Checking the rules: Comparing bodychecking, head contact, and injury risk across adolescent girls', boys’, and para ice sports in Canada

Objective To compare incidence rates (IR) of bodychecking (BC), head contacts (HC), and suspected injuries across Canadian adolescent ice sports (girls' ice hockey, ringette, boys’ ice hockey, and para ice hockey) via a cross-sectional video-analysis study. Methods Video-recordings were obtained from 144 games played between 2008 and 2022 (2021–2022 for ringette, girls', and para ice hockey; 2008–2021 for boys’ ice hockey) in Canadian arenas. Video-recordings were analyzed using Dartfish video-analysis software to compare all ice sports. Univariate Poisson regression analyses (adjusted for cluster by team, offset by game-minutes) were used to estimate BC, HC, and suspected injury IRs and incidence rate ratios (IRRs) to compare rates across sports. Proportions of BCs and direct HC (HC 1 ) penalized were reported. Results Compared with non-elite non-BC boys' ice hockey, there were significantly higher rates of BC in non-BC girls' ice hockey (IRR = 2.67, 95%CI: 1.82–3.90), non-BC ringette (IRR = 5.72, 95%CI: 4.03–8.11), and BC-permitted boys' ice hockey (IRR elite = 9.15, 95%CI: 6.63–12.64; IRR non-elite = 5.89, 95%CI: 4.07–8.53). HC rates were significantly higher for non-BC girls' ice hockey (IRR = 2.76, 95%CI: 2.05–3.71), non-BC ringette (IRR = 4.06, 95%CI: 3.02–5.46), and BC-permitted boys’ ice hockey (IRR elite = 3.18, 95%CI: 2.41–4.18; IRR non-elite = 2.64, 95%CI: 1.92–3.62). Para ice hockey did not significantly differ for both BC and HC. The proportions of player-to-player HCs penalized ranged from 0 to 20% across sports. Conclusions The high rates of BC are concerning in ice sports prohibiting BC (ringette and girls’ ice hockey). The low proportion of penalized HCs across all ice sports suggests a need for improved policy enforcement to prevent injuries and concussions.