Objective Canada’s national winter sport of ice hockey has high youth participation, however, research surrounding the female game is limited and the injury burden remains high. This study aimed to compare the incidence of head contact (HC), high-intensity player-to-player contact known as body checking (BC; prohibited in the female game), and suspected concussion between male and female youth ice hockey.

Design Cross-sectional.

Setting Game video-recordings captured in Calgary, Canada.

Participants Ten male and ten female elite U15AA (13–14-year-old) game video-recordings collected in the 2020–21 and 2021–22 seasons, respectively.

Assessment of Risk Factors An analysis of physical contact and injury mechanisms using video-analysis.

Outcome Measures Videos were analyzed frame-by-frame in Dartfish video-analysis software and all player contacts were tagged including HCs [direct (HC1), indirect (HC2)], BCs (level 4–5 trunk contact on a 1–5 scale), and suspected concussion based on validated criteria. Univariate Poisson regression clustering by team-game offset by game-length was used to estimate incidence rates (IR) and incidence rate ratios (IRR, 95% confidence intervals).

Main Results There were no significant differences in the rates of direct HC (IRMale=8.88/100team-minutes; IRFemale=9.30/100team-minutes; IRR=1.04, 0.77–1.42) or suspected concussion (IRMale=0.59/100team-minutes; IRFemale=0.25/100team-minutes; IRR=0.42, 0.12–1.42) between cohorts. A 13% lower rate of total physical contacts was found in the female game (IRR=0.87, 0.79–0.96) with 70% lower rates of BC (IRR=0.30, 0.23–0.39). Although prohibited in the female game, only 5.4% of HC1s and 18.6% of BC resulted in a penalty.

Conclusions Rates of direct HCs and suspected concussion were similar in male and female youth ice hockey. BC rates were lower in the female game, yet still prevalent despite being prohibited.