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Abstract and Introduction
Abstract
Background Although there is a growing understanding of the consequences of concussions in hockey, very little is known about the precipitating factors associated with this type of injury.
Aim To describe player characteristics and situational factors associated with concussions in the National Hockey League (NHL).
Methods Case series of medically diagnosed concussions for regular season games over a 3.5-year period during the 2006–2010 seasons using an inclusive cohort of professional hockey players. Digital video records were coded and analysed using the Heads Up Checklist.
Results Of 197 medically diagnosed concussions, 88% involved contact with an opponent. Forwards accounted for more concussions than expected compared with on-ice proportional representation (95% CI 60 to 73; p=0.04). Significantly more concussions occurred in the first period (47%) compared with the second and third periods (p=0.047), with the majority of concussions occurring in the defensive zone (45%). Approximately 47% of the concussions occurred in open ice, 53% occurred in the perimeter. Finally, 37% of the concussions involved injured players' heads contacting the boards or glass.
Conclusions This study describes several specific factors associated with concussions in the NHL, including period of the game, player position, body size, and specific locations on the ice and particular situations based on a player's position.
Introduction
Professional hockey is a highly complex game involving a combination of physical strength, speed, agility, diverse physiological demands and technical mastery. In addition to these attributes, players must execute the sport within an enclosed area containing hard surfaces and obstacles, such as the surrounding boards and perimeter glass, the ice surface, goal nets, stationary and moving officials and perhaps, most importantly, their opponents. With all of these interacting factors, the risk for injury is significant. Of particular concern among the medical and public communities is one of the most common injuries in hockey, namely, concussion.
Although there is a growing understanding of the consequences of concussions in sport, very little is known about the precipitating mechanisms associated with this type of injury in hockey. Although some risk factors for concussion have been reported, for example, the increased susceptibility for players in the forward position, a thorough description of intrinsic and extrinsic risk factors for concussion has not been completed at the National Hockey League (NHL) level.
The analysis of injury mechanisms using video records appears to be a promising approach to objectively identify, quantify, reduce and ultimately prevent injuries from occurring. The exceptional quality and quantity of video records of NHL games is a valuable and rich source of data, allowing for the examination of situational factors and injury mechanisms among professional hockey players. This paper represents a first effort to systematically analyse video recordings of NHL concussions over 3.5 regular seasons (ie, 2006/2007—2009/2010) with a specific focus on describing players' characteristics and situational factors.
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