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A Systematic Review of the Association Between Body Checking and Injury in Youth Ice Hockey

Warsh, Joel M BSc(Hons)*; Constantin, Şerban A BSc*; Howard, Andrew MD, MSc; Macpherson, Alison PhD*

Clinical Journal of Sport Medicine: March 2009 - Volume 19 - Issue 2 - p 134-144
doi: 10.1097/JSM.0b013e3181987783
Critical Review

Objective: The objective of this study is to systematically examine the risk of injury associated with body checking in youth ice hockey.

Data Sources: A systematic review of the relevant electronic databases was conducted including PubMed and Web of Science. The main search terms included “hockey, ice hockey, injury, body checking, child, adolescent, and pediatric.”

Study Selection: The initial search identified 898 potential articles, and, after verifying inclusion criteria, 260 articles were selected for further assessment. The Downs and Black instrument for nonrandomized studies (Downs 1998) was used to assess the quality of the articles.

Data Extraction: Studies included reported on body checking as a mechanism of injury and compared injury rates in checking to non-checking leagues in children 20 years or younger.

Data Synthesis: Twenty studies met the inclusion criteria and they predominantly found increased injuries associated with body checking. The relative risk of injury associated with body checking in comparative studies ranged from 0.6 to 39.8. Checking was the reported mechanism of injury between 2.9% and 91% of injuries. All but 1 study that met our inclusion criteria found an increased risk of injuries when body checking was permitted.

Conclusions: Increased injuries attributable to checking were found where checking was allowed. This study supports policies that disallow body checking to reduce injuries in young children.

From the *School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; and †Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.

Submitted for publication June 10, 2008; accepted December 10, 2008.

The authors state that they have no financial interest in the products mentioned within this article.

Reprints: Joel Warsh, Bsc(Hons), MSc Candidate, c/o Alison Macpherson, PhD, School of Kinesiology and Health Science, 337 Bethune College, York University, 4700 Keele St, Toronto, ON M3J IP3, Canada (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.