Objective To determine if the risk of game-related concussion differs for Pee Wee (11–12 years) ice hockey players in the season following a national policy change disallowing body checking (2013/2014) when compared to a season (2011/2012) when body checking was allowed.

Design Historical cohort study.

Setting Community ice hockey rinks.

Participants Pee Wee players were recruited from 59 teams in all divisions of play in Alberta (n=883) in 2011/12 prior to the rule change and from 73 teams in 2013/14 following the rule change (n=617).

Assessment of risk factors Pee Wee ice hockey players before and after a national body checking policy change.

Outcome measures Suspected concussions were identified by a team therapist/safety designate and referred to a sport medicine physician. Concussions were included if they met the Zurich 2013 Consensus definition of concussion.

Main results There were 104 game-related concussions (IR=2.79/1000 game-hours) in Alberta prior to the rule change and 24 concussions (IR=1.08/1000 game-hours) after. Based on a multivariable Poisson regression model adjusting for player size, age, body checking attitudes, previous injury, level of play, and position, accounting for clustering by team, the rate of concussion declined following the policy change [IRR=0.34 (95% CI; 0.21 – 0.56)]. Overall, a physician diagnosed 67.3% and 79.1% of suspected game concussions in 2011/2012 and 2013/2014, respectively.

Conclusions Introduction of the national policy change disallowing body checking in Pee Wee resulted in a 66% reduction in the Alberta Pee Wee ice hockey concussion rate. These findings have important implications for youth ice hockey policy.

Competing interests None.