Higher rates of head contacts and injuries in female ringette compared to ice hockey: An opportunity for prevention

Emily Hemming, Ally, J Sobry, Alexis Cairo, Rylen, A. Williamson, Ash Kolstad, Stephen West, Claude Goulet, Kelly Russell, Carolyn Emery

Research output: Contribution to journalConference articlepeer-review


Objective: Ringette and female ice hockey are high participation sports in Canada. Despite policies disallowing body checking,
both sports have high injury and concussion rates. This study aimed to compare physical contact (PC), head contact (HC), and
suspected injury and concussion incidence rates (IRs) in female varsity ringette and ice hockey. Design: Cross-sectional.
Setting: Canadian ice arenas. Participants: Eighteen Canadian female university ringette and ice hockey tournament/playoff
games in the 2018-2019/2019-2020 seasons. Assessment of Risk Factors: Game video-recordings were analyzed using
Dartfish video-analysis software to compare both sports. Main Outcome Measures: Univariate Poisson regression analyses
(adjusted for cluster by team, offset by game-minutes) were used to estimate PC, HC, and suspected injury IRs and incidence rate
ratios (IRRs) to compare rates across sports. Proportions of body checks (level 4-5 trunk PC) and direct HC (HC1) penalized were
reported. Results: Analyses of 36 team-games (n 5 18 ringette, n 5 18 hockey) revealed a 19% lower rate of PCs in ringette than
ice hockey {IRR 5 0.81 [95% confidence interval (CI), 0.73-0.90]}, but a 98% higher rate of body checking [IRR 5 1.98 (95% CI,
1.27-3.09)] compared to ice hockey. Ringette had a 40% higher rate of all HC1s [IRR 5 1.40 (95% CI, 1.00-1.96)] and a 3-fold higher
rate of suspected injury [IRR 5 3.11 (95% CI, 1.13-8.60)] than ice hockey. The proportion of penalized body checks and HC1s were
low across sports.
Conclusions: Body checking and HC1 rates were significantly higher in ringette compared to ice hockey,
despite rules disallowing both, and very few were penalized. These findings will inform future injury prevention research in ringette
and female ice hockey.
Original languageEnglish
Pages (from-to)151-156
Number of pages6
JournalClinical Journal of Sport Medicine
Issue number2
Publication statusPublished - 1 Mar 2023


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