Citation

Blake T, Hagel BE, Emery CA. Clin. J. Sport. Med. 2012; 22(4): 377-378.

Affiliation

Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.

Copyright

(Copyright © 2012, Canadian Academy of Sport Medicine, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/JSM.0b013e31826038e0

PMID

22732345

Abstract

OBJECTIVE: : To determine whether boys' ice hockey programs have higher injury rates from intentional body contact or from unintentional contact and whether allowing body checking increases the rate of injuries. DESIGN: : Cohort study over 5 seasons. Many of the participants played for more than one season. SETTING: : Youth ice hockey programs during the years 2002-2007 in Ontario, Canada. PARTICIPANTS: : The study included between 2594 and 2730 boys aged 4-18 years in each season, for a total of 13 292 player-years. ASSESSMENT OF RISK FACTORS: : Player time was estimated from the trainers' reports of the number of games and practices during the season for each team, with the assumption that all players attended practices and participated in one-third of each game. Risk factors included team age group (5 groups), level of play (house league, select, and representative [rep]), games versus practices, and whether checking was permitted. House league teams were not permitted to body check, but checking was allowed in select teams from 11 years (peewee), and rep teams from 9 years. MAIN OUTCOME MEASURES: : The main outcome measures were rates of injury in relation to unintentional contact, intentional contact, and body checking and across age group, level of play and games and practices. Injuries were reported by the team trainers using the Hockey Canada injury report form, which included a physician's statement of the diagnosis and information on the cause of injury. Intentional contact (body checks) included contact with an opposing player in games, with a team member during practices, and illegal contacts, such as cross-checking or slashing. Unintentional contacts were collisions between same-team players during games, collisions with the boards, falling on the ice, or being hit by the puck. Time missed because of injury was recorded. Injury data were checked by phone calls to 22 families and found to be reliable. An injury required missing ≥1 day of activity. MAIN RESULTS: : The total number of injuries for the 5 seasons was 247 (range per season, 40-60). Overall, unintentional collision injuries accounted for 66% (95% confidence interval [CI] 60%-72%) of injuries (house/select leagues, 69.3% and rep leagues, 60.8% of unintentional contact injuries). Greater numbers of serious injuries (concussions, contusions, sprains/strains, fractures, and dislocations) occurred in unintentional collisions than in intentional collisions (P for each category, <0.05). Rate ratios (RR) for injuries in intentional collisions in the select league and the rep league compared with the house league were 2.33 (95% CI, 0.49-11.04) and 2.65 (95% CI, 0.53-13.35), respectively, and for unintentional collisions RR, 0.64 (95% CI, 0.20-2.00) and 1.50 (95% CI, 0.51-4.45), respectively (P for each comparison, >0.20). Including all levels of play, in comparisons with peewee (age 11-12 years), younger boys (7-10 years) had a lower rate of injuries from all causes (P ≤ 0.011) and older boys (13-18 years) tended to have a higher rate of injuries from intentional causes (P ≤ 0.058) but not unintentional causes. The rates of injuries in games increased with age and league level (top rate per 1000 hours of play, bantam rep, 10.64), but rates of injuries in practices were low and relatively stable (range, 0.00-0.82/1000 hours of play). In divisions that allowed body checking versus those that did not, RR for injuries from intentional contact was 3.95 (95% CI, 0.80-19.50), from unintentional contact, 3.27 (95% CI, 1.07-10.00), and including all injuries, 3.75 (95% CI, 1.51-9.34). CONCLUSIONS: : More injuries and more serious injuries in boys' ice hockey occurred from unintentional collisions than from intentional contact. In divisions where body checking was allowed, almost 4 times as many injuries occurred from both intentional and unintentional contacts.

Language: en