Hopkins PodBlog

Is body checking absolutely fundamental to ice hockey? No doubt ice hockey fans would roar a resounding yes! but a study in this week's JAMA illustrates just how dangerous body checking is for neophyte hockey players in Canada.

Turns out Canada has some fascinating social experiments percolating, and this is one of them: in the province Alberta, body checking is allowed among PeeWee hockey players. Those are players 11-12 years old. In Quebec province, this practice is forbidden. Researchers crunched data from the top 60% of divisions of play for the 2007-2008 ice hockey season for both leagues, representing close to 2200 players.

The data show that when Alberta players were compared with Quebecoise, the former were at a three fold higher risk for concussion, severe injury, and severe concussion. There was no difference in rates of injury for the two study groups experienced during practice, when presumably, players aren't body checking each other with a view to a kill.

Risk factors for more frequent injury included smaller body size and hours of play, while severe concussion was associated with position played and the player's attitude toward the practice of body checking. Clearly the take home conclusion is that if we want to reduce injuries, some of them severe, to young hockey players body checking should not be allowed. It's unclear to me why body checking is necessary at all at any level of play, but I guess hockey fans are a bloodthirsty lot, and as Rick quips in the podcast, "I went to a boxing match and a hockey game broke out," perhaps it is expected.

This study is published at a time when concussions experienced while playing sports are receiving a lot of media attention. A week ago I attended an NFL/Johns Hopkins conference on 'mild traumatic brain injury,' or concussion, sponsored by the NFL. The central question is what is the risk of repeated injury on the subsequent development of dementia or other health problems later in life? Other questions identified during the conference included ways to assess severity of injury, appropriate recuperation periods before returning to play, and others. A dearth of evidence is apparent, as is the need for considerable research to convincingly answer these questions. But here's one thought that occurs to me: professional football players choose to play football, but PeeWee hockey players are not in a position to assess evidence and make informed decisions, and therefore protective measures must be undertaken by coaches and parents. If we're worried about the deleterious health impact of head injury in adults, what are the consequences in children?

Other topics this week include a new use for an old drug: allopurinol and angina in the Lancet, nonsteroidal antiinflammatory drugs and cardiovascular risk in Circulation, Cardiovascular Quality Outcomes, and abuse of prescription medications in US teenagers from the CDC. Check out our YouTube, and until next week, y'all live well.