete to Alleviate Pressure Ulcers: A Case Report

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Case Report Theater

    Poster Presenter(s)

  • ES

    Eli Schmidt, MD,MS

    Resident
    University of Minnesota PM&R Program
    Bloomington, Minnesota

    • Co-Author(s)

  • Kersten Schwanz, MD

    Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Inver Grove Heights, Minnesota

  • MR

    Michael Rice, MD

    Resident, Department of Emergency Medicine
    Medical College of Wisconsin Affiliated Hospitals
    Wauwatosa, Wisconsin

  • DR

    David Rotter, Other

    President, CPO
    David Rotter Prosthetics, LTD
    Joliet, Illinois

  • Mike j. Uihlein, MD

    Assistant Professor, Department of Emergency Medicine, Medical College of Wisconsin
    Medical College of Wisconsin
    Grafton, Wisconsin

Disclosure(s):
Eli Schmidt, MD,MS: No financial relationships to disclose
Case Diagnosis: Spina bifida with left ischial tuberosity pressure ulcer

Case Description or Program Description: 22-year-old male Team USA para ice hockey athlete with a history of spina bifida status post 2 stage flap repair of a non-healing full thickness pressure injury of the left ischial tuberosity was evaluated with static and dynamic pressure mapping to address the risk of recurrent pressure injury with return to sport. First, the athlete was fitted for a new bucket after his prosthetist had made adjustments to offload the ischial tuberosity. Then static and dynamic pressure mapping was obtained with the athlete sitting in the bucket and during common skating maneuvers.

Setting: International level para ice hockey.

Assessment/Results: Maximum, minimum and average seated pressures were obtained using a wireless pressure mat while sitting, free skating, and during a hockey stop. Video showing the skating maneuvers correlating in real-time with the dynamic changes in pressure was also obtained.

Surprisingly for all maneuvers, the area of greatest pressure was over the right greater trochanter where the pressures peaked at 260 mmHg. Average pressure at this area while static, during free skate and during a hockey stop was 60 mmHg, 75 mmHG and 80 mmHg, respectively.

Discussion (relevance): An unanticipated area of high pressure was found over the right greater trochanter while no areas of high pressure were found at the ischial tuberosities. These findings were brought to the prosthetics team and the area of concern was identified with real-time pressure mapping and then addressed with padding.

To the author’s knowledge, no study has investigated dynamic pressure mapping in para ice hockey. Further, only 2 studies measured static pressures in this population, and neither found significant pressures over the greater trochanter.

Conclusions: Dynamic pressure mapping allowed for real-time evaluation and intervention of a para ice hockey athlete who has now returned to play with no further skin breakdown noted.