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Illegal Contact Found to Often Lead to Concussions in Youth Ice Hockey Players

More than four of every 10 concussions among ice hockey players between the ages of 12 and 18 involve illegal contact, suggests a study published online Friday in the journal Pediatrics.

The study examined data from 397 youth ice hockey players between the ages of 12 and 18 from September 2012 through April 2014 to evaluate the concussion incidence rates of games versus practices and across varying age levels. Roughly 40 percent of the participants (159) were between the ages of 12 and 14, while the remaining 238 were in the 15- to 18-year-old age group. A majority (330) were males. The 67 females all participated in non-checking leagues.

Across all age groups, 37 of the 397 participants suffered a medically diagnosed concussion during the two-year study. Eleven of those concussions (29.7 percent) occurred in practices, while the remaining 26 (70.3 percent) came during games. Overall, the youths recorded 23,369 total athletic exposures, defined as every time a single player participates in a practice or a game. Of those exposures, 12,784 were in practices and 10,585 were in games, which indicates a significantly higher concussion incidence rate in games compared to practices.

Every one of the 37 concussions involved player-to-player contact, and more than half (19) of those involved "secondary contact with the boards." Additionally, 16 of the 37 concussions suffered involved "illegal contact resulting in a penalty," according to the authors. That finding "supports the need for more stringent enforcement of penalties for illegal contact in youth ice hockey to mitigate this behavior, especially when involving a player's head," they concluded.

The study authors found a higher concussion-incidence rate among the 12- to 14-year-old age group compared to the 15- to 18-year-old age group, as 16 concussions occurred during 5,638 athletic exposures for the former versus 21 concussions during 17,731 athletic exposures for the latter. The concussion incidence rate for the 12- to 14-year-olds across games and practices was 2.84 per 1,000 athletic exposures, compared to 1.18 per 1,000 for the 15- to 18-year-olds. This finding actually differs from other sports, which often feature higher concussion incidence rates among older athletes, perhaps due to physiological changes across age groups. The study authors surmise that "the disparity in size, strength, and speed across boys at this time" may be responsible for the higher concussion risk in early adolescence.

They noted a small sample size as a limitation of the study, acknowledging the need for future research to "investigate further the possible risk factors for discrepancies in concussion rates, such as checking policies and illegal contact." Until such research takes place, however, the authors noted one possible change for youth ice hockey leagues to consider.

"To avoid illegal and aggressive or risky play, the most recent policy from the American Academy of Pediatrics Council on Sports Medicine and Fitness suggests delaying introduction of checking until age 15," they wrote. "Youth leagues that permit body checking have higher concussion rates than those [that] do not, and a rule change to prohibit body checking was shown to decrease the incidence of concussion after two years."


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