Background Appropriate helmet fit is thought to contribute to the protective effect of helmets in reducing the risk of concussion in sports. Only one previous study has evaluated helmet fit in youth ice hockey; however, inter-rater reliability was not assessed.

Objective To evaluate helmet fit in youth ice hockey players and assess inter-rater reliability of helmet fit criteria.

Design Self-report and observational evaluations.

Setting 2016 Hockey Calgary Summer Day Camps.

Participants Canadian youth (11–18 years) ice hockey players.

Methods Helmet fit criteria were developed from previously published ice hockey, skiing, snowboarding and motorcycle helmet fit criteria. A total of 60 players underwent self-report and observational helmet fit evaluations by two independent assessors. Inter-rater reliability was assessed using descriptive statistics and Cohen's kappa coefficient.

Results Most players rated helmet fit (90%) and comfort (87%) as ‘excellent’ or ‘good’. Most helmets (93%) and cages (84%) displayed the Canadian Standards Association (CSA) sticker or stamp. Only 23% of players satisfied all helmet fit criteria for both assessors; however, 70% of players failed three or fewer criteria across the evaluations of both assessors. The most commonly failed helmet fit criterion was ‘crown of helmet is 1–2 fingers above eyebrows’, which was failed by 22% of players. For inter-rater reliability, the most commonly disputed helmet fit criterion was ‘helmet does not cover eyes when pressing down’, which was disagreed upon by the assessors for 33% of players; however, all other criteria were agreed upon for over 80% of players. Substantial agreement (K>0.8) was found for 19% of helmet fit criteria, whereas 50% of criteria had little agreement beyond chance (K<0.2).

Conclusions The majority of youth ice hockey players did not satisfy all helmet fit criteria for both assessors. The association between helmet fit and concussion needs to be investigated.