Key result
The abrupt cessation of play and altered seasons due to COVID-19 significantly increased the incidence of upper body injuries in the 2020-21 (IRR 1.70) and 2021-22 (IRR 1.40) NHL seasons compared to pre-pandemic levels.
Why the study?
Returning to play after an abrupt cessation of activity is a known risk factor, but differences in NHL injury and illness occurrence and severity between pre-pandemic and post-pandemic seasons were not established.
Does an abrupt cessation of play due to the COVID-19 pandemic increase the incidence and severity of injuries and illnesses in NHL players?
Cohort (n=1,872)
Does an abrupt cessation of play due to the COVID-19 pandemic increase the incidence and severity of injuries and illnesses in NHL players?
The abrupt cessation of play due to the COVID-19 pandemic was associated with an increased incidence of upper body injuries and greater injury severity in subsequent NHL seasons.
Answers are grounded in this paper and cite their sources.
May warrant targeted upper body injury prevention after prolonged breaks in NHL; leaves open causality and generalizability to other sports.
Background: The National Hockey League (NHL) saw an unprecedented disruption to the competitive calendar due to the COVID-19 pandemic in March of 2020. Returning to play following an abrupt cessation of activity is a known risk factor for athletes. Purpose: To analyze the occurrence and severity of events (injury and illness) in the NHL and to understand any differences in occurrence and severity between pre-pandemic seasons and seasons that immediately followed. Study Design: Descriptive Epidemiology Study. Methods: Using a retrospective cohort inclusive of all players on active rosters in the NHL between 2016-2023, public access injury and illness data were collected. Outcome measures included event incidence, period prevalence, and severity (mean days lost; MDL), as well as incidence rate ratio (IRR) comparing pre- and post-pandemic seasons. Results: IRR for illness peaked in December 2021 (IRR = 62.46; 95% CI 13.65 to 285.91). Incidence of upper body injuries was significantly higher in 2020-21 (IRR = 1.70, p = 0.001) and 2021-22 (IRR = 1.40, p = 0.044) compared to pre-pandemic seasons (Incidence = 17.58 injuries / 1000 player-hours). Injury incidence increased as the 2022-23 season progressed (p = 0.004); injury incidence was stable across all other seasons. Mean days lost (MDL) to injury was higher in 2020-21 (MDL = 18.12, p < 0.001), 2021-22 (MDL = 18.46, p = 0.015), and 2022-23 (MDL = 18.12, p < 0.001) compared to pre-pandemic seasons (MDL = 17.34). Conclusion: Incidence of upper body injuries increased in the 2020-21 and 2021-22 NHL regular seasons while it decreased significantly in the 2022-23 regular season compared with the four pre-pandemic seasons. This suggests a need to examine if modifiable risk factors exist for determining optimal return to play strategies following an abrupt cessation of play. Level of Evidence: 3.
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Pinkoski et al. (2024) conducted a cohort in Injury and illness (n=1,872). Abrupt cessation of play and altered seasons due to COVID-19 vs. Pre-pandemic seasons (2016-2020) was evaluated on Incidence of upper body injuries (2020-21 season vs pre-pandemic) (IRR 1.70, 95% CI 1.23-2.36, p=0.001). The abrupt cessation of play and altered seasons due to COVID-19 significantly increased the incidence of upper body injuries in the 2020-21 (IRR 1.70) and 2021-22 (IRR 1.40) NHL seasons compared to pre-pandemic levels.
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