Concussions In Youth Hockey Researched

The American College of Sports Medicine published a study in the December 2001 issue of its official monthly journal, Medicine & Science in Sports & Exercise that assesses the causes, treatments and other aspects of concussion in hockey in order to make recommendations on prevention. The study results will be useful for the team physician, coach, trainer and parents in working with young hockey players at all levels.

Hockey players move around the ice at amazing speed, said David Goodman, Ph.D., of Simon Fraser University in Burnaby, B.C., who was lead researcher. They hit rigid surfaces and one another at 15 to 30 miles an hour, so it's not surprising that hockey rates among the highest of all contact sports for concussion. Our purpose was to gather information that could lead to reducing concussion incidence and shaping treatment strategy.

The researchers designed a study that would establish a baseline and follow-up method for data collection, based on a three-point grading system for concussion established by the American Academy of Neurology. In addition, players completed a concussion history questionnaire to examine how and why concussions occurred. Four hundred forty players in a 14-team league participated in the study over a two-year period. All the players were male, ages 15 - 20 years. The regular season, spanning six months, consisted of 54 games for each team. Players wore standard hockey pads, helmets with half visors, and mouth guards.

The incidence of concussion over the youths' playing career was high; 379 concussions were reported, with over 60 percent of the layers indicating they had suffered at least one concussion. Player position seemed to affect the incidence; fewer goaltenders reported concussions than did forwards or defensemen. The greatest cause of concussion, whether the player lost consciousness or not, was head striking the boards, including the end glass. Elbow, shoulder or ice contact ran second. Slightly less than a third of the concussion patients were tended by a team physician at the site; 37 percent were transported to a hospital.

The researchers noted that the proportion of players injured in their study compared similarly to the rate of concussion in the National Hockey League between 1984 and 1990. Citing evidence from a study of ice hockey injury rates in Finland, they noted that certain aspects of the North American game may affect the rate at which forwards are injured compared with the other positions. The most enlightening information, however, came in the degree to which illegal plays such as elbowing figured in the rate of concussion. Elbow contact to the jaw or another part of the head caused 20 percent of the concussions reported in one year. These rates are consistent with other information on hockey injuries. Fighting did not account for as many concussions as elbowing by itself.

The researchers conclude that rule changes and rule enforcement should focus on action where a clear intent to injure is evident, and that continued use of a mouth-guard is indicated as it may reduce the proportion and severity of concussion. Finally, they note that the trend toward having a team physician present is very influential in proper assessment of concussion as well as determining when the player should be returned to play.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 18,000 International, National and Regional members are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life.

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