Dryden DM, Francescutti LH, Rowe BH, Spence JC, Voaklander DC. Epidemiology of women's recreational ice hockey injuries. Med Sci Sports Exerc 2000;32:1378–1383.
ObjectiveWomen's Recreational Ice Hockey Injuries
To examine the incidence and nature of injuries in female recreational ice hockey players.
DesignWomen's Recreational Ice Hockey Injuries
Cohort study for the duration of the 1997 to 1998 ice hockey season.
SettingWomen's Recreational Ice Hockey Injuries
Women's ice hockey leagues, Edmonton, Canada.
ParticipantsWomen's Recreational Ice Hockey Injuries
Participants were recruited from all the teams in the 2 women's ice hockey leagues, which represented ¬90% of the area's women's recreational ice hockey players. The study included 314 players from 33 teams (74% of the players). Players were subdivided into women in adult teams (adult women's recreational teams [AWRT]), n = 236, mean age 27 years) and midget teams (≤18 years of age, n = 78, mean age 14.7 years).
Assessment of risk factorsWomen's Recreational Ice Hockey Injuries
Players were recruited in the dressing room immediately after the first game of the season. Information on anthropomorphic, demographic, and lifestyle characteristics and history of injuries was obtained. Telephone interviewers collected game participation and injury data monthly.
Main outcome measuresWomen's Recreational Ice Hockey Injuries
Injuries were defined as any acute injury sustained while playing women's ice hockey during any game or practice that resulted in the women missing the remainder of the game or practice, a subsequent game or practice, and/or required the women to consult a health professional. Diagnoses were self-reported or obtained from the health professional consulted. Injury rates were calculated as number of injuries divided by the sum of the players' reported game and practice attendances.
Main resultsWomen's Recreational Ice Hockey Injuries
102 players reported 125 injuries during the season (7.5 injuries/ 1,000 player exposures [PE]). Among the AWRT there were 93 injuries (7.8 injuries/1,000 PE) compared with 32 injuries to midget players (6.7 injuries/1,000 PE). For all players the lower extremity was most frequently injured (AWRT, 28% of injuries and midget, 41%) followed by injuries to the upper extremity, the torso, and the head/neck/face (29% and 22%; 25% and 31%; and 18% and 6%, for AWRT and midget, respectively). Overall the most frequently injured sites were the lower back (14%), the knee (12%), and the shoulder (10%). The predominant injury diagnosis for AWRT players was sprain/strain (57%) and for midget players was contusion (50%). The dominant mechanism of injury was player contact from collisions or body checks (40%). These were similar for AWRT and midget players. 66% of injuries occurred during league games, 27% during play-off, tournament, and exhibition games, and 7% during practices. The greatest proportion of injuries (44%) occurred during the third period of games. Medical attention was not sought for 36% of injuries. 1 player was hospitalized for a meniscal tear. 18% of injuries resulted in an absence from hockey of (≥8 days.
ConclusionWomen's Recreational Ice Hockey Injuries
Both adult and young women playing recreational ice hockey are at risk for injury, more so during games than practices.
Source of funding: Royal Alexandra Hospital Foundation, Alberta.
For article reprint: Dr. Don Voaklander, Department of Rural Health, University of Melbourne, PO Box 6500, Shepparton, Victoria 3632, Australia.
CommentaryWomen's Recreational Ice Hockey Injuries
The study by Dryden et al. was designed to be able to compare injury rates in a recreational women's hockey league with a similar study of a men's recreational league. 1 Schick et al., 2 in a study of Canada West Universities Athletic Association (CWUAA) teams, found an injury rate similar to Dryden and also compared females with males. In their larger study (33 versus 12 teams), Dryden et al. concluded that the injury rate was lower in the women's league (7.5 injuries/1,000 PE overall) than in the men's league (12.2 injuries/1,000 PE). However, Schick did not find a significant difference although there were fewer injuries on the women's teams (7.77 injuries/1,000 PE) than the men's teams (9.19 injuries/1,000 PE). The results may differ because Schick investigated more highly competitive teams than did Dryden.
The most common female injuries (>80%) in the recreational league were sprains, strains, and contusions, whereas concussion was the most common injury in the CWUAA. Injuries resulting from contact were the most common injuries in both cases. Body checking is not allowed at any level of women's hockey but there is contact with boards, ice, an opponent, sticks, etc. The high incidence of concussion in CWUAA women's hockey raises concern, but generalization to women's hockey in the United States may not be possible because equipment requirements differ in the two countries. Since studies in boxing have shown a reduction in concussions by the use of mouth guards, they have become mandatory for women hockey players in the U.S.A. Neck guards to reduce serious lacerations are mandatory in Canada. Both studies noted a higher incidence of low back injuries in women than in men, which deserves further study. As in studies on men, injuries seem to be more common in games versus practices, early season or league versus late season or play-offs, and late in the game versus early. Understanding the epidemiology of hockey injuries should spur future research in the direction of injury prevention.