Background A Canadian study reports the highest concussion rates in ringette and ice hockey, compared to other female team sports. Although high-intensity physical contacts (PC) are prohibited in both sports, player-to-player PCs accounted for 58–64% of injuries.
Objective To compare incidence rates (IR) of in-game PCs, head contacts (HC), and suspected injuries in female varsity ice hockey and ringette.
Setting Canadian ice hockey arenas.
Participants Female university ringette and ice hockey tournament/playoff games in the 2018–2019/2019–2020 seasons.
Assessment of Risk Factors Game video-recordings were analyzed using Dartfish video-analysis software. Validated criteria were used to assess PC intensity (level 1–5), PC type (e.g., trunk contact, push), HC type (i.e., HC1=direct player-to-player, HC2=indirect environmental), and suspected injury (i.e., concussion, musculoskeletal).
Main Outcome Measurements Univariate Poisson regression analyses (adjusted for cluster by team, offset by game-minutes) was used to estimate PC and HC IRs and incidence rate ratios (IRRs, 95% confidence intervals) comparing sports.
Results Analyses of 36 team-games (n=18 ringette, n=18 ice hockey) revealed that ringette had a 19% lower rate of PCs (IR=310.38 contacts/100 team-minutes, 95%CI;285.40–337.54) than ice hockey (IR=382.48 contacts/100 team-minutes, 95%CI;356.80–410.00) (IRR=0.81, 95%CI;0.73–0.90). Ringette had a 68% higher rate (IRR=1.68, 95%CI:1.22–2.31) of total HCs (IR=17.92 contacts/100 team-minutes, 95%CI;14.71–21.83) compared to ice hockey (IR=10.67 contacts/100 team-minutes, 95%CI;8.28–13.75). Ringette had a 3-fold higher rate (IRR=3.11, 95%CI;1.13–8.60) of suspected injury (IR=1.46 HCs/100 team-minutes, 95%CI;0.72–2.93) compared to ice hockey (IR=0.47 HCs/100 team-minutes, 95%CI;0.22–1.00).
Conclusions This study demonstrated a lower rate of PCs in ringette than female ice hockey. However, ringette had a significantly higher rate of HCs and suspected injuries than ice hockey. These findings can inform future research targeting prevention strategies in both sports.