Objective To determine if there is an association between the risk of all injury or concussion and win–loss records or penalty minutes in competitive youth ice hockey players (ages 11–14).

Design, setting, participants This is a secondary data analysis of a 2-year cohort study in Alberta and Quebec on the 2007/2008 (Pee Wee) and 2008/2009 (Bantam) seasons.

Main outcome measures Incidence rate ratios (IRRs) were estimated based on Poisson regression for game-related injury and concussion and adjusted for cluster by team.

Results A total of 140 teams from Alberta (n=2081) and 137 teams (n=2018) from Quebec were included in the analysis. There were 451 game-related injuries (121 concussions) from Alberta and 280 (62 concussions) from Quebec. For game-related injuries, the IRR between players from teams with more than 50% wins and players with less or equal to 50% wins was 0.78 (95% CI 0.64–0.95) for all injuries, 0.75 (95% CI 0.52–1.08) for concussions, 0.64 (95% CI 0.47–0.88) for injuries resulting in time loss of more than 7 days, and 0.74 (95% CI 0.39–1.40) for concussions resulting in time loss of more than 10 days; adjusting for clustering by team and other important risk factors (ie, province, age, level of play, previous injury, weight and position). There was no association found between the total penalty minutes per game and game-related injury or concussion.

Conclusions There was a significant association found between team performance (ie, win/loss/tie record) and injury risk with a 22% lower injury rate and 36% lower injury rate resulting in less than 7 days time loss in Pee Wee and Bantam ice hockey teams winning more than 50% of all season games. Total penalty minutes per game were not associated with injury or concussion rates.