Bodychecking experience and rates of injury among ice hockey players aged 15-17 years
Eliason PH, Hagel BE, Palacios-Derflingher L, Warriyar V, Bonfield S, Black AM, Mrazik M, Lebrun C, Emery CA
CMAJ. June 2022
Hockey
Who participated in this study?
941 ice hockey players, aged 15-17, in Alberta
When did this study occur?
Over 3 ice hockey seasons, from the 2015/16 season to the 2017/18 season.
Why did we do this research?
To evaluate the associations between bodychecking experience and the rates of injury and concussion.
What did we find?
Ice hockey players with 3+ years of experience in bodychecking had higher rates of all injury, of injury resulting in more than 7 days time loss, and of concussion, when compared to players with 2 years or less of experience.
No association found between body checking experience and injury or concussion rates
Eliason P, Hagel BE, Palacios-Derflingher L, Warriyar KV V, Bonfield S, Black AM, Babul S, Mrazik M, Lebrun C, Emery C
Br J Sports Med. February 2022
Who participated in this study?
1647 U15 ice hockey players
When did this study occur?
2013-2014 ice hockey season until 2017-2018 ice hockey season.
Why did we do this research?
To compare rates of injury and concussion in leagues allowing body checking with varying years of body checking experience
What did we find?
No association was found between body checking experience and injury or concussion rates.
Body checking in non-elite adolescent ice hockey leagues
Emery ca, Eliason P, Warriyar V, Palacios-Derflingher L, Black AM, Krolikowski M, Spencer N, Sick S, Kozak S, Schneider KJ, Babul S, Mrazik M, Lebrun C, Goulet C, Macpherson A, Hagel BE
Br J Sports Med. January 2022
Who participated in this study?
Ice hockey players, aged 15-17 years, in Alberta and British Columbia.
When did this study occur?
Between 2015 and 2018
Why did we do this research?
To evaluate the effect of policy change disallowing body checking in adolescent ice hockey leagues on reducing rates of injury and concussion.
What did we find?
The rate of injury was 62% lower and rate of concussion was 51% lower in leagues not permitting body checking.
Reality Check 2: The Cost-Effectiveness of Policy Disallowing Body Checking in Non-Elite
Currie GR, Lee R, Palacios-Derfligher L, Hagel B, Black AM, Babul S, Mrazik M, Marshall DA, Emery CA
Int J Environ Res Public Health. June 2021
Who participated in this study?
608 players from Calgary and Edmonton leagues where body checking was allowed in games and 396 players from Calgary, Vancouver and Kelowna leagues where it was not allowed in games.
When did this study occur?
The leagues where body checking was allowed occurred in Calgary & Edmonton during the 2014-2015 season and in Edmonton during the 2015-2016 season.
The leagues where body checking was not allowed occurred in Vancouver & Kelowna during the 2014-2015 season and in Calgary during the 2015-2016 season.
Why did we do this research?
To compare rates of game injuries and costs among non-elite Bantam ice hockey leagues that allow body checking and those that did not.
What did we find?
Disallowing body checking in non-elite 13-14-year-old ice hockey would prevent injuries and reduce public healthcare costs.
An Economic Evaluation of Disallowing Body Checking in 11- to 12-Year-Old Ice Hockey Leagues
Currie GR, Lee R, Black AM, Palacios-Derfligher L, Hagel BE, Emery CA, Marshall DA
Sports Health. June 2021
Who participated in this study?
Alberta Pee Wee hockey players, aged 11-12 years
When did this study occur?
During the 2011-2012 season where body checking was allowed in games and during the 2013-2014 season where body checking was not allowed in games.
Why did we do this research?
To determine if the injuries and injury-related costs differ for Pee Wee ice hockey players in the season after a national policy change disallowing body checking in games compared with a season when body checking was allowed in Alberta.
What did we find?
With a significant reduction in injuries and lower public health care system and private costs, the policy change is supported.
Incidence of Head Contacts, Penalties, and Player Contact Behaviors in Youth Ice Hockey
Williamson RA, Kolstad AT, Krolikowski M, Nadeau L, Goulet C, Hagel BE, Emery CA
Orthop J Sports Med. March 2021
Who participated in this study?
16 elite U15 games (510 players) prior to the Hockey Canada "zero tolerance for head contact" policy change and 16 elite U15 games (486 players) after the policy change were video recorded.
When did this study occur?
Games before the policy change were during the 2008-2009 ice hockey season and games after the policy change were during the 2013-2014 ice hockey season.
Why did we do this research?
To compare the rates of primary and secondary head contacts and "zero tolerance for head contact" policy enforcement in elite U15 ice hockey leagues.
What did we find?
Despite the implementation of the "zero tolerance for head contact" policy, there was no difference in rate of primary head contacts (direct contact by player) and secondary head contacts (indirect contact via boards, glass or ice surface). There was no difference in the proportion of primary head contacts penalized from before or after implementation.
Mouthguard use in youth ice hockey & the risk of concussion: nested case-control study of 315 cases
Chisholm DA, Black AM, Palacios-Derflingher L, Eliason PH, Schneider KJ, Emery CA, Hagel BE
Br J Sports Med. July 2020
Who participated in this study?
315 participants who sustained a suspected concussion during a game or practice and 270 participants who sustained a non-concussion injury.
When did this study occur?
The 2011-2012 ice hockey season and the three ice hockey seasons between 2013 & 2016.
Why did we do this research?
To determine the association between concussion and mouthguard use in youth ice hockey.
Disallowing body checking in non-elite 13- to 14-year-old ice hockey leagues
Emery C, Palacios-Derflingher L, Black AM, Eliason P, Krowlikowski M, Spencer N, Kozak S, Schneider KJ, Babul S, Mrazik M, Lebrun CM, Goulet C, Macpherson A, Hagel BE
Br J Sports Med September 2019
Who participated in this study?
608 players from 49 body checking teams and 396 players from 33 non-body checking teams in Calgary, Edmonton, Kelowna and Vancouver.
When did this study occur?
2014-2016
Why did we do this research?
To compare rates of injury and concussion among non-elite Bantam ice hockey leagues that disallow body checking to non-elite Bantam leagues that allow body checking
What did we find?
Disallowing body checking in non-elite Bantam ice hockey resulted in a 56% lower rate of injury. There is growing evidence that disallowing body checking is associated with fewer injuries.
The Association Between Moderate and Vigorous Physical Activity and Time to Medical Clearance
Lishchynsky JT, Rutschmann TD, Toomey CM, Palacios-Derflingher L, Yeates KO, Emery CA, Schneider KJ
Front Neurol June 2019
Who participated in this study?
30 ice hockey players (12-17 yrs old) that were diagnosed with a concussion sustained during ice hockey
When did this study occur?
2015-2016
Why did we do this research?
To evaluate the association between the amount of moderate and vigorous physical activity during the first 3 days following concussion diagnosis and time to medical clearance to return to play in youth ice hockey players
What did we find?
More time in moderate and vigorous physical activity early in recovery period may result in greater time to medical clearance to return to full participation
Concussion Burden, Recovery, and Risk Factors in Elite Youth Ice Hockey Players
Schneider KJ, Nettel-Aguirre A, Palacios-Derfliingher L, Mrazik M, Brooks BL, Woollings K, Blake T, McKay C, Lebrun C, Barlow K, Taylor K, Lemke N, Meeuwisse WH, Emery CA
Clin J Sport Med October 2018
Who participated in this study?
659 elite male and 119 elite female youth ice hockey players
When did this study occur?
2011-2012 ice hockey season
Why did we do this research?
To examine rates of concussion and more severe concussion (time loss of greater than 10 days) in elite 13- to 17-year-old ice hockey players
What did we find?
Concussion incidence rate was 17.60 concussions/100 players, 1.31 concussions/1000 player-hours. Time loss greater than 10 days was reported in 74% of cases and 20% had time loss greater than 30 days.
Physical activity and concussion risk in youth ice hockey players
Blake TA, Doyle-Baker PK, Brooks BL, Palacios-Derflingher L, Emery CA
BMJ Open September 2018
Who participated in this study?
1208 Pee Wee, Bantam and Midget male ice hockey players in Alberta, Canada
When did this study occur?
2011-2015
Why did we do this research?
To examine the association between meeting physical activity volume recommendations and concussion rates
What did we find?
Concussion rate of players who did not meet the Canadian physical activity volume recommendations was more that twice the concussion rate of players who met recommendations among Pee Wee, Bantam and non-elite.
The risk of injury associated with body checking among Pee Wee ice hockey players
Black AM, Hagel BE, Palacios-Derflingher L, Schneider KJ, Emery CA
Br J Sports Med December 2017
Who participated in this study?
883 Pee Wee players from 59 teams in Calgary, Alberta in 2011-2012 and 618 Pee Wee players from 73 teams in 2013-2014
When did this study occur?
2011-2012 & 2013-2014 seasons
Why did we do this research?
To determine if the risk of injury, including concussions, changes for Pee Wee ice hockey players in the season following a national policy change disallowing body checking
What did we find?
Introduction on the 2013 national body checking policy resulted in a 50% relative reduction in injury rate and a 64% reduction in concussion rate
The Effect of the "Zero Tolerance for Head Contact" Rule Change on the Risk of Concussions
Krolikowski MP, Black AM, Palacios-Derflingher L, Blake TA, Schneider KJ, Emery CA
Am J Sports Med February 2017
Who participated in this study?
891 Pee Wee (70% elite) and 378 Bantam (30% elite) before the rule change and 588 Pee Wee and 242 Bantam in the same levels of play after the policy change
When did this study occur?
2007-2008, 2008-2009, 2011-2012
Why did we do this research?
To determine if the risk of game-related concussions and more severe concussions and the mechanisms of a concussion differed for Pee Wee class and Bantam class players after the 2011 “zero tolerance for head contact” policy change compared with players of similar divisions before the policy change
What did we find?
The policy change did not reduce the risk of game-related concussion in Pee Wee or Bantam. Increased concussion awareness and education after the policy change may have contributed to the increase risk of concussion found after the policy change
Do children and adolescent ice hockey players differ in robotic testing?
Little CE, Emery C, Scott SH, Meeuwisse W, Palacios-Deflingher L, Dukelow SP
J Neuroeng Rehabil October 2016
Who participated in this study?
385 pediatric/adolescent ice hockey players
When did this study occur?
2013-2014 ice hockey season
Why did we do this research?
To determine whether differences in baseline performance on multiple robotic tasks could be identified between pediatric/adolescent ice hockey players
What did we find?
No differences in sensorimotor and/or cognitive performance across multiple parameters using KINARM end point robotic testing
Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction
Black AM, Macpherson AK, Hagel BE, Romiti MA, Palacios-Derflingher L, Kang J, Meeuwisse WH, Emery CA
Br J Sports Med January 2016
Who participated in this study?
590 non-elite Pee Wee players from Alberta and 281 from Ontario; 294 elite Pee Wee players from Alberta and 166 from Ontario
When did this study occur?
2011-2012 ice hockey season
Why did we do this research?
to compare the risk of injury and concussion between non-elite Pee Wee ice hockey players in leagues where body checking is permitted and leagues where policy change disallowed body checking
What did we find?
The rate of injury and concussion were threefold greater in non-elite Pee Wee ice hockey players in leagues where body checking was permitted. The rate of injury and concussion did not differ between provinces in elite levels where body checking was allowed.
Baseline evaluation in youth ice hockey players
McKay CD, Schneider KJ, Brooks BL, Mrazik M, Emery CA
J Orthop Sports Phys Ther May 2014
Who participated in this study?
714 AA and AAA Bantam and Midget hockey players, aged 12-17
When did this study occur?
2011-2012 hockey season
Why did we do this research?
To examine the differences in concussion history and attention or learning disorders
What did we find?
There was substantial disagreements between instruments reporting learning disorders.
Psychometric properties and reference values for the ImPACT neurocognitive test battery
McKay CD, Brooks BL, Mrazik M, Jubinville AL, Emery CA
Arch Clin Neuropsychol March 2014
Who participated in this study?
704 elite hockey players, aged 13-17 years
When did this study occur?
2011-2012 hockey season
Why did we do this research?
To determine psychometric properties and reference values for ImPACT
What did we find?
Players aged 16-17 years had better visual processing speeds than younger individuals. Girls had a greater total symptom rating than boys.
Injury rates, types, mechanisms and risk factors for injury in female youth ice hockey
Decloe MD, Meeuwisse WH, Hagel BE, Emery CA
Br J Sports Med January 2014
Who participated in this study?
Female youth ice hockey players, aged 9-17, in Girls Hockey Calgary Association
When did this study occur?
2008-2009 season
Why did we do this research?
To examine the rates, types, mechanisms and risk factors of female youth hockey
The epidemiology of professional ice hockey injuries: a prospective report of six NHL seasons
McKay CD, Taufts RJ, Shaffer B, Meeuwisse WH
Br J Sports Med January 2014
Who participated in this study?
All NHL teams
When did this study occur?
The 2006-2007 season through the 2011-2012 season
Why did we do this research?
To determine injury and illness rates in the NHL over six seasons. To identify predictors of injury-related time loss in this population
What did we find?
Being a goaltender, being injured on the road, and being injured by a body check were the greatest risk factors.
Subjective but not objective, lingering effects of multiple past concussions in adolescents
Brooks BL, McKay CD, Mrazik M, Barlow KM, Meeuwisse WH, Emery CA
J Neurotrauma September 2013
Who participated in this study?
643 Bantam and Midget hockey players, aged 13-17
When did this study occur?
2011-2012 hockey season
Why did we do this research?
To examine whether there are lingering effects from past concussions in adolescent athletes
What did we find?
Significantly more symptoms were reported in those with two or more concussions than those with one or no prior.
Preseason reports of neck pain, dizziness, and headache as risk factors for concussion
Schneider KJ, Meeuwisse WH, Kang J, Schneider GM, Emery CA
Clin J Sport Med July 2013
Who participated in this study?
3832 male ice hockey players, aged 11-14, in Alberta and Quebec
When did this study occur?
2007-2008 PeeWee season and 2008-2009 Bantam season
Why did we do this research?
To determine the risk of concussion for players who reported neck pain, dizziness, and/or headache in the preseason
What did we find?
Athletes who reported these symptoms in the preseason were at a greater risk of concussion during the season
The role of psychosocial factors for injury in elite youth ice hockey
McKay C, Campbell T, Meeuwisse W, Emery C
Clin J Sports Med May 2013
Who participated in this study?
316 Bantam and Midget male ice hockey players, aged 13-17, in Calgary, Alberta
When did this study occur?
2007-2008 hockey season
Why did we do this research?
To determine the risk of injury associated with athletic identity, attitudes towards body checking, competitive state anxiety, and re-injury fear
What factors increase the risk of concussion in elite youth ice hockey players?
Blake TA, Kang J, Meeuwisse WH, Lemke N, Schneider KJ, Taylor KA, Emery CA
Br J Sports Med March 2013
Who participated in this study?
764 Bantam and Midget hockey players, aged 12-17
When did this study occur?
Published March 2013
Why did we do this research?
To examine the risk of concussion among elite youth male and female ice hockey players.
What did we find?
There is a greater risk of concussion for 15-17 year old players with a previous history of concussion.
Risk of injury and concussion associated with team performance and penalty minutes
Emery CA, Kang J, Schneider KJ, Meeuwisse WH
Br J Sports Med November 2011
Who participated in this study?
2081 players from Alberta and 2018 players from Quebec
When did this study occur?
2007-2008 PeeWee season and 2008-2009 Bantam season
Why did we do this research?
To determine if there is an association between the risk of all injury or concussion and win-loss records or penalty minutes in competitive youth ice hockey players
What did we find?
There is a lower injury risk in teams winning at least 50% of their games. There is no associations between penalty minutes and injury rate.
The risk of injury associated with body checking in young ice hockey players
Emery CA, Kang J, Shrier I, Goulet C, Hagel BE, Benson BW, Nettel-Aguirre A, McAllister JR, Hamilton GM, Meeuwisse WH
JAMA June 9 2010
Who participated in this study?
PeeWee hockey players, aged 11-12 years, in Alberta and Quebec
When did this study occur?
2007-2008 hockey season
Why did we do this research?
To compare the risk of injury and concussion in a body-checking league (Alberta) to a non-body checking league (Quebec)
What did we find?
There was a significantly increased risk of injury and concussion in the body checking league (Alberta) compared with the non-body checking league (Quebec).
Examining Attitudes Toward Body Checking, Levels of Emotional Empathy, and Levels of Aggression
Emery CA, McKay CD, Campbell TS, Peters AN
Clin J Sport Med May 2009
Who participated in this study?
Male hockey players from PeeWee, Bantam and Midget teams in the Minor Hockey Association of Calgary
When did this study occur?
2007-2008 hockey season
Why did we do this research?
To examine the attitudes toward body checking, levels of emotional empathy and levels of aggression in body checking and non-body checking youth hockey leagues
What did we find?
Attitudes toward body checking, and levels of empathy and aggression did not influence injury risk.
Risk factors and mechanisms of injury in female youth ice hockey players
Decloe MD, Emery CA, Hagel B, Meeuwisse WH
Clin J Sport Med May 2009
Who participated in this study?
Young female hockey players, aged 9-17 years, in the Girls Hockey Calgary Association (GHCA)
When did this study occur?
2008-2009 hockey season
Why did we do this research?
To examine the incidence of injury, the type/severity of injury, and the mechanisms of injury
What did we find?
The overall injury rate was 1.9 injuries/1000 player hours. Previous injury, session type (games) and menstrual history (in PeeWee only) were risk factors for injury.
Injury Rates, Risk Factors, and Mechanisms of Injury in Minor Hockey
Emery CA, Meeuwisse WH
The American Journal of Sports Medicine December 2006
Who participated in this study?
Male minor hockey players, aged 9-17 years, from 71 teams in the Minor Hockey Association of Calgary
When did this study occur?
2004-2005 hockey season
Why did we do this research?
To examine injury rates, risk factors, and mechanisms of injury in minor hockey
What did we find?
The most common types were concussions and shoulder sprain/dislocations. The most common mechanism of injury was body checking. The risk of injury appeared to increase with increasing age and skill level.
Injury Rates and Profiles in Female Ice Hockey Players
Schick DM, Meeuwisse WH
The American Journal of Sports Medicine January 2003
Who participated in this study?
Female varsity players from the Canada West University Athletic Association
When did this study happen?
1998-1999 hockey season
Why are we doing this research?
To compare injury rates, risk factors, and mechanisms of injury between gender in varsity hockey
What did we find?
Females had similar injury rates to males. Concussions and ankle sprains were the most common types of injury in females. Most injuries were due to a contact related mechanism.
The impact of face shield use on concussions in hockey
Benson BW, Rose MW, Meeuwisse WH
Br J Sports Med February 2002
Who participated in this study?
Varsity male hockey players from the Canada Inter-University Athletic Union
When did this study occur?
1997-1998 hockey season
Why did we do this research?
To compare the risk of concussion with players wearing full face shields compared with half face shields (visors)
What did we find?
A full face shield compared with half face shield reduced severity of concussion (playing time loss).
Risk factors for groin injuries in hockey
Emery CA, Meeuwisse WH
Med Sci Sports Exerc September 2001
Who participated in this study?
NHL players
When did this study occur?
1998-1999 training camp and regular season
Why did we do this research?
To examine what factors might increase the risk of groin injury
What did we find?
Low levels of off-season training and previous injury can increase the risk of a groin injury. Veterans were at a greater risk of injury than rookies
Head and Neck Injuries Among Ice Hockey Players Wearing Full Face Shields vs Half Face Shields
Benson BW, Mohtadi NGH, Rose MS, Meeuwisse WH
JAMA December 1999
Who participated in this study?
Male varsity hockey players in the Canadian Inter-University Athletics Union
When did this study occur?
1997-1998 season
Why did we do this research?
To determine the risk of a head or neck injury in hockey players wearing full face shields compared with those wearing half shields
What did we find?
Wearing a full face shield reduces the risk of sustaining facial and dental injuries without an increase in the risk of neck injuries, concussions, or other injuries.
Groin and abdominal strain injuries in the National Hockey League
Emery CA, Meeuwisse WH, Powell JW
Clin J Sport Med July 1999
Who participated in this study?
NHL players
When did this study occur?
1991-1992 season through 1996-1997
Why did we do this research?
To analyze groin and abdominal strain injuries
What did we find?
The rate of strain injuries increased over the 6 seasons. Training camps had the highest risk of strain injuries. Games had a higher risk compared to practices for the strain injuries. Abdominal injuries tended to be more severe than groin injuries.