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.