Sport Injury Prevention Research Centre

Hockey

Our group has conducted various research projects which examined injury risk in hockey.
See below for highlights of the nine studies conducted (7 male, 2 female).
Study 1 (M)      Study 2 (F)      Study 3 (M)      Study 4 (M)       Study 5 (F)
Study 6 (M)      Study 7 (M)      Study 8 (M)      Study 9 (M)

1. (2010) The risk of injury associated with body checking in young ice hockey players?

WHO?
      Peewee hockey players (11-12 yr olds) in Alberta and Quebec.
WHEN?
     2007-2008 hockey season.
WHY?
     To compare the risk of injury and concussion in a body-checking league (Alberta) to a non-body checking league.
FINDINGS:
     There was a significantly increased risk of injury and concussion in the body checking league (Alberta) compared with the non-body checking league (Quebec).

Emery CA Kang J, Shrier I, Goulet C, Hagel B, Benson B, Nettel-Aguirre A, McAllister J, Hamilton GM, Meeuwisse WH. "Risk of injury associated with body checking among youth ice hockey players“. JAMA. 2010; 303(22): 2265-2272.

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2. (2009) Injury rates, risk factors and mechanisms of injury in female youth ice hockey

WHO?
     Young female hockey players (9-17) in the Girls Hockey Calgary Association (GHCA).
WHEN?
     2008-09 season.
WHY?
     To examine the incidence of injury, the type/severity of injury and mechanisms of injury.
FINDINGS:
     • The overall injury rate was 1.9 injuries / 1000 player hours.
     • Previous injury, session type (games) and menstrual history (in PeeWee only) were risk factors for injury.

Decloe M, Emery CA, Hagel B, Meeeuwisse WH. “Injury rates, risk factors and mechanisms of injury in female youth ice hockey“ (ABSTRACT). Clin J Sport Med 2009; 19 (3); 247

No abstract summary available
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3. (2009) Attitudes toward body checking; does it influence injury?

WHO?
      Male hockey players from Pee Wee (ages 11-12), Bantam (ages 13-14) and Midget (ages 15-16) teams in the Minor Hockey Association of Calgary were recruited.
WHEN?
     2007-2008 hockey season.
WHY?
     To examine the attitudes toward body-checking, levels of emotional empathy and levels of aggression in body-checking and non-body-checking youth hockey leagues.
FINDINGS:
     Attitudes toward body checking, and levels of empathy and aggression did not influence injury risk.

Emery CA, McKay CD, Campbell TS, Peters AN. Examining attitudes toward body checking, levels of emotional empathy, and levels of aggression in body checking and non-body checking youth hockey leagues. Clin J Sport Med 2009;19(3):207-15

In this prospective cohort study, 283 participants from Pee Wee (ages 11-12), Bantam (ages 13-14) and Midget (ages 15-16) teams were randomly recruited, by team, from the Minor Hockey Association of Calgary. There were 13 teams from the body checking league (138 participants) and 24 teams from the non-body checking league (145 participants). Participants completed four self report questionnaires: (1) Medical Questionnaire; (2) Body-Checking Questionnaire; (3) Empathy Index for Children and Adolescents; and (4) Buss-Perry Aggression Questionnaire. The players were then followed through the season for injury reports. The injury definition included any hockey injury resulting in medical attention, the inability to complete a hockey session, and/or missing a subsequent hockey session. Body-checking players reported more positive attitudes toward body-checking (35.59, 95% CI: 34.52-36.65) than non-body-checking players (22.43, 95% CI: 21.38-23.49) (t = -17.34; p<0.00005). There was no significant difference between the empathy scores between cohorts (t=1.51, p=0.13). The mean aggression score for the body-checking players (76.22, 95% CI: 73.18–79.25) was significantly higher than the mean for the non-body-checking players (70.57, 95% CI: 67.35 – 73.80) (t = - 2.52; p = 0.013). Attitudes toward body checking, and levels of empathy and aggression did not influence injury risk.
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4. (2006) Injury Rates and Risk Factors in Minor Hockey

WHO?
     Male minor hockey players (aged 9-17 years) from 71 teams in the Minor Hockey Association of Calgary.
WHEN?
     2004-2005 hockey season.
WHY?
     To examine injury rates, risk factors, and mechanisms of injury in minor hockey.
FINDINGS:
     • The most common types were concussions and shoulder sprain/dislocations.
     • The most common mechanism of injury was body checking.
     • The risk of injury appeared to increase with increasing age and skill level.

Emery CA, Meeuwisse WH. Injury rates, risk factors, and mechanisms of injury in minor hockey. Am J Sports Med 2006;34(12):1960-9.

In a descriptive epidemiological study of 986 minor hockey players (aged 9-17 years) in Calgary, the risk factors for hockey injury were examined. Seventy-one teams participated, and injury report data was collected by certified athletic therapists or candidates. Over the course of the 2004-2005 season, 216 players sustained 296 injuries. The overall injury rate was 30.02 injuries/100 players/season (95% CI: 27.17-32.99), or 4.13 injuries/1000 players hours (95% CI: 3.67-4.62). The most commonly reported injuries were concussion, shoulder sprain/dislocation, and knee sprain. The mechanism of injury in 45% of cases was body checking. Compared to the youngest age group (Atom, ages 9-10), the risk of injury was greater in Pee Wee (11-12 years) (relative risk = 2.97, 95% CI: 1.63-5.8), Bantam (13-14 years) (relative risk = 3.72, 95% CI: 2.08-7.14), and Midget (15-16) (relative risk = 5.43, 95% CI: 3.14-10.17) leagues. The risk of injury also appeared to increase with increasing skill level in the Pee Wee and Bantam age groups.
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5. (2003) Varsity level female hockey injury profile

WHO?
     Female varsity players from the Canada West University Athletic Association.
WHEN?
     1998-1999 hockey season.
WHY?
     To compare injury rates, risk factors, and mechanisms of injury between gender in varsity hockey.
FINDINGS:
     • Females had similar injury rates to males.
     • Concussions and ankle sprains were the most common types of injury in females.
     • Most injuries were due to a contact related mechanism.

Schick DM, Meeuwisse WH. Injury rates and profiles in female ice hockey players. Am J Sports Med 2003;31(1):47-52.

No abstract summary available
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6. (2002) Impact of face shield use on concussions in hockey

WHO?
     Varsity male hockey players from the Canada Inter-University Athletic Union.
WHEN?
     1997-1998 hockey season.
WHY?
     To compare the risk of concussion with players wearing full face shields compared with half face shields (visors).
FINDINGS:
     A full face shield compared with half face shield reduced the severity of concussion (playing time lost).

Benson B, Rose M, Meeuwisse W. The impact of face shield use on concussions in ice hockey: a multivariate analysis. Br J Sports Med 2002;36(1):27-32.

No abstract summary available
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7. (2001) Risk factors for groin injuries in hockey

WHO?
     NHL players
WHEN?
     1998–1999 training camp and regular season.
WHY?
     To examine what factors might increase the risk of groin injury.
FINDINGS:
     • Low levels of off-season training and previous injury can increase the risk of a groin injury.
     • Veterans were at a greater risk of injury than rookies.

Emery CA, Meeuwisse WH. Risk factors for groin injuries in hockey. Med Sci Sports Exerc 2001;33(9):1423-33.

No abstract summary available
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8. (1999) Groin and abdominal strain injuries in the NHL

WHO?
     NHL players
WHEN?
     The 1991-1992 season to the 1996-1997 season.
WHY?
     To analyze groin and abdominal strain injuries.
FINDINGS:
     • The rate of strain injuries increased over the 6 seasons.
     • Training camps had the highest risk of strain injuries.
     • Games had a higher risk compared to practices for the strain injuries.
     • Abdominal injuries tended to be more severe than groin injuries.

Emery CA, Meeuwisse WH, Powell JW. Groin and abdominal strain injuries in the National Hockey League. Clin J Sport Med 1999;9(3):151-6.

Using a retrospective case series design, groin and abdominal strain injuries in elite male hockey players in the National Hockey League (NHL) over six seasons of play were examined. An inclusive sample of 7,050 players who played from the 1991-1992 to 1995-1996 seasons were included, with further analysis of a subset of 2,600 players from the 1995-1996 to 1996-1997 seasons. A total of 617 groin/abdominal strain injuries were reported over the six seasons of play. The cumulative incidence rate increased from 12.99 injuries/100 players/year in the 1991-1992 season to 19.87 injuries/100 players/year in the 1996-1997 season. The incidence density during training camp was five times that during the regular season, and 20 times that during the postseason. Approximately 23.5% of the injuries reported were recurrent. In greater than 90% of the injuries reported, the mechanism of injury was non-contact, and mean time loss for abdominal injuries (10.59 sessions) was significantly greater than for groin injuries (6.59 sessions). Each NHL team is estimated to lose 25 player games per year to groin/abdominal injuries. The impact of these injuries, and their increasing frequency, warrants the development and implementation of prevention strategies.
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9. (1999) Head and neck injuries among hockey players wearing full / half face shields

WHO?
     Male varsity hockey players in the Canadian Inter-University Athletics Union.
WHEN?
     The 1997-1998 season.
WHY?
     To determine the risk of a head or neck injury in hockey players wearing full face shields compared with those wearing half shields.
FINDINGS:
     Wearing a full face shield reduces the risk of sustaining facial and dental injuries without an increase in the risk of neck injuries, concussions, or other injuries

Benson B, Mohtadi N, Rose M, Meeuwisse W. Head and neck injuries among ice hockey players wearing full face shields vs half face shields. JAMA 1999;282:2328-32.

No abstract summary available
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