Physical Contact and Suspected Injury Rates in Female versus Male Youth Ice Hockey: A Video-Analysis Study.

OBJECTIVE: Canada's national winter sport of ice hockey has high youth participation; however, research surrounding female ice hockey is limited and the injury burden remains high. This study compared rates of head contact (HC), body checking (BC; high-intensity player-to-player contact), and suspected concussion between female and male youth ice hockey. DESIGN: Cross-sectional. SETTING: Game video-recordings captured in Calgary, Canada. PARTICIPANTS: Ten female (BC prohibited) and 10 male (BC permitted) U15 elite AA (13-14-year-old) game video-recordings collected in the 2021 to 22 seasons and 2020 to 21, respectively. ASSESSMENT OF RISK FACTORS: An analysis of player-to-player physical contact and injury mechanisms using video-analysis. MAIN OUTCOME MEASURES: Videos were analyzed in Dartfish video-analysis software and all physical contacts were coded based on validated criteria, including HCs (direct [HC1], indirect [HC2]), BC (levels 4-5 on a 5-point intensity scale), and video-identified suspected concussions. Univariate Poisson regression clustering by team-game offset by game-length (minutes) were used to estimate incidence rates and incidence rate ratios (IRR, 95% confidence intervals). RESULTS: The female game had a 13% lower rate of total physical contacts (IRR = 0.87, 0.79-0.96) and 70% lower rate of BC (IRR = 0.30, 0.23-0.39). There were however no differences in the rates of direct HC (IRR = 1.04, 0.77-1.42) or suspected concussion (IRR = 0.42, 0.12-1.42) between the cohorts. Although prohibited in the female game, only 5.4% of HC1s and 18.6% of BC resulted in a penalty. CONCLUSIONS: The rates of HC1s and suspected concussions were similar across youth ice hockey. BC rates were lower in the female game, yet still prevalent despite being prohibited.

Higher Rates of Head Contacts, Body Checking, and Suspected Injuries in Ringette Than Female Ice Hockey: Time to Ring in Opportunities for Prevention.

OBJECTIVE: Ringette and female ice hockey are high participation sports in Canada. Despite policies disallowing body checking, both sports have high injury and concussion rates. This study aimed to compare physical contact (PC), head contact (HC), and suspected injury and concussion incidence rates (IRs) in female varsity ringette and ice hockey. DESIGN: Cross-sectional. SETTING: Canadian ice arenas. PARTICIPANTS: Eighteen Canadian female university ringette and ice hockey tournament/playoff games in the 2018-2019/2019-2020 seasons. ASSESSMENT OF RISK FACTORS: Game video-recordings were analyzed using Dartfish video-analysis software to compare both sports. MAIN OUTCOME MEASURES: Univariate Poisson regression analyses (adjusted for cluster by team, offset by game-minutes) were used to estimate PC, HC, and suspected injury IRs and incidence rate ratios (IRRs) to compare rates across sports. Proportions of body checks (level 4-5 trunk PC) and direct HC (HC 1 ) penalized were reported. RESULTS: Analyses of 36 team-games (n = 18 ringette, n = 18 hockey) revealed a 19% lower rate of PCs in ringette than ice hockey {IRR = 0.81 [95% confidence interval (CI), 0.73-0.90]}, but a 98% higher rate of body checking [IRR = 1.98 (95% CI, 1.27-3.09)] compared to ice hockey. Ringette had a 40% higher rate of all HC 1 s [IRR = 1.40 (95% CI, 1.00-1.96)] and a 3-fold higher rate of suspected injury [IRR = 3.11 (95% CI, 1.13-8.60)] than ice hockey. The proportion of penalized body checks and HC 1 s were low across sports. CONCLUSIONS: Body checking and HC 1 rates were significantly higher in ringette compared to ice hockey, despite rules disallowing both, and very few were penalized. These findings will inform future injury prevention research in ringette and female ice hockey.

High Injury and Concussion Rates in Female Youth Team Sport: An Opportunity for Prevention.

The aim of this study was to investigate sport-related injury rates, types, locations, and mechanisms in female youth team sports. This was a secondary analysis of a cross-sectional study. An anonymous online survey was administered to high school students (ages 14-19) in Alberta, Canada. The survey included questions regarding demographic information, sport participation and self-reported injuries sustained in the past year. Results were analyzed for girls who reported playing a top ten team sports for female participation. For girls participating in team sports, the overall injury rate was 55.5 injuries/100 participants/year. The rate of at least one concussion was 9.4 concussions/100 participants/year. Injury and concussion rates were highest in ringette (Injury rate=42.9 injuries/100 participants/year, Concussion rate=19.0 concussions/100 participants/year) and rugby (Injury rate=40.0, Concussion rate=15.3). The top three most serious injury locations were the knee (24.7%), ankle (21.6%) and head (16.1%). The most common injury types were joint/ligament sprain (26.71%), fracture (13.0%) and concussion (11.8%). Contact mechanisms accounted for 73.4% of all serious injuries reported in girls team sports. Team sport injury rates are high in female youth team sports. Specific consideration of sport-specific injury rates, types and mechanisms in girls' team sports will inform development and evaluation of targeted sport-specific prevention strategies.

The Epidemiology of Youth Sport-Related Shoulder Injuries: A Systematic Review.

Background: Youth around the globe place their shoulders at risk for injury when participating in sports. Shoulder injuries may vary in severity, produce the potential for time-loss from sport, and result in functional disability. We sought to explore sport-related shoulder injuries in youth by identifying injury rates, risk factors, injury mechanisms, and injury prevention strategies. Methods: All relevant full-text articles were identified by searching MEDLINE, EMBASE, CINAHL, Sport Discus, and the Cochrane Controlled Trials Registry. No date restrictions were used. All full-text studies reporting original research describing sport-related shoulder injury among female and/or male youth from 5 to 18 years old were included. Results: Of 3,889 studies screened, 97 described shoulder injury in youth sports. Shoulder injuries were identified in 24 unique sports. The median seasonal prevalence of shoulder injury was 10.9% (range 1.2-28.2%). The most common injury mechanisms identified were contacted with another player, contact with the playing environment, and falling to the ground. Risk factors for shoulder injury identified were side-to-side strength imbalances, weak external rotator muscles, and scapular dyskinesia. One study evaluated a successful training strategy to prevent shoulder injuries, but two other interventions demonstrated no effect. Conclusions: Sport-related shoulder injuries are prevalent among youth athletes. Injury risk factors identified included modifiable intrinsic factors such as strength, range of motion, and training load. The most common injury mechanism was direct contact with either another person or an object in the playing environment. Innovative shoulder-specific strategies are needed to reduce shoulder injuries in this population. Trial Registration: PROSPERO ID: CRD42020189142.