Kapow! NHL Still Getting Hit to the Head

Concussions among NHL players have not decreased since Rule 48 was introduced

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) A lot of hockey fans follow the game for the hard hitting action. The last few seasons may not have appeared as violent, but the pros are still getting a good knocking to the head. Despite the introduction of Rule 48, which prohibits contact to the head with a body check, the number of concussions among National Hockey League (NHL) players has not decreased, a recently published study found.

Other changes may need to be introduced to the game to prevent head injuries among hockey players, according to the researchers of this study.

"Wear a helmet when playing contact sports."

The aim of this study, led by Laura Donaldson, from the Division of Neurosurgery and Injury Prevention Research Office at St. Michael’s Hospital at the University of Toronto in Ontario, Canada, was to see whether changes to hockey rules designed to limit contact to the head

reduced the number of concussions that occurred among players in the NHL over the last couple of seasons.

Rule 48, which made hits to the head illegal, was introduced during the 2010-11 and 2011-12 hockey seasons. Using official game records and team injury reports, the researchers tracked the number of concussions that occurred over three hockey seasons between 2009 and 2012.

The researchers of this study also compared the number of concussions that occurred among players in the Ontario Hockey League (OHL), which has had a longstanding ban on hits to the head.

For every 100 NHL regular season games, the researchers found that 5.23 concussions per 100 games occurred over the three seasons. When including head injuries similar to concussions, the number increased to 8.8 head injuries per 100 games.

At the same time, 5.05 concussions per 100 games occurred among players in the OHL during regular season games, or 7.1 similar head injuries per 100 games in total.

The researchers found that the number of NHL concussions or suspected concussions was lower in the 2009-10 season than in the 2010-11 season. The number of concussions did not increase from 2010-11 to 2011-12.

Body checking, or when players slam into each other, caused almost two-thirds of the NHL concussions. About 29 percent of concussions and 37 percent of suspected concussions were caused by illegal moves not allowed in the game.

Hits by pucks caused 12 percent of concussions, and unintentional collisions with other players caused another 5 percent of concussions.

Concussions continue to be a serious risk for both NHL and OHL players, the researchers wrote.

The proportion of players in each playing position who sustained a concussion did not change across the three seasons.

Goalies were more than 50 percent less likely to get a concussion compared to other players. Taller skaters were about 10 percent less likely to get a concussion compared to shorter players.

On the other hand, defensive players in both the OHL and the NHL were 36 percent more likely to get a concussion compared to other players, the researchers found.

The researchers wrote that this higher concussion rate might be due to players turning their back to retrieve pucks along the walls of the rink.

"Despite recent actions taken by the NHL to introduce Rule 48 regulating body checking to the head, concussion incidence among NHL hockey players has not decreased," the researchers wrote in their report.

"Both the scope and enforcement of this rule may need to be addressed in both leagues, or else other changes will need to be introduced to the game in order to reduce injury among elite hockey players," they wrote.

The authors noted a couple of limitations to their study, including that they did not look at medical records or players' final diagnoses.

The researchers only looked at teams' injury reports and publicly available data. However, the researchers said these reports were clear and accurate. Still, the number of concussions could be higher than what was reported.

The researchers also could not determine whether the increase in NHL concussions during the 2010-11 season was caused by an increase in reporting or an actual increase in the number of concussions.

This study was published online July 17 in the journal PLOS One.

No conflicts of interest were declared.

Review Date: 
July 17, 2013
Last Updated:
July 31, 2013