Checking Injury in Youth Ice Hockey

Youth ice hockey body checking contributes to significant injuries

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) As the popularity of youth ice hockey has grown in recent years, the injuries associated with it have grown as well.

A recent study looked more closely at the injuries that occur with youth ice hockey.

In addition, a statement from the American Academy of Pediatrics addressed ways to reduce injury risk from the sport.

One of the most important ways to reduce injury risk, the AAP wrote, was to expand programs to prevent body checking in the sport.

Body checking is deliberately obstructing an opponent by putting one's body in their way.

"Youth ice hockey with strict body checking rules is safest."

The study, led by Stephanie Polites, MD, of the Department of Surgery at the Mayo Clinic in Rochester, Minnesota, investigated injuries resulting during youth ice hockey.

The authors analyzed all the cases of children under age 18 who came to the Mayo Clinic with ice hockey injuries between July 1997 and July 2013.

During that 16-year period, 155 children came in with 168 injuries. Twenty-six of the injuries occurred in girls.

The most common injuries were to the arms and legs, followed by traumatic brain injury.

The least common injuries overall were ones occurring to the face, spine and trunk, but spine injuries and traumatic brain injuries occurred most frequently to girls and children under 14 years old.

Players aged 15 years old or older were most likely to have face injuries.

Overall, 65 patients required admission to the hospital, including 14, or 8.3 percent of the total group, who needed intensive care.

Nearly a quarter (23 percent) required a major procedure due to their injuries.

The majority of the injuries had occurred as a result of intentional contact between players.

"Hockey organizations have implemented initiatives to improve player safety, and ongoing investigation is needed to evaluate their effectiveness and develop new programs," the authors wrote.

The American Academy of Pediatrics Council on Sports Medicine and Fitness issued a Policy Statement related to reducing the risk of injury from body checking in youth ice hockey.

"To promote ice hockey as a lifelong recreational pursuit for boys, the American Academy of Pediatrics recommends the expansion of nonchecking programs and the restriction of body checking to elite levels of boys’ youth ice hockey, starting no earlier than 15 years of age," the committee wrote.

They noted that more than 12,500 ice hockey players under age 19 go to the emergency room for injuries, and the injuries among 9- to 14-year-olds more than doubled between 1990 and 2006.

Between 2008 and 2012, about two injuries out of every 1,000 practices or games (athlete exposures) occurred among boys ice hockey.

They also noted that the concussion rate among boys ice hockey is second only to football in terms of frequency.

About one in five injuries from ice hockey are concussions, and 30 percent of the concussions occurring in ice hockey resulted from being body checked, the committee wrote.

"Body checking is associated with a more aggressive style of play, and aggressive play is associated with more severe injury," the committee wrote.

"Players in leagues in which body checking is allowed have been shown to have lower levels of empathy, to have higher levels of aggression, and to respond more positively to statements about injuring another player with a body check to increase their team’s chances of winning," they wrote.

Players in those leagues also responded more positively to statements about being willing to body check an opposing player even if they knew it would injure the other player.

The AAP therefore made several recommendations related to youth ice hockey:

  • expanding non-checking programs for boys aged 15 and older
  • restricting body checking to the highest competition levels, no earlier than 15 years old
  • strictly enforcing zero-tolerance rules against any contact to the head
  • reinforcement of rules to prevent body contact from behind
  • emphasis on coaching and education to prevent body contact from behind
  • more research intuit he effects of legal body checking

The study and policy statement were published May 26 in the journal Pediatrics. The study did not use external funding, and the authors reported no conflicts of interest.

Review Date: 
May 25, 2014
Last Updated:
July 14, 2014