Reduction of high school ice hockey injuries with implementation of new checking/boarding rules.

Nadkarni L, Haskins A, Holt C, Dexter W. Clinical Journal of Sport Medicine: September 22, 2020. Publish Ahead of Print. doi: 10.1097/JSM.0000000000000846

Take-Home Message

High school players experienced a 40% reduction in injuries due to being checked after implementing ice hockey rule changes that increased penalties for dangerous checking and boarding.


One of the most common mechanisms for ice hockey injuries is body checking or boarding. Hence, in 2014 the US National Federation of State High School Associations increased the penalties for dangerous checking and boarding. While this rule change aimed to reduce the number of injuries related to body checking or boarding, it remains unclear if these rule changes impacted injury rates. Therefore, Nadkarni and colleagues completed a retrospective study to assess the impact these rule changes had on injury rates among US high school ice hockey players. Researchers obtained injury data from the High School Reporting Information Online (RIO) sports injury surveillance database. The data in this database includes athlete exposures, injury reports, and injury mechanisms. The authors examined data for 3 seasons before and 2 seasons after the rule changes.

They found a 40% reduction in the rates of injury due to being checked during the 2 seasons after the rule change (5.0 vs. 8.3 injuries per 10,000 athlete exposures). Interestingly, there was no difference in overall injury rates or injuries when checking another player.


The authors concluded that ice hockey rule changes likely decreased injuries from being checked among high school players. While the overall injury rate was relatively unchanged, the rate of injury due to being checked decreased. This finding may be because injuries from no other mechanisms changed. Since the authors detected no other changes in injury rates – besides injuries from being checked – we could infer that the rule change and not some other changes over time contributed to these findings.  It would be interesting for future research to examine how athletes felt about the rule changes. That data would help inform future research on rule changes focused on reducing injury rates and improving athlete safety. In the meantime, clinicians and sports administrators could use these results to highlight the potential importance that rule changes can have at making high school sports safer.

Questions for Discussion

What rule changes have you witnessed which have had a positive impact on injury rates? How did coaches, athletes, and medical personnel perceive that rule change?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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