Inj Prev 16:113-118 doi:10.1136/ip.2009.022764
  • Systematic review

Risk factors for injury and severe injury in youth ice hockey: a systematic review of the literature

  1. McKay Carly2
  1. 1University of Calgary, Canada
  2. 2University of Western Ontario, Canada
  1. Correspondence to Carolyn A Emery, Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta T2N1N4 Canada; caemery{at}
  1. Contributors I acknowledge that I had full access to all the data in this study and take responsibility for the integrity of the data and the accuracy of the data analysis. My co-authors have all reviewed and been suitability involved to also take responsibility for this work.

  • Accepted 28 October 2009


Objective To identify risk factors for injury in youth ice hockey (ie, body checking, age, player position, player experience and level of play).

Study design Systematic review and meta-analysis.

Methods A systematic review of the literature, including a meta-analysis component was completed. Ten electronic databases and the American Society for Testing and Materials Safety in Ice Hockey series (volumes 1–4) were systematically searched with strict inclusion and exclusion criteria to identify articles examining risk factors for injury in youth ice hockey.

Results Participation in games, compared with practices, was associated with an increased risk of injury in all studies examined. Age, level of play and player position produced inconsistent findings. Body checking was identified as a significant risk factor for all injuries (summary rate ratio: 2.45; 95% CI 1.7 to 3.6) and concussion (summary odds ratio: 1.71; 95% CI 1.2 to 2.44).

Conclusions Findings regarding most risk factors for injury remain inconclusive; however, body checking was found to be associated with an increased risk of injury. Policy implications regarding delaying body checking to older age groups and to only the most elite levels requires further rigorous investigation.


  • Funding Dr Emery and Dr Hagel are supported by a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research. Dr Emery also holds and a New Investigator Award from the Canadian Institutes of Health Research and a Professorship in Paediatric Rehabilitation funded through the Alberta Children's Hospital Foundation. Dr Hagel holds a Professorship in Child Health and Wellness funded by the Alberta Children's Hospital Foundation, through the support of an anonymous donor and Canadian National Railway Company. Melissa Decloe's MSc was supported by the Social Sciences and Humanities Research Council of Canada (SSHRCC), a Department of Paediatrics Child Health Research Group Scholarship and the Joanne A. Vincenten Scholarship from the Alberta Centre for Injury Control. Carly McKay is supported by SSHRCC.

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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