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Update and Overview of Spinal Injuries in Canadian Ice Hockey, 1943 to 2011: The Continuing Need for Injury Prevention and Education

Tator, Charles H. MD, PhD; Provvidenza, Christine MSc; Cassidy, J. David PhD, DrMedSc

Clinical Journal of Sport Medicine: May 2016 - Volume 26 - Issue 3 - p 232–238
doi: 10.1097/JSM.0000000000000232
Original Research

Objective: To identify spinal injuries in Canadian ice hockey from 2006 to 2011 and to discuss data from 1943 to 2011 and impact of injury prevention programs.

Design: Data about spinal injuries with and without spinal cord injury in ice hockey have been collected by ThinkFirst's (now Parachute Canada) Canadian Ice Hockey Spinal Injuries Registry since 1981 through questionnaires from practitioners, ice hockey organizations, and media.

Setting: All Canadian provinces and territories.

Participants: All registered Canadian ice hockey players.

Assessment of Risk Factors: Age, gender, level of play, location, mechanism of injury.

Main Outcome Measures: Incidence, incidence rate, prevalence, and nature (morbidity) of the injuries.

Results: Between 2006 and 2011, 44 cases occurred, 4 (9.1%) of which were severe. The incidence in the recent years continues to be lower than the peak years. From 1943 to 2011, 355 cases have been documented, primarily males (97.7%) and cervical spine injuries (78.9%), resulting from impact with the boards (64.2%). Check or push from behind (36.0%) was still the most common cause of injury, although slightly lower during 2006 to 2011. From 1943 to 2011, Prince Edward Island, New Brunswick, and British Columbia/Yukon had the highest injury rates. Ontario and Quebec continued to show markedly different injury rates, with Ontario more than twice that of Quebec.

Conclusions: Current data for 2006 to 2011 indicate that spinal injuries in ice hockey continue to occur, although still at lower rates than the peak years 1982 to 1995. It is imperative to continue educating players and team officials about spinal injury prevention and to reinforce the rules against checking or pushing from behind to reduce the incidence of these serious injuries.

*Canadian Ice Hockey Spinal Injuries Registry, Parachute Canada, Toronto, Ontario, Canada;

Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, Toronto, Ontario, Canada;

University of Toronto, Toronto, Ontario, Canada;

§Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network; and

Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Corresponding Author: Charles H. Tator, MD, PhD, Toronto Western Hospital, Room 4W-422, 399 Bathurst St, Toronto, ON, Canada M5T 2S8 (

The authors report no conflicts of interest.

Received February 12, 2015

Accepted June 09, 2015

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