Earlier this year, Carolyn Emery and colleagues published a systematic review and meta-analysis of risk factors for injury and severe injury in youth ice hockey in Injury Prevention. They found that body checking was identified as a significant risk factor for all injuries (summary rate ratio: 2.45; 95% CI 1.7 to 3.6) and concussion (summary odds ratio: 1.71; 95% CI 1.2 to 2.44). They suggested an intervention delaying body checking to older age groups and to only the most elite levels, but called for further investigation.

Taking their own advice to heart, they have now published a prospective cohort study looking at risk of injury and concussion for Pee Wee (ages 11-12 years) ice hockey players in a league where body checking is permitted as compared to a league in which body checking is not permitted. They found triple the risk of game-related injuries and concussions in the league where body checking was permitted.

About 900,000 children and teenagers play ice hockey through Hockey Canada and USA Hockey. The American Academy of Pediatrics recommends checking not be allowed in youth hockey for children 15 and under, but the practice continues. It remains a very controversial issue in the youth ice hockey community, and these findings should serve to both focus and guide the debate.