Experts see increased number of youth hockey concussions – Pittsburgh Post-Gazette

A recent study looking at injuries in youth ice hockey, spearheaded by a University of Pittsburgh researcher, came up with some surprising results: The number of collisions among players in youth hockey are typically higher in younger players than older ones, mostly because of the players’ inexperience and difference in body size, strength and development.

Researchers and youth hockey coaches, however, disagree on the best way to reduce the number of these collisions, which can result in concussions and other injuries.

In the study published online Jan. 8 in the journal Pediatrics, Anthony P. Kontos, assistant director of research at the UPMC Sports Concussion Program, followed nearly 400 players associated with youth ice hockey teams in Western Pennsylvania, Boston and Birmingham, Ala.

Because participation in youth hockey has doubled over the past two decades, Mr. Kontos, who holds a Ph.D in kinesiology, wanted to determine the incidence of concussions in relation to games, practice and ages of players on the ice. While research had been done on other sports such as football and hockey, limited data had been recorded on the incidences of injury affecting different age groups in youth hockey.

One of the primary causes of concussions among youth hockey members is “body checking,” when a player comes into contact with an opponent while trying to steal the puck. Some families pull their children out of youth hockey after they turn 13, the age when they are allowed to body check.

After a year of examining concussion data, Mr. Kontos, 46, and his team noticed that the incident rate ratio of concussions from games to practice was comparable to rates in other sports, with most resulting from illegal or accidental contact.

Concussions per exposure occurred about three times as often in games compared to practice. Younger players (e.g. 12- to 14-year-olds) had a higher rate of concussions than older players (15- to 18-year-olds). That differed from sports such as football, where concussion rates increased as children aged.

“Imagine the human head as an egg, where the yolk is the brain, the white is blood and spinal fluid surrounding the brain, and the outer shell is the human skull,” said Mr. Kontos. “When the head is jostled or tackled directly, the action causes brain tissue to move around in the cerebral fluid, bruising against the skull.”

The head trauma initiates an “energy crisis” in the brain, where the organ requires energy at a time when it’s less able to get and use it effectively, he said. Concussions cause temporary loss of mental function, leading to physical and emotional symptoms like confusion, nausea, dizziness and amnesia.

Some youth hockey coaches believe checking should be banned from the sport entirely as a way to protect players from harm.

Bob Arturo, the director of hockey at the Robert Morris University Island Sports Center, on Neville Island, has observed many youth concussions during his 40 years of coaching. He said they usually were attributed to accidents or “finishing the check,” meaning that a player continues to crash into opponents even after they have passed the puck. Mr. Arturo said he has “outright banned checking here at the RMU league because of the damage it causes players over time,” but it is often allowed at other rinks.

Mr. Arturo believes that hockey would be a safer activity if the “finishing the check” practice was removed entirely. “If we can’t ban it, we should at least raise the checking age by a year or two,” he said. Finishing the check, while allowed, can lead to concussions and other types of head trauma.

Beginning with the 2011-12 season, USA Hockey raised the the age for body checking to the Bantam level (ages 13-14) from the Pee-Wee level (ages 11-12). Also, any check to the head or neck is prohibited. Body checking is banned for girls or women of all ages.

Both Mr. Arturo and Mr. Kontos disagree with this regulation being based just on age, however, because of the disparities in puberty and development among boys.

A youth hockey game could have two opponents, both 13, who are at different stages of development: Child A could be 130 pounds, scrawny and lack facial hair; Child B could be two heads taller, 220 pounds and needing to shave daily. Encouraging both of these individuals to body check with each other would be unfair, they said.

Mr. Arturo also suggested that USA Hockey could follow procedures adopted in Canada, which allow an athlete to body check based on skill level instead of age.

“Concussions don’t need a direct hit. They can be caused by a hit in the person’s chest, which causes the brain to move or rotate,” Mr. Kontos said. “So a helmet will never prevent all concussions.”

In contact sports like hockey, medical professionals need to recognize concussions almost immediately. And even when concussion symptoms disappear, the brain is not yet fully functional.

Many years of recurrent concussions can cause abnormal brain activity and other mental problems.

While all this information on adolescent concussions might deter families from putting their children onto the ice, Mr. Kontos advises that parents should still encourage their kids to play contact sports.

Young hockey players should be educated at an early age how to be aware of their surroundings and avoid on-ice opponents. Mr. Kontos and other researchers believe coaches should teach their pupils good body control on the ice, reducing the amount of accidents during practice and games.

“Be aware of concussions but don’t be scared of them. Concussions are treatable. All forms of athletics have some risk. But safe physical activity has tons of health benefits, and [that] should outweigh the fears,” Mr. Kontos said.

John F. Gilmore III: jgilmore@post-gazette.com; 412-263-1130.