Br J Sports Med doi:10.1136/bjsm.2009.063693
  • Original article

Intentional versus unintentional contact as a mechanism of injury in youth ice hockey

  1. Barry Willer1
  1. 1University at Buffalo, Buffalo, New York, USA
  2. 2University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Scott Darling, Department of Orthopaedics, University at Buffalo, 160 Farber Hall, 3435 Main Street, Buffalo, NY 14214, USA; sdarling{at}
  • Accepted 19 January 2010
  • Published Online First 19 May 2010


Background Youth ice hockey injury rates and mechanisms have been described by various classification systems. Intentional versus unintentional contact was used to classify mechanisms of injuries. All injuries (n=247) in one youth hockey programme over a 5-year period were recorded and included in the analysis.

Purpose To evaluate youth ice hockey injuries and compare programmes that allow body checking versus programmes that do not allow body checking. A primary goal was to determine whether programmes that allow body checking have increased injury rates from intentional body contact. Another goal was to describe the rates of injury across ages, levels of competitive play and during games versus practices.

Methods Rates of injury were compared for three levels of competition (house, select and representative) for approximately 3000 boys aged 4–18 years over a 5-year period. This represents 13 292 player years. Data were collected prospectively in this cohort study. All injuries were reported prospectively by a designated team official and verified by a physician. The log injury rate (per 1000 player hours) was modelled via Poisson regression with log player hours used as an offset. Rate ratio was used to explain the covariate-adjusted injury rate for each of three groups (all injuries, intentional injuries, unintentional injuries).

Results Unintentional contacts accounted for 66.0% of overall injuries (95% CI 60.0 to 72.0), compared with 34.0% from intentional contacts (p<0.001;Z=5.25). Serious injuries (fractures, dislocations, concussions) resulted more often from unintentional collisions (p=0.04). Players in more competitive leagues that allow body checking had a greater incidence of total injuries than less competitive leagues.

Conclusions Most injuries in the youth hockey programme studied were the result of unintentional contact, and were generally more severe. These findings were not expected given previously published research.


  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the State University of New York at Buffalo.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

    Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

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