Brain Injuries Rise Sharply in Minor League Hockey

Minor league hockey players are more than 10 times likely to suffer a brain injury since body checking was first allowed among the 9- and 10-year olds, according to a study led by Michael Cusimano, MD, a neurosurgeon at St. Michael’s Hospital neurosurgeon in Toronto.

The findings, published online in the journal Open Medicine, add to the growing evidence that body checking holds greater risk than benefit for youth and support widespread calls to ban the practice.

According to the researchers, led by Cusimano, director of the Injury Prevention Research Centre at St. Michael’s, the odds of visiting an emergency department due to a brain injury from body checking increased significantly among all minor hockey players after Hockey Canada relaxed body checking rules in the 1998/1999 season. At that time, the organization allowed, for the first time, body contact among 9- and 10-year olds in the Atom division.

The team examined the records of 8,552 male youth 6-17 years old who attended one of five emergency departments in Ontario for hockey-related injuries that occurred before and after the rule change. Researchers found more than half of hockey-related injuries were a result of body checking. What’s more, the risk of a head or neck injury, including concussions, increased across all minor hockey divisions.

“Our work confirmed the fact that body checking is the most common cause of injury in hockey. While proponents argue lowering the age for body checking helps players learn how to properly body check and reduces injuries at older ages, our study clearly showed the opposite―the risk of all injuries and especially, brain injuries, increases with exposure to body checking,” Cusimano said in a statement.

“While all age groups showed increases in injuries, the youngest were the most vulnerable and that body checking puts youth unnecessarily at the risk of the long-term effects of brain injuries, such as cognitive and social-behavioral problems.”

For some time, researchers like Dr. Cusimano have called on organizations like the National Hockey League (NHL) to take more leadership in reducing the incidence of brain injuries. In recent weeks, pressure has mounted on the NHL after Sidney Crosby of the Pittsburgh Penguins and Max Pacioretty of the Montreal Canadiens suffered serious concussions that sidelined both players.

“Ice hockey is a sport with great potential to increase the health of individuals, but practices that increase the risk for the vast majority of players must be minimized,” Cusimano said.

“It is now very clear that there is no benefit to any one or any group to continue to allow body checking. Hockey organizers, sponsors, the media, coaches, trainers, and players and parents must come together to advocate for multifaceted approaches that include changes to the rules to reduce the risk of injury.”