Permitting body checking in youth hockey increases the risk of game-related injuries, including concussions, threefold, according to a Canadian study published today in the Journal of the American Medical Association (JAMA).
That finding will undoubtedly raise concern among the parents of the 35,000 or so Minnesota kids who play hockey. Here, as in most places in the U.S., body checking is permitted in youth hockey (played by boys and girls) — but not in girls’ hockey — starting at the Pee Wee level (ages 11 and 12).
For this new study, Pee Wee players — 2,154 in all — were followed for a single season (October 2007 to March 2008). Roughly half (1,108) played for a league in the Canadian province of Alberta, which permits body checking at that age level. The other half (1,046) played for a league in Quebec, whose Pee Wee players are not allowed to body check.
At the end of the season, there were 241 injuries (including 78 concussions) in the Alberta league versus 91 injuries (23 concussions) in the Quebec league. Injuries were defined as those “requiring medical attention, resulting in the inability to complete a session, and/or time loss from hockey.”
Body checking represents a “significant” public health concern, the study’s authors concluded.
Gathering injury data in Minnesota
Of course, many parents and other adults involved in Minnesota’s youth hockey programs are already aware of the sport’s physical risks, particularly when body checking is allowed. Up to 86 percent of youth ice hockey injuries that occur during games have been linked to body checking. The most common injury: concussion.
“We’re very concerned about the risk of traumatic brain injuries or concussions,” Dr. Michael Stuart, co-director of the Mayo Clinic’s Sports Medicine Center in Rochester and chief medical officer for U.S.A. Hockey, the nation’s governing body for all amateur hockey, told me in a phone interview earlier this week.
But, he added, no one really knows right now how many of Minnesota’s youth are getting injured playing hockey, or under what circumstances, or even if the incidence of injury is going up or down. There is no official registry for such data.
“We think it’s probably increasing, but if somebody tells you that, they’re only speculating,” Stuart said.
Minnesota Hockey, a U.S.A. Hockey affiliate, began collecting injury reports voluntarily from some of its teams two-and-a-half seasons ago. That data has yet to be officially crunched and analyzed, but Hal Tearse, coach-in-chief for Minnesota Hockey and chair of its safety committee, believes he’s seen an increase in injuries over the 39 years he’s been coaching hockey.
“Concussions seem to be much more severe than they were 25 years ago,” he told me. That increase in the severity of the injuries — if it holds up when the data is analyzed — may be because players are bigger and faster than in years past, he said. Variations in skill level may also be a factor.
“The data that we’ve collected would indicate that players with lower skill levels, particularly at skating, are most at risk,” he added.
A growing controversy
Body checking has long been a controversial subject. In 2003, two neuroscientists wrote a commentary in the Canadian Medical Association Journal that called for eliminating body checking in youth hockey. Here in the U.S., the American Academy of Pediatrics has repeatedly recommended that body checking be banned in games played by youth aged 15 and younger.
Getting people — players and parents and coaches alike — to recognize the dangers of body checking hasn’t been easy, however. Here are some telling bits of information from the Canadian commentary:
- “In one community, players 14-15 years old were less likely than younger players to believe that sportsmanship was ‘real important.’ Moreover, 26% of players 12-15 years old who understood that body checking from behind could cause serious injury or death reported that they would be willing to do so if they were angry or wanted ‘to get even.’ ”
- “In addition, parents may be encouraging their children to win at all costs in the hope of their pursuing scholarships and professional contracts. In one study, 32% of injured players said that they would continue to body check to ensure a win; an additional 6% said they would do so in order to injure another player.”
But that was then (the 1990s). This is now. Our knowledge about the lifelong impact that even a single concussion has on a person’s physical and mental health has grown significantly during the past decade. Both Stuart and Tearse say the old win-at-any-cost attitudes once espoused by many hockey enthusiasts are changing. Minnesota Hockey has initiated a “Fair Play” safety program. Last year, it also launched a less competitive (and less time-demanding) youth recreational league — one that doesn’t permit body checking.
In October, the Mayo Clinic will be hosting a two-day “Ice Hockey Summit: Action on Concussion” program for medical experts from around the country. “It’s not going to just be a scientific program,” said Stuart. “We hope to develop an evidence-based action plan” — a plan, he added, that may include recommendations for rule changes.
It starts at home
In the meantime, what should parents with kids who love playing hockey do to reduce the risk of injury? Stuart (whose three sons play professional hockey in various leagues around the world, including son Mark, who plays defense for the Boston Bruins) offers a couple of suggestions:
- Keep your perspective. “Parents should always remember that the objectives of hockey are fun and skill development — learning to skate and to play hockey,” he said.
- Enforce the existing rules. “Many injuries are the result of rule infractions,” Stuart said. “It’s important to foster an atmosphere of sportsmanship and mutual respect. That starts at home.”