Epidemiology of injuries in professional ice hockey: a prospective study over seven years

Background Ice hockey injuries epidemiology is still poorly understood and very few studies are focused on it, especially about professional players. Methods Our prospective study collected all injuries occurring on ice during practice and games over 7 years (2006–2013) in a professional hockey team playing in the 1st division championship in Switzerland. Results During the 7 seasons, we recorded a total of 525 injuries and 190 injuries with time loss (TL). Mean injuries incidence was 5.93 (95% CI 5.28 to 6.27) injuries/1000 h/player and with time loss 2.14 (95% CI 1.79 to 2.39) injuries/1000 h/player. The lower limb was the most affected part of the body, with a total of 40.4% of all injuries, mostly knee Medial Collateral Ligament tear and muscle adductors/abdominal sprain. For the upper limb, shoulder was the most affected joint with mostly acromioclavicular sprain and shoulder dislocation. Forwards had a significant (p < 0.05) higher risk than defensemen for knee Medial Collateral Ligament (MCL) tear. There was no significant difference in the concussion risk between forwards and defensemen, but defensemen had a significant higher risk (p < 0.05) to have a more severe concussion. Conclusion This study provides a better understanding about professional ice hockey epidemiology, which is still insufficiently researched and understood. We also found some significant risk factors, being a forward for knee MCL tear, being a defensemen for concussion severity. Concussion program prevention seems to be effective but it is crucial to continue the follow up of concussion on long term and expand the surveillance system to all the League.

Epidemiology of Female Youth Ice Hockey Injuries Presenting to United States Emergency Department’s from 2007 to 2016

Objectives: Female youth ice hockey players are an overlooked population. No national study has established incidence rates for injuries in female youth ice hockey. The objective of this study was to establish incidence rates by injury location, diagnosis, and mechanism of injury using USA Hockey sanctioned age divisions. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for all ice hockey injuries (product code 1279) from January 1, 2007 to December 31, 2016. Cases involving players over the age of 19 and males were excluded. Each injury’s narrative text field was reviewed to determine mechanism of injury. Data was analyzed using (IBM®, v24). Comparisons of incidence by age were made using student’s two sample t-test with 95% confidence interval. Trend analyses were performed using a linear regression. USA Hockey membership statistics were used to establish population at risk and calculate incidence rates. All incidence rates were reported per 10,000 person-years. Results: A total of 384 patients, representing an estimated 10,398 ice hockey-related injuries, presented to NEISS-participating United States emergency departments. During the study period, female youth ice hockey players increased significantly from 44,678 in 2007 to 57,792 in 2016 (p=3.9x10-5, R-squared=0.89, ß =0.94). The overall number of injuries, however, only slightly increased from 992 in 2007 to 1,042 in 2016 (p=ns). Thus, the incidence rate (IR) of injuries fell from 222.1 to 180.2 during the study period. The most commonly injured body parts were the head (n=3048, IR=554.5), trunk (n=1399, IR=256.4), knee (n=1127, IR=169), shoulder (n=704, IR=153.3) and ankle (n=591, IR=120.2). The most common diagnoses were strain/sprain (n=2002, IR=417.7), contusion (n=1877, IR= 348), internal organ injury (n=1863, IR=320), concussion (n=1112, IR=218) and fracture (n=1255, IR=202). The top mechanisms of injury were player-to-player contact (n= 3016, IR=535), falls (n=2249, IR=380.9), and contact with boards (n=942, IR=165.8). The incidence rate of injuries increased with age; The 0-8, 9-10, 11-12, 13-14, 15-16 and 17-19 age divisions had IR’s of 24, 84, 226, 381, 360, and 750, respectively. The player-to-player mechanism of injury also increased with age. The largest IR gap between ages fell between the 11-12 and 13-14 age groups, similar to what has been observed in male ice hockey studies. Player-to-player contact is the leading mechanism of injury in all age groups except the 0-8 age group. Head injuries increased with age division: 0-8 (n=15, IR=1), 9-10 (n=153, IR=17.4), 11-12 (n=598, IR=67.2), 13-14 (n=885, IR=115.1), 15-16 (n=650, IR=121.6) and 17-19 (n=746, IR=232.2). The two most common diagnoses of head injuries were concussion (36%) and internal organ injury (61%), both of these diagnoses increasing with age. In fact, concussion diagnosis increased significantly between each age group (p<0.01). Conclusion: We established the first collection of injury incidence rates for female ice hockey gleaned from a national database. Though body checking is illegal at all levels of women’s ice hockey, player-to-player contact prevailed as the leading mechanism of injury in all but the 0-8 age division. It was also the leading mechanism for the most common injury sites, including the head. This study laid bare an unspoken but long understood fact of the girl’s game that body checking is common and major contributor to the game’s injury burden.

The Impact of Body Checking on Youth Ice Hockey Injuries

Background: Body checking is a common cause of youth ice hockey injuries. Consequently, USA Hockey raised the minimum age at which body checking is permitted from the Pee Wee level (11-12 years old) to the Bantam level (13-14 years old) in 2011. Purpose/Hypothesis: The purpose of this investigation was to determine the impact of body checking on the distribution of injuries reported in youth ice hockey players. We hypothesized that the elimination of body checking at the Pee Wee level would lower the frequency of serious injuries, particularly concussions. Study Design: Descriptive epidemiology study. Methods: Injury data from the National Electronic Injury Surveillance System (NEISS), a United States Consumer Product Safety Commission database, were analyzed for Pee Wee and Bantam players between January 1, 2008 and December 31, 2010 and again between January 1, 2013 and December 31, 2015. Data on the location of injury, diagnosis, and mechanism of injury were collected. The location of injury was categorized into 4 groups: head and neck, upper extremity, lower extremity, and core. Diagnoses investigated included concussions, fractures, lacerations, strains or sprains, internal organ injuries, and other. The mechanism of injury was broken down into 2 categories: checking and other. Results: Between the 2008-2010 and 2013-2015 seasons, overall injuries decreased by 16.6% among Pee Wee players, with injuries caused by body checking decreasing by 38.2% ( P = .012). There was a significant change in the distribution of diagnoses in the Pee Wee age group during this time frame ( P = .007): strains or sprains, internal organ injuries, and fractures decreased in frequency, while the number of concussions increased by 50.0%. In the Bantam age group, recorded injuries decreased by 6.8%, and there was no change in the distribution of the location of injury, diagnosis, or mechanism of injury ( P > .05). Conclusion: There was an observed reduction in the total number, mechanism, and type of injuries when body checking was eliminated from the Pee Wee level. There was, however, an unexpected increase in the number of concussions.