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A systematic video analysis of National Hockey League (NHL) concussions, part II: how concussions occur in the NHL
  1. Michael G Hutchison1,2,
  2. Paul Comper1,3,
  3. Willem H Meeuwisse4,
  4. Ruben J Echemendia5,6
  1. 1David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Ontario, Canada
  2. 2Injury Prevention Research Office, Keenan Research Centre, St. Michael's Hospital, Toronto, Ontario, Canada
  3. 3Graduate Department of Rehabilitation Science, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4Faculty of Kinesiology, Hotchkiss Brain Institute, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada
  5. 5Psychological and Neurobehavioral Associates, Inc., State College, Pennsylvania, USA
  6. 6University of Missouri—Kansas City, Kansas City, Missouri, USA
  1. Correspondence to Dr Michael Hutchison, David L. MacIntosh Sport Medicine Clinic, Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, Canada M5S 2W6; michael.hutchison{at}


Background Concussions in sports are a growing cause of concern, as these injuries can have debilitating short-term effects and little is known about the potential long-term consequences. This work aims to describe how concussions occur in the National Hockey League.

Methods Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006–2010 seasons. Digital video records were coded and analysed using a standardised protocol.

Results 88% (n=174/197) of concussions involved player-to-opponent contact. 16 diagnosed concussions were a result of fighting. Of the 158 concussions that involved player-to-opponent body contact, the most common mechanisms were direct contact to the head initiated by the shoulder 42% of the time (n=66/158), by the elbow 15% (n=24/158) and by gloves in 5% of cases (n=8/158). When the results of anatomical location are combined with initial contact, almost half of these events (n=74/158) were classified as direct contact to the lateral aspect of the head.

Conclusions The predominant mechanism of concussion was consistently characterised by player-to-opponent contact, typically directed to the head by the shoulder, elbow or gloves. Also, several important characteristics were apparent: (1) contact was often to the lateral aspect of the head; (2) the player who suffered a concussion was often not in possession of the puck and (3) no penalty was called on the play.

  • Concussion
  • Contact sports
  • Head injuries
  • Injury Prevention
  • Ice hockey

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