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No association found between body checking experience and injury or concussion rates in adolescent ice hockey players
  1. Paul Eliason1,2,3,4,
  2. Brent E Hagel1,2,3,5,6,
  3. Luz Palacios-Derflingher1,5,7,
  4. Jean-Michel Galarneau1,
  5. Vineetha Warriyar K V1,
  6. Stephan Bonfield1,
  7. Amanda Marie Black1,2,3,4,
  8. Shelina Babul8,
  9. Martin Mrazik9,
  10. Constance Lebrun10,
  11. Carolyn Emery1,2,3,4,5,6
  1. 1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Albert, Canada
  2. 2Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
  3. 3O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
  4. 4Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
  5. 5Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  6. 6Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  7. 7Australian Health Services Research Institute (AHSRI), Faculty of Business and Law, University of Wollongong, Wollongong, NSW, Australia
  8. 8British Columbia Injury Research and Prevention Unit, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  9. 9Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
  10. 10Family Medicine, Faculty of Medicine and Dentistry and Glen Sather Sport Medicine Clinic, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Paul Eliason, Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; pheliaso{at}ucalgary.ca

Abstract

Objectives To compare rates of injury and concussion among U-15 (ages 13–14 years) ice hockey players playing in leagues allowing body checking, but who have a varying number of years of body checking experience.

Methods This 5-year longitudinal cohort included U-15 ice hockey players playing in leagues where policy allowed body checking. Years of body checking experience were classified based on national/local body checking policy. All ice hockey game-related injuries were identified using a validated injury surveillance methodology. Players with a suspected concussion were referred to a study sport medicine physician. Multiple multilevel Poisson regression analysis was performed, adjusting for important covariates and a random effect at a team level (offset by game exposure hours), to estimate injury and concussion incidence rate ratios (IRRs).

Results In total, 1647 players participated, contributing 1842 player-seasons (195 players participating in two seasons). Relative to no body checking experience, no significant differences were found in the adjusted IRRs for game-related injury for players with 1 year (IRR=0.94; 95% CI: 0.69 to 1.28) or 2+ years (IRR=0.89; 95% CI: 0.56 to 1.40) body checking experience. No differences were found in the rates of concussion for players with 1 year (IRR=0.79; 95% CI: 0.51 to 1.22) but was significantly lower for players with 2+ years (IRR=0.51; 95% CI: 0.28 to 0.94) compared with no body checking experience.

Conclusions Among ice hockey players aged 13–14 years participating in leagues permitting body checking, the adjusted rates of all injury were not significantly different between those that had body checking experience and those that did not. While the rates of concussion were significantly lower among those with 2+ years of body checking experience, the number of concussions potentially prevented in U-15 does not offset the number of concussions prevented through policy disallowing body checking at U-13.

  • athletic injuries
  • brain concussion
  • child health
  • hockey
  • sporting injuries

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

https://doi.org/10.1136/bjsports-2021-104691

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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    Footnotes

    • Twitter @aacademic, @cattonline, @CarolynAEmery

    • Correction notice This article has been corrected since it published. An author has been added and amendments to the results section and tables have been corrected in the online version online and not in print.

    • Contributors PE, BEH, LP-D, AMB and CE contributed to the study proposal development. PE, BEH, LP-D, VWKV, AMB and CE contributed to the data collection, entry and data cleaning. PE, BEH, LP-D, VWKV, SB and CE contributed to the data analysis and interpretation of study results. SB, MM and CL contributed to all aspects of data collection at study sites outside of Calgary. CE and BEH contributed to acquisition of funding, study design and led all aspects of the cohort. All authors critically reviewed and edited the manuscript before submission. CE is the study gurantor.

    • Funding The funding for this study was provided by Alberta Innovates Health Solutions (Collaborative Research and Innovation Opportunities Programme Grant # 3685), the Canadian Institutes of Health Research (Institute of Neuroscience, Mental Health and Addictions Grant #293332) and the Hotchkiss Brain Institute (University of Calgary).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Hockey Canada, BC Hockey, Hockey Calgary, and Hockey Edmonton were involved as knowledge brokers in contributing to approval of study design, study recruitment, injury surveillance methods, support of safety designate role and dissemination of research findings within the hockey community. The research questions and outcome measures were developed and informed by the priorities, experience, and preferences of Hockey Canada, BC Hockey, Hockey Calgary and Hockey Edmonton. Hockey players, parents, coaches and administrators in Hockey Canada, BC Hockey, Hockey Calgary, Airdrie Minor Hockey, and Hockey Edmonton were dedicated to the collection of weekly exposure data, identification of a player with a suspected concussion, and supporting communication with the research team for injury follow-up. A knowledge broker from Hockey Canada and Hockey Calgary informed the methods and time commitment for study participation by players and parents and safety designates.

    • Provenance and peer review Not commissioned; externally peer reviewed.