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Does disallowing body checking in non-elite 13- to 14-year-old ice hockey leagues reduce rates of injury and concussion? A cohort study in two Canadian provinces
  1. Carolyn Emery1,2,
  2. Luz Palacios-Derflingher1,2,
  3. Amanda Marie Black1,
  4. Paul Eliason1,
  5. Maciek Krolikowski1,
  6. Nicole Spencer1,
  7. Stacy Kozak1,
  8. Kathryn J Schneider1,
  9. Shelina Babul3,
  10. Martin Mrazik4,
  11. Constance M Lebrun5,
  12. Claude Goulet6,
  13. Alison Macpherson7,
  14. Brent E Hagel8
  1. 1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  2. 2Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3Faculty of Medicine, University of British Columbia, Vancouver, Alberta, Canada
  4. 4Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, Alberta, Canada
  5. 5Depatment of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
  6. 6Department of Physical Education, Laval University, Quebec, Quebec, Canada
  7. 7Faculty of Health, York University, Toronto, Ontario, Canada
  8. 8Department of Paediatrics, Cumming Scjhool of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Carolyn Emery, Kinesiology, University of Calgary, Calgary, Alberta T2N1N4, Canada; caemery{at}


Objective To compare rates of injury and concussion among non-elite (lowest 60% by division of play) Bantam (ages 13–14 years) ice hockey leagues that disallow body checking to non-elite Bantam leagues that allow body checking.

Methods In this 2-year cohort study, Bantam non-elite ice hockey players were recruited from leagues where policy allowed body checking in games (Calgary/Edmonton 2014–2015, Edmonton 2015–2016) and where policy disallowed body checking (Kelowna/Vancouver 2014–2015, Calgary 2015–2016). All ice hockey game-related injuries resulting in medical attention, inability to complete a session and/or time loss from hockey were identified using valid injury surveillance methodology. Any player suspected of having concussion was referred to a study physician for diagnosis and management.

Results 49 body checking (608 players) and 33 non-body checking teams (396 players) participated. There were 129 injuries (incidence rate (IR)=7.98/1000 hours) and 54 concussions (IR=3.34/1000 hours) in the body checking teams in games. After policy change, there were 31 injuries (IR=3.66/1000 hours) and 17 concussions (IR=2.01/1000 hours) in games. Policy disallowing body checking was associated with a lower rate of all injury (adjusted incidence rate ratio (IRR)=0.44; 95% CI: 0.27 to 0.74). The point estimate showed a lower rate of concussion (adjusted IRR=0.6; 95% CI: 0.31 to 1.18), but this was not statistically significant.

Conclusion Policy change disallowing body checking in non-elite Bantam ice hockey resulted in a 56% lower rate of injury. There is growing evidence that disallowing body checking in youth ice hockey is associated with fewer injuries.

  • injury
  • injury prevention
  • concussion
  • adolescent
  • ice hockey

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  • Contributors CAE, LPD, AMB, PE, KJS, SB, MM, CL, CG, AM and BEH contributed to the study proposal development. CAE, AMB, MK, NS and SK contributed to data collection, entry, and data cleaning. CAE, LPD, AMB, PE and BEH contributed to the data analysis and interpretation of study results. SB, MM and CB contributed to all aspects of data collection at study sites outside of Calgary. CAE 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.

  • Funding This study was funded by Alberta Innovates Health Solutions (Collaborative Research and Innovation Opportunities Program 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 consent for publication Not required.

  • Ethics approval Ethics approval was received from the research ethics boards at the University of Calgary (Ethics ID: REB14-0348 and REB14-2209), University of Alberta (Ethics ID: REB Pro00024093) and the University of British Columbia (Ethics ID: CW14-0304/H14-01894).

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.