Youth hockey: checking associated with higher injury risk

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© Paul A. Souders/CORBIS

Recent increases in the number of youth hockey players suffering concussions after collisions on the ice prompted a team of Canadian researchers to investigate how body-checking rules in Pee Wee hockey leagues factors into injury incidence. In a study of more than 2,000 youth hockey players from Alberta and Quebec — roughly half of whom played in a league that prohibits body checking — researchers found that those who played under rules allowing checking faced a three-fold risk for injury, including serious injuries such as severe concussion.

The American Academy of Pediatrics has long advocated no-checking policies for hockey leagues with players ages 15 and younger, yet, within ice hockey communities the appropriate age to introduce body checking is an ongoing source of debate. For example, a 2005 study of more than 2,000 youth hockey players followed for two seasons found that body checks accounted for only 12% of injuries, while unintentional collisions and illegal checking contributed to more than half of all on-ice injuries. Barry Willer, author of the 2005 study, said at the time that delaying the introduction of body checks could actually increase the risk of injury: “Bringing body checking into the game at an age when players are big, strong, fast skaters fueled by testosterone could be disastrous from an injury standpoint.”

In a 2009 review of 20 studies examining injuries in youth hockey leagues, NYU researchers found that body checking was consistently associated with a higher risk of injuries such as fractures and concussions, and that the severity of these injuries was most concentrated among 13-year-old players.

This latest analysis, published in the June 9 issue of the Journal of the American Medical Association, found that injury rates were significantly higher among 11- and 12-year-olds who played in ice hockey leagues in which body checking was allowed. The researchers say that an important next step is to analyze injury incidence in the next age group (13- and 14-year-olds) in both leagues that allow and prohibit checking, to determine how two years’ experience with body checking influences injury rates.