Head-impact mechanisms in men's and women's collegiate ice hockey

Context: Concussion injury rates in men's and women's ice hockey are reported to be among the highest of all collegiate sports. Quantification of the frequency of head impacts and the magnitude of head acceleration as a function of the different impact mechanisms (eg, head contact with the ice) that occur in ice hockey could provide a better understanding of this high injury rate.

Objective: To quantify and compare the per-game frequency and magnitude of head impacts associated with various impact mechanisms in men's and women's collegiate ice hockey players.

Design: Cohort study.

Setting: Collegiate ice hockey rink.

Patients or other participants: Twenty-three men and 31 women from 2 National Collegiate Athletic Association Division I ice hockey teams.

Main outcome measure(s): We analyzed magnitude and frequency (per game) of head impacts per player among impact mechanisms and between sexes using generalized mixed linear models and generalized estimating equations to account for repeated measures within players.

Intervention(s): Participants wore helmets instrumented with accelerometers to allow us to collect biomechanical measures of head impacts sustained during play. Video footage from 53 games was synchronized with the biomechanical data. Head impacts were classified into 8 categories: contact with another player; the ice, boards or glass, stick, puck, or goal; indirect contact; and contact from celebrating.

Results: For men and women, contact with another player was the most frequent impact mechanism, and contact with the ice generated the greatest-magnitude head accelerations. The men had higher per-game frequencies of head impacts from contact with another player and contact with the boards than did the women (P < .001), and these impacts were greater in peak rotational acceleration (P = .027).

Conclusions: Identifying the impact mechanisms in collegiate ice hockey that result in frequent and high-magnitude head impacts will provide us with data that may improve our understanding of the high rate of concussion in the sport and inform injury-prevention strategies.