Less Body Checking May Protect Adolescent Ice Hockey Players

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.

Emery C, Palcios-Derflingher L, Black AM, et al. Br J Sports Med. 2019. [Epub Ahead of Print].

https://www.ncbi.nlm.nih.gov/pubmed/31492676?dopt=Abstract

Take-Home Message

Youth ice hockey leagues (age 13-14 years) that eliminated body checking had fewer injuries and concussions than leagues that allowed body checking.

Summary

Policy changes that prohibit body checking reduce injury rates by at least 50% in youth ice hockey (11-12-year olds). Similar policy changes are being implemented for older players. However, the effectiveness of these policies among 13- to 14-year old athletes remains unclear. Emery and colleagues completed a prospective cohort study to assess the rate of injury and concussion among non-elite Bantam leagues (ages 13 to 14 years) with or without policies prohibiting body checking. Researchers recruited 49 teams that allowed body checking and 33 teams which prohibited body checking. The authors monitored injuries with a baseline questionnaire, Sport Concussion Assessment Tool, weekly exposure sheet, and injury report form. The authors defined an injury as any injury that resulted in medical attention or a loss of time from hockey. An athletic therapist followed up on all injuries. A suspected concussion was referred to a sports medicine physician. Overall, players who participated in a league that prohibited body checking had 40 to 54% fewer reported injuries, severe injuries, and possibly fewer concussions as compared to leagues that allowed body checking.

Viewpoints

Overall, the authors found evidence to support rules that eliminate body checking from youth ice hockey to decrease the number of injuries. However, we are unable to claim that the rules cause a decrease in injury. Despite this limitation, these findings support prior evidence from younger ice hockey players and American football (see below) that suggest reducing the amount of contact decreases the number of recorded injuries. It would be interesting to see more research to better understand the impact of eliminating body checking on injury rates and the risk of injury when body checking is introduced. This should include more data regarding the number and severity of contact, equipment usage, and more details about injuries sustained in the absence of body checking. Until these types of studies can be completed, clinicians in sports medicine and parents should advocate for rules limiting or eliminating body checking during games in youth ice hockey.

Questions for Discussion

What experiences do you have with rules limiting the amount of full contact in sports? What barriers inhibit the expansion of these rules?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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5 Comments

Gavin Goeltz on October 15, 2019 at 2:21 pm

The results of this study are to be expected. Removing athletes from the what is generally accepted as the most dangerous part of contact sports should reduce the injury risk. Especially in the case of concussions. Generally, concussions are cause by contact with other players or the playing surface from the result of contact. Removing contact could decrease the total amount of contact with playing surfaces that can cause head injury.

I wonder if there is a difference in the injury rate between contact sports when contact is removed. Also, I wonder if this would hold true as at all levels of play up to professional. Overall, I assume it would.

Hannah Emerson on November 5, 2019 at 12:09 am

I think that removing checking for hockey does not help to reduce injuries and concussions in the long-term. Rather, I think that we should be training these athletes on how to properly “take” a hit, and on neck strengthening exercises to reduce the risk of a concussion. Although removing checking may help in the short-term, when athletes are thrown back into hockey when this rule is removed this will not help them to be any stronger. In fact, in those 15 y/o and older is when you will see greater differences in BMI among various athletes. I think it would be better to acclimatize these athletes to checking when they are all similar in BMI before puberty. Do you see any long-term benefit to removing checking from hockey for just a short amount of time?
Kyle Harris on November 15, 2019 at 8:46 pm

Gavin,

Thanks for your comment. I agree that generally, this would be expected. I think the more complex nuance of the study is when and if this additional contact should be added back in. This is something that studies have yet to really look at. Some research, has explored different techniques that could be helpful here, but not a comprehensive solution. Have you had any experience with sports specific training which might impact these rates?

Thanks for your comment!

Kyle Harris on October 21, 2019 at 3:03 pm

Gavin, thanks for your comment! I agree that this is expected given the parameters of the study. I think the next step will be the most interesting as body checking can be introduced at different times. I wonder if there will be certain protective strategies which are more effective at different ages. In regards to your other comment, I would also be really interested to see this study done with other sports as well, given the different amounts of contact in different sports. Thanks again!

Andriana on November 15, 2019 at 12:36 am

I think that the idea of eliminating body check in hockey is ideal in youths. Although there is very limited research on this study, wouldn’t it be better to enforce it anyway? We wouldn’t lose anything and gain everything, being able to reduce risk of injury as well as concussions is great. I’ve seen other research in football like promoting helemet-less practices programs that saw a decline in concussions but I personally never experienced any of it. Many barriers that we would see is just the idea of people and coaches just not willing to change the rules since body checking is a part of hockey but I do think with more research we might be able to see a change in rules or the opposite, maybe less body checks didn’t decrease injury risks but we’ll see when we have more research to verify.

Gavin Goeltz on October 15, 2019 at 2:21 pm

The results of this study are to be expected. Removing athletes from the what is generally accepted as the most dangerous part of contact sports should reduce the injury risk. Especially in the case of concussions. Generally, concussions are cause by contact with other players or the playing surface from the result of contact. Removing contact could decrease the total amount of contact with playing surfaces that can cause head injury.

I wonder if there is a difference in the injury rate between contact sports when contact is removed. Also, I wonder if this would hold true as at all levels of play up to professional. Overall, I assume it would.
- Hannah Emerson on November 5, 2019 at 12:09 am
  
  I think that removing checking for hockey does not help to reduce injuries and concussions in the long-term. Rather, I think that we should be training these athletes on how to properly “take” a hit, and on neck strengthening exercises to reduce the risk of a concussion. Although removing checking may help in the short-term, when athletes are thrown back into hockey when this rule is removed this will not help them to be any stronger. In fact, in those 15 y/o and older is when you will see greater differences in BMI among various athletes. I think it would be better to acclimatize these athletes to checking when they are all similar in BMI before puberty. Do you see any long-term benefit to removing checking from hockey for just a short amount of time?
- Kyle Harris on November 15, 2019 at 8:46 pm
  
  Gavin,
  
  Thanks for your comment. I agree that generally, this would be expected. I think the more complex nuance of the study is when and if this additional contact should be added back in. This is something that studies have yet to really look at. Some research, has explored different techniques that could be helpful here, but not a comprehensive solution. Have you had any experience with sports specific training which might impact these rates?
  
  Thanks for your comment!
Kyle Harris on October 21, 2019 at 3:03 pm

Gavin, thanks for your comment! I agree that this is expected given the parameters of the study. I think the next step will be the most interesting as body checking can be introduced at different times. I wonder if there will be certain protective strategies which are more effective at different ages. In regards to your other comment, I would also be really interested to see this study done with other sports as well, given the different amounts of contact in different sports. Thanks again!
Andriana on November 15, 2019 at 12:36 am

I think that the idea of eliminating body check in hockey is ideal in youths. Although there is very limited research on this study, wouldn’t it be better to enforce it anyway? We wouldn’t lose anything and gain everything, being able to reduce risk of injury as well as concussions is great. I’ve seen other research in football like promoting helemet-less practices programs that saw a decline in concussions but I personally never experienced any of it. Many barriers that we would see is just the idea of people and coaches just not willing to change the rules since body checking is a part of hockey but I do think with more research we might be able to see a change in rules or the opposite, maybe less body checks didn’t decrease injury risks but we’ll see when we have more research to verify.