684 FO39 – Skating on the edge of risk for female adolescent ice hockey players: a 5-year canadian longitudinal cohort study

Background Ice hockey is a popular global sport with growing participation for boys and girls yet remains a high-risk injury sport. While evidence for risk factors including bodychecking policy have been well established, others such as sex and concussion history have been understudied to date. Objective To examine factors associated with game and practice-related injury rates in Canadian adolescent (ages 11–17) ice hockey. Design Prospective cohort (2013–2018). Setting Community ice hockey arenas. Participants 4418 male and female ice hockey players from all levels of play (6584 player-seasons) participating in under-13 (ages 11–12), under-15 (ages 13–14), and under-18 (ages 15–17) age groups. Assessment of Risk Factors Multilevel Poisson regression (adjusting for cluster by team and including multiple imputation for missing covariates) was used to estimate incidence rate ratios (IRRs) for sex, age group, bodychecking policy, year of play, level of play, weight, previous injury within last 12 months, lifetime concussion history, and position. Main Outcome Measurements All injuries (medical attention, inability to complete session, time-loss from playing) were identified using validated injury surveillance methodology. Results There were 1184 game-related and 182 practice-related injuries. Factors associated with game-related injury included female sex (IRR=1.57,95%CI; 1.18–2.08), previous injury (IRR=1.46,95%CI; 1.26–1.70), and lifetime concussion history (IRR=1.41,95%CI; 1.23–1.62). Goaltenders were protected (IRR=0.54,95%CI; 0.40–0.72) relative to forwards, as were players exposed to policy disallowing bodychecking in games (IRR=0.44,95%CI; 0.35–0.55). Female sex (IRR=1.90,95%CI; 1.10–3.28) and lifetime concussion history were also significantly associated with practice-related injury (IRR=1.53,95%CI; 1.08–2.18). Conclusions Several factors associated with injury rates in youth ice hockey were identified. In addition to a 56% lower rate of game-related injury in non-bodychecking leagues, girls and players with previous injury and concussion history experience the highest rates of injury. Future research examining female-specific injury prevention strategies in youth ice hockey is a priority.