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].

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.


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.


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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