Risk of Injury Associated With Body Checking Among Youth Ice Hockey Players | Adolescent Medicine | JAMA | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.175.212.130. Please contact the publisher to request reinstatement.
1.
 Hockey Canada Annual Report 2008. Hockey Canada Web site. http://www.hockeycanada.ca/index.php/ci_id/55192/la_id/1.htm. Accessed February 18, 2010
2.
 Hockey Annual Report USA 2007/2008. USA Hockey Web site. http://www.usahockey.com/uploadedFiles/USAHockey/Menu_About_USA_Hockey/USAH%20Annual%20Report%200708_WEB.pdf. Accessed February 18, 2010
3.
Emery CA, Meeuwisse WH, McAllister JR. Survey of sport participation and sport injury in Calgary and area high schools.  Clin J Sport Med. 2006;16(1):20-2616377971PubMedGoogle ScholarCrossref
4.
Emery CA, Tyreman H. Sport participation, sport injury, risk factors and sport safety practices in Calgary and area junior high schools.  Paediatr Child Health (Oxford). 2009;14(7):439-444Google Scholar
5.
Benson B, Meeuwisse W. The risk of concussion associated with mouthguard use among professional ice hockey players [abstract].  Clin J Sport Med. 2005;15(5):395Google ScholarCrossref
6.
Brust JD, Leonard BJ, Pheley A, Roberts WO. Children's ice hockey injuries.  Am J Dis Child. 1992;146(6):741-7471595632PubMedGoogle Scholar
7.
Emery CA, Meeuwisse WH. Injury rates, risk factors, and mechanisms of injury in minor hockey.  Am J Sports Med. 2006;34(12):1960-196916861577PubMedGoogle ScholarCrossref
8.
Roy M, Bernard D, Roy B, Marcotte G. Body checking in Peewee Hockey.  Phys Sportsmed. 1989;17(3):119-126Google Scholar
9.
Marchie A, Cusimano MD. Bodychecking and concussions in ice hockey: should our youth pay the price?  CMAJ. 2003;169(2):124-12812874161PubMedGoogle Scholar
10.
Roberts WO, Brust JD, Leonard B. Youth ice hockey tournament injuries: rates and patterns compared to season play.  Med Sci Sports Exerc. 1999;31(1):46-519927009PubMedGoogle ScholarCrossref
11.
 2007-09 Official Rules of Ice Hockey. USA Hockey Web site. http://www.usahockey.com/uploadedfiles/usahockey/menu_officials/menu_rulesequipment/rulebook%200709.pdf. 2007. Accessed January 19, 2010
12.
 Background on checking. Hockey Canada Web site. http://www.hockeycanada.ca. Accessed February 18, 2010
13.
Hayes RJ, Bennett S. Simple sample size calculations for cluster-randomized trials.  Int J Epidemiol. 1999;28(2):319-32610342698PubMedGoogle ScholarCrossref
14.
Meeuwisse WH, Love EJ. Development, implementation, and validation of the Canadian Intercollegiate Sport Injury Registry.  Clin J Sport Med. 1998;8(3):164-1779762475PubMedGoogle ScholarCrossref
15.
McCrory P, Johnston K, Meeuwisse W,  et al.  Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.  Br J Sports Med. 2005;39(4):196-20415793085PubMedGoogle Scholar
16.
Emery CA, McKay CD, Campbell TS, Peters AN. Examining attitudes towards body-checking, levels of emotional empathy, and levels of aggression in body-checking and non-body checking youth hockey leagues.  Clin J Sport Med. 2009;19(3):207-21519423973PubMedGoogle ScholarCrossref
17.
Fuller CW, Ekstrand J, Junge A,  et al.  Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries.  Clin J Sport Med. 2006;16(2):97-10616603877PubMedGoogle ScholarCrossref
18.
McCrory P, Meeuwisse W, Johnston K,  et al.  Consensus statement on concussion in sport: the 3rd International Conference on Concussion in Sport held in Zurich, November 2008.  Br J Sports Med. 2009;43:(suppl 1)  i76-i9019433429PubMedGoogle ScholarCrossref
19.
Broglio SP, Puetz TW. The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: a meta-analysis.  Sports Med. 2008;38(1):53-6718081367PubMedGoogle ScholarCrossref
20.
Iverson G. Predicting slow recovery from sport-related concussion: the new simple-complex distinction.  Clin J Sport Med. 2007;17(1):31-3717304003PubMedGoogle Scholar
21.
Lau B, Lovell M, Collins M, Pardini J. Neurocognitive and symptom predictors of recovery in high school athletes.  Clin J Sport Med. 2009;19(3):216-22119423974PubMedGoogle ScholarCrossref
22.
Makdissi M. Is the simple versus complex classification of concussion a valid and useful differentiation?  Br J Sports Med. 2009;43:(suppl 1)  i23-i2719433420PubMedGoogle ScholarCrossref
23.
Warsh JM, Constantin SA, Howard A, Macpherson A. A systematic review of the association between body checking and injury in youth ice hockey.  Clin J Sport Med. 2009;19(2):134-14419451769PubMedGoogle ScholarCrossref
24.
Emery CA, Hagel B, Decloe MD, McKay C. Risk factors for injury and severe injury in youth ice hockey: a systematic review of the literature.  Inj Prev. 2010;16(2):113-11820363818PubMedGoogle ScholarCrossref
25.
 Stata Statistical Software [computer program].  Version 10.0. College Station, TX: StataCorp; 2005
26.
Willer B, Kroetsch B, Darling S, Hutson A, Leddy J. Injury rates in house league, select, and representative youth ice hockey.  Med Sci Sports Exerc. 2005;37(10):1658-166316260964PubMedGoogle ScholarCrossref
27.
Emery CA. Risk factors for injury in child and adolescent sport: a systematic review of the literature.  Clin J Sport Med. 2003;13(4):256-26812855930PubMedGoogle ScholarCrossref
28.
Wiggins W. Implication of Introducing Body-Checking in Ice Hockey at Different Ages [master's thesis]. Thunder Bay, ON, Canada: Lakehead University; 1999
29.
Brunelle JP, Goulet C, Arguin H. Promoting respect for the rules and injury prevention in ice hockey: evaluation of the fair-play program.  J Sci Med Sport. 2005;8(3):294-30416248470PubMedGoogle ScholarCrossref
Original Contribution
June 9, 2010

Risk of Injury Associated With Body Checking Among Youth Ice Hockey Players

Author Affiliations

Author Affiliations: Sport Medicine Centre, Roger Jackson Centre for Health and Wellness Research, Faculty of Kinesiology (Drs Emery, Kang, Benson, and Meeuwisse, Ms McAllister, and Mr Hamilton), Alberta Children's Hospital, Department of Pediatrics, Faculty of Medicine (Drs Emery, Hagel, and Nettel-Aguirre), and Department of Community Health Sciences, Faculty of Medicine (Drs Emery, Hagel, Nettel-Aguirre, and Meeuwisse), University of Calgary, Calgary, Alberta, Canada; Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada (Dr Shrier); and Department of Physical Education, Faculty of Education, Laval University, Quebec City, Quebec (Dr Goulet).

JAMA. 2010;303(22):2265-2272. doi:10.1001/jama.2010.755
Abstract

Context Ice hockey has one of the highest sport participation and injury rates in youth in Canada. Body checking is the predominant mechanism of injury in leagues in which it is permitted.

Objective To determine if risk of injury and concussion differ for Pee Wee (ages 11-12 years) ice hockey players in a league in which body checking is permitted (Alberta, Canada) vs a league in which body checking is not permitted (Quebec, Canada).

Design, Setting, and Participants Prospective cohort study conducted in Alberta and Quebec during the 2007-2008 Pee Wee ice hockey season. Participants (N = 2154) were players from teams in the top 60% of divisions of play.

Main Outcome Measures Incidence rate ratios adjusted for cluster based on Poisson regression for game- and practice-related injury and concussion.

Results Seventy-four Pee Wee teams from Alberta (n = 1108 players) and 76 Pee Wee teams from Quebec (n = 1046 players) completed the study. In total, there were 241 injuries (78 concussions) reported in Alberta (85 077 exposure-hours) and 91 injuries (23 concussions) reported in Quebec (82 099 exposure-hours). For game-related injuries, the Alberta vs Quebec incidence rate ratio was 3.26 (95% confidence interval [CI], 2.31-4.60 [n = 209 and n = 70 for Alberta and Quebec, respectively]) for all injuries, 3.88 (95% CI, 1.91-7.89 [n = 73 and n = 20]) for concussion, 3.30 (95% CI, 1.77-6.17 [n = 51 and n = 16]) for severe injury (time loss, >7 days), and 3.61 (95% CI, 1.16-11.23 [n=14 and n=4]) for severe concussion (time loss, >10 days). The estimated absolute risk reduction (injuries per 1000 player-hours) that would be achieved if body checking were not permitted in Alberta was 2.84 (95% CI, 2.18-3.49) for all game-related injuries, 0.72 (95% CI, 0.40-1.04) for severe injuries, 1.08 (95% CI, 0.70-1.46) for concussion, and 0.20 (95% CI, 0.04-0.37) for severe concussion. There was no difference between provinces for practice-related injuries.

Conclusion Among 11- to 12-year-old ice hockey players, playing in a league in which body checking is permitted compared with playing in a league in which body checking is not permitted was associated with a 3-fold increased risk of all game-related injuries and the categories of concussion, severe injury, and severe concussion.

×