Analyzing Injury in Canadian Youth Ice Hockey through a Mixed Method Observational Design: Moving Beyond the Mechanisms of Injury to the Socio-Cultural Complexities of Implementing Injury Prevention Strategies

Abstract

Ice hockey is a sport known for its speed and skill. However, its intensely physical nature is associated with the potential risk of injury, which has become a major public controversy in Canada (Cusimano, Sharma, Lawrence, et al., 2013; Emery et al., 2010). Epidemiological research has adequately documented the frequency and severity of injury (King & LeBlanc, 2006; Yard & Comstock, 2006). Yet, because of methodological limitations and the lack of systematic and mandatory injury prevention strategies implemented nationwide, injuries remain high (Cusimano, Nastis, & Zuccaro, 2013; Emery et al, 2010). An alternative methodology, combined with broadening injury definitions can provide a more detailed assessment of the risks of, and circumstances, around injury. A methodology, based primarily on observational techniques, was utilized to examine injury in body checking hockey when it is first introduced to youth players. Injury was defined as ‘any physical trauma that has occurred as a result of participation in an organized competition’ including four categories of injury severity. In a comparison of Ontario Peewee (ages 11-12) with Québec Bantam (ages 13-14) boys hockey, no significant differences were found in overall injury (χ2: 0.22; p:0.64), however, there were significant differences in frequency of body checking related injury; 76% versus 59% (χ2:4.76; p:0.03). The odds of being injured due to body checking are 2.158 times higher in Peewee (βex 2.158; 95%CI: 1.07-4.34; p:0.03) indicating no increased risk of injury when body checking is introduced later while delaying introduction reduces the frequency of body checking related injury. Ongoing public debate in Canada concerning safety in youth hockey is understood through the theoretical lens of discourse (Foucault, 1972, 1990). The dominant discourse in Canada around hockey is based in a traditional, physically dominant model, where intense physical contact is not only inevitable but desirable. The reverse discourse prioritizes the safety of participants over the potential of lessening the intense physicality of the Canadian style of play. These competing discourses create tension and ambivalence amongst safety advocates and conservative hockey practitioners and enthusiasts. The emotionality of hockey stakeholders often overwhelms logic regarding safety decisions, ultimately impacting progressive injury prevention initiatives.