Factors associated with significant injuries in youth ice hockey players

Study objective: To assess the implementation of published injury prevention strategies in injured youth ice hockey players, to examine factors contributing to current youth ice hockey injuries, and to assess attitudes of participants toward injury-risk activities. Methods: Case series describing a convenience sample of 103 children presenting to a children's hospital emergency department with an injury sustained playing youth ice hockey. Using a questionnaire, patients self-reported their compliance with protective equipment guidelines, the circumstances of injury, and their attitudes toward risk-taking in youth ice hockey. Results: A total of 103 patients suffered 113 injuries. For each piece of required equipment, compliance approached 100%, penalties were assigned on 4% of plays causing injury. An additional 36% of patients injured during game play felt that a penalty should have been assigned. Fifty-seven percent of injuries were caused by checking. Fifty-eight percent of injuries caused by checking met our criteria for significant injury. Significant injury was more likely when initiating or receiving a check perceived to be legal than when receiving a check perceived as illegal (P = 0.032). Twenty-four percent of patients stated spinal cord injury and 45% stated brain injury was not possible given their usual protective equipment, To win, 32% of patients stated that they would check illegally, and 6% stated that they would purposely injure. Conclusion: While compliance with protective-equipment requirements was good, rule enforcement was perceived to be inadequate. Elimination of checking would potentially reduce the number of significant injuries more than would the enforcement of existing rules. Injured youth hockey players are under-informed about the hazards of their sport and are too willing to engage in potentially injurious activities.