Checking: Who’s right?

The optimal age for the introduction of body checking in field hockey has always been a controversial subject(1). In recent years, regulatory changes have been introduced across Canada. Indeed, Hockey Canada took a stand and banned body checking at the Pee-wee level in 2013, 2 years after the United States and no less than 27 years after the province of Quebec. Recently, Hockey Québec decided to reserve contact for elite players only. The school field hockey league (LHPS) wanted to allow its players to play with body checking from age 13, but the Quebec government asked them to rejoin Hockey Québec. So, the government asked them to follow the regulations and prohibit checking. Many don’t agree with Hockey Québec’s new regulations, and others are outraged that the PHSA’s rules are dictated by Hockey Québec.

Public opinion on checking in field hockey is often based on anecdote rather than evidence, and on field hockey tradition rather than player interest and safety. What’s more, the media send out a contradictory message to the public, promoting safe play and concussion prevention on the one hand, and valorizing violent body checking on the other(2). Checking is basically a defensive tactic designed to regain control of the puck by projecting the body towards the opponent to separate him from the puck(1) and should not be used to injure or intimidate an opponent(6).

Radio-Canada recently published an article entitled “Concussions; le field hockey sans mises en échec serait presque aussi risqué? Conclusions based on preliminary statistics from a study currently underway in the United States are far too simplistic. The researchers compared a female cohort with a male cohort, whereas the literature shows that concussion diagnosis is more frequent in women than in men for various reasons (14). Caution should be exercised when reading certain articles, and that’s why SciencePerfo brings you the latest scientific evidence on the impact of body checking in field hockey.

Alberta Pee-wee (checking allowed) VS Ontario Pee-wee (first year checking is prohibited) 2011-2012. (1)

• 3 X more injuries for Pee-wee players when checking is allowed
• 3 X more concussions for Pee-wee players when checking is allowed
• Checking is the most frequent injury mechanism for Pee-wee players when checking is allowed.

Alberta Pee-wee (body checking allowed) VS Quebec Pee-wee (more than 20 years after body checking was banned) 2007-2008 (3)

• 3 X more injuries for Pee-wee players when checking is allowed
• 4 x more concussions for Pee-wee players when checking is allowed
• Checking is the most frequent injury mechanism for Pee-wee players when checking is allowed.
• 2.5 X more healthcare costs for Pee-wee players when body checking is allowed (5)

Alberta Bantam (Pee-wee and Bantam body checking allowed) VS Quebec Bantam (Body checking introduced at Bantam level) 2008-2009 (4)

• 1.5 times more injuries among bantam players exposed to body checking for the first time
• The incidence of injuries and concussions is the same in the year checking is introduced, whether at Pee-Wee or Bantam level.
• A history of injury increases the risk of sustaining an injury.
• A history of concussions increases the risk of suffering a concussion

The policy of delaying checking at the Bantam level had three goals(2) :

• To allow players to acquire and develop fundamental field hockey skills for two more years without the distraction of checking. We’re talking about skills such as skating, puck control, passing and shooting.
• To provide young people with the safest environment in which to play.
• Allow players two more years to learn and develop the technical skills needed to check a player.

Integrating its scientific evidence is a challenge. Among researchers, there is a unanimous consensus that checking should not be introduced before the age of 13, and should be reserved for elite players(2). Some researchers, aware of the negative impact of repeated blows to the head on the brain(7,8,9,10), suggest a more conservative approach, postponing the whole thing until age 16 and beyond(6). In addition, other evidence suggests that the use of body checking leads to more aggressive players and an attitude that promotes violence in sport(11,12,13).

In short, Hockey Québec’s latest decisions are in line with the scientific evidence currently available. For its part, the LHPS feels handcuffed by the regulations, as it would like to attract the elite to its ranks. It’s a controversial subject that we’ll be following closely over the coming months. Only in a few years will it be possible to measure the full impact of these changes on field hockey in Quebec.

Written by Maxime Provencher, M. Physiotherapy

References :
1.Black AM, Macpherson AK, Hagel BE, Romiti MA, Palacios-Derflingher L, Kang J, Meeuwisse WH, Emery CA. Policy change eliminating body checking in non-elite ice hockey leads to a threefold reduction in injury and concussion risk in 11- and 12-year-old players. Br J Sports Med. 2016 Jan;50(1):55-61
2. CD, Meeuwisse WH, Emery CA. Informing body checking policy in youth ice hockey in Canada: a discussion meeting with researchers and community stakeholders.Can J Public Health. 2014 Nov 5;105(6):e445-9
3. Emery CA, Kang J, Shrier I, Goulet C, Hagel BE, Benson BW, Nettel-Aguirre A, McAllister JR, Hamilton GM, Meeuwisse WH. Risk of injury associated with body checking among youth ice hockey players.JAMA. 2010 Jun 9;303(22):2265-72
4. Emery C, Kang J, Shrier I, Goulet C, Hagel B, Benson B, Nettel-Aguirre A, McAllister J, MeeuwisseW.Risk of injury associated with bodychecking experience among youth field hockey players. CMAJ. 2011 Aug 9;183(11):1249-56.
5. Lacny S, Marshall DA, Currie G, Kulin NA, Meeuwisse WH, Kang J, Emery CA. Reality check: the cost-effectiveness of removing body checking from youth ice hockey.Br J Sports Med. 2014 Sep;48(17):1299-305
6. Council on Sports Medicine and Fitness, Brooks A, Loud KJ, Brenner JS, Demorest RA, Halstead ME, Kelly AK, Koutures CG, LaBella CR, LaBotz M, Martin SS, Moffatt K. Reducing injury risk from body checking in boys’ youth ice hockey.Pediatrics. 2014 Jun;133(6):1151-7
7. McAllister TW, Flashman LA, Maerlender A, Greenwald RM, Beckwith JG, Tosteson TD, Crisco JJ, Brolinson PG, Duma SM, Duhaime AC, Grove MR, Turco JH. Cognitive effects of one season of head impacts in a cohort of collegiate contact sport athletes. Neurology. 2012 May 29;78(22):1777-84
8. Stern RA, Riley DO, Daneshvar DH, Nowinski CJ, Cantu RC, McKee AC. Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM & R: the journal of injury, function, and rehabilitation. 2011;3(10 Suppl 2):S460-7
9. Broglio SP, Eckner JT, Paulson HL, Kutcher JS. Cognitive Decline and Aging: The Role of Concussive and Subconcussive Impacts. Exerc Sport Sci Rev. 2012;40(3):138-44.
10. Talavage TM, Nauman EA, Breedlove EL, Yoruk U, Dye AE, Morigaki KE, et al. Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. Journal of neurotrauma. 2013.
11. Emery CA, McKay CD, Campbell TS, Peters AN. Examining attitudes toward body checking, levels of emotional empathy, and levels of aggression in body checking and non-body checking youth field hockey leagues. Clin J Sport Med. 2009;19(3):207-215
12. Mihalik JP, Greenwald RM, Blackburn JT, Cantu RC, Marshall SW, Guskiewicz KM. Effect of infraction type on head impact severity in youth ice hockey. Med Sci Sports Exerc. 2010;42(8):1431-1438
13. Malenfant S, Goulet C, Nadeau L, Hamel D, Emery CA. The incidence of behaviours associated with body checking among youth ice hockey players. J Sci Med Sport. 2012; 15(5):463-467
14.Covassin T, Elbin RJ, Crutcher B, Burkhart S. The management of sport-related concussion: considerations for male and female athletes. Transl Stroke Res. 2013 Aug;4(4):420-4