Journal: Injury
Title: Pediatric Ice Hockey Injury Trends Presenting to U.S. Emergency Departments: A 10-Year Review of National Injury Data
Authors: Luca M. Valdivia, MS, MD Candidate at the Icahn School of Medicine at Mount Sinai
Sheena Ranade, MD, Associate Professor of Orthopedics, and Pediatrics, at the Icahn School of Medicine at Mount Sinai
Bottom line: This study analyzes pediatric ice hockey injuries in emergency departments throughout the United States, finding a post-pandemic rise in head and shoulder injuries as well as hospitalizations.
Why this study is unique: This is the first study of its kind to assess these trends using recent National Electronic Injury Surveillance System (NEISS) data through 2023.
Why the study is important: This research highlights emerging injury patterns in youth ice hockey, specifically a rise in serious head and shoulder injuries after the pandemic. Understanding these trends can inform safer equipment standards, improve injury prevention strategies, and guide policy changes to better protect young athletes.
How the research was conducted: This research was conducted using data from NEISS, a publicly available, nationally representative database operated by the U.S. Consumer Product Safety Commission which collects injury data from a sample of approximately 100 hospitals with 24-hour emergency departments, allowing for the estimation of injury patterns across the United States. Data were collected for all ice hockey-related injuries in the pediatric (under 18 years) population between January 1, 2014, and December 31, 2023.
Results: These findings show that while overall injury rates in pediatric ice hockey have remained steady, several interesting post-pandemic trends emerged. Firstly, the data shows an increase in injuries among female youth hockey players since 2020, potentially attributed to the rise in popularity and accessibility of women's ice hockey in recent years. Additionally, the data shows a rise in head and shoulder trauma for youth hockey players since 2020, as well as a rise in fractures, particularly to the upper extremities. The hospitalization rate from these injuries has also increased post-pandemic which may reflect a rise in more serious injuries, such as fractures or head trauma, or it could be due to changes in injury management practices with more severe injuries requiring hospital stays for better care. Hospitalization trends may also be influenced by the increase in high-energy injuries, as seen in the rising frequency of shoulder and head trauma. Increased violence in teenage hockey, possibly due to a shift toward more aggressive play, might also be contributing to these higher rates of hospitalization.
What this study means for doctors: This research emphasizes the importance of thorough concussion assessments, injury documentation, and awareness of rising injury severity post-pandemic. The findings suggest clinicians should continue to play a key role in educating families about proper equipment use and return-to-play protocols. Additionally, as youth hockey becomes more competitive and aggressive, further investigation into the long-term effects of these severe injuries on young athletes is essential.
What this study means for patients: This study could impact youth hockey by influencing safety guidelines, encouraging better protective equipment standards, and informing rule changes to reduce high-risk play. It may also guide future research and help health care providers, coaches, and parents make more informed decisions to protect young athletes from serious injury.
What the next steps are for this work: Next steps include conducting additional studies which track injuries with more detailed exposure data such as hours played, position, and level of play. Researchers may then evaluate the effectiveness of specific safety interventions and examine the long-term consequences of these injuries in youth athletes.
Quotes:
"Our hope with this paper is to draw attention to the types of injuries that occur in hockey and highlight the importance of well-fitting gear to prevent such injuries," says Dr. Ranade.
"Our study highlights critical trends in pediatric ice hockey injuries across a decade of national emergency department data, with a concerning rise in head and shoulder trauma after 2020. As youth participation in hockey grows, so too does the responsibility to protect these athletes through improved safety equipment and education. These findings underscore the urgent need for targeted injury prevention strategies to keep the sport both competitive and safe for developing players," says Mr. Valdivia.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with 48,000 employees working across seven hospitals, more than 400 outpatient practices, more than 600 research and clinical labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time—discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes approximately 9,000 primary and specialty care physicians and 11 free-standing joint-venture centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida. Hospitals within the System are consistently ranked by Newsweek's® "The World's Best Smart Hospitals, Best in State Hospitals, World Best Hospitals and Best Specialty Hospitals" and by U.S. News & World Report's® "Best Hospitals" and "Best Children's Hospitals." The Mount Sinai Hospital is on the U.S. News & World Report® "Best Hospitals" Honor Roll for 2024-2025.
