New study recommends youth hockey leagues ban bodychecking until age 18

A prominent Canadian neurosurgeon who led a new study exploring the prevalence of post-concussion symptoms (PCS) in minor hockey players who suffered brain injuries is calling for the introduction of bodychecking in the sport to be delayed until players are 18 years old.

“The brains of 16- and 17-year-old hockey players are still too vulnerable,” Dr. Charles Tator said in an interview on Wednesday with TSN. “We are seeing that too many players are suffering the effects of brain trauma from permitted bodychecking, and in some cases, the symptoms can be there forever.”

Dr. Tator’s study was published Sept. 23 in the Canadian Journal of Neurological Sciences.

“There is a common misconception that introducing bodychecking at an early age can help prevent injuries such as concussion by ensuring that children are skilled in how to withstand a bodycheck, when in fact there is no data to support this,” the study said.

“Youth hockey leagues should raise the age of permissible bodychecking to 18 from the current age of 13-14. We show the potential to prevent 85 per cent of bodycheck-caused concussions by raising the permissible bodychecking age from its current age of 13-14 to 18 years of age. There is also the potential to eliminate years of suffering from bodycheck-induced PCS.”

Tator, a neurosurgeon in Toronto with the Canadian Concussion Centre who was invested in 2000 as a member of the Order of Canada for his work researching brain injuries, said he understand leagues, teams, parents, and possibly players will probably resist his recommendation. But he pointed out that NHL players pushed back when helmets and then later visors were made mandatory in the professional game.

“Each step in protecting players has met with resistance,” he said. “It’s expected because change is disruptive.”

Tator’s study followed a cohort of 87 youth hockey players (66 males, 21 females) who were between the ages of 10 and 18 when they suffered concussions between 1997 and 2017.

Bodychecking was responsible for 34 players’ concussions, the study said. Other events that caused concussions included fighting, being hit with sticks and pucks, falls, and elbows to the head.

“In the present study, [post-concussion syndrome] occurred in 70 (80.4 per cent) of the 87 concussed youth players including 24 of the 34 (70.6 per cent) patients concussed by bodychecking,” the study said. “The potential severity of this condition is emphasized by one of our cases who remained symptomatic for 14 years (168 months). Most of the bodycheck cases were boys: only three of 21 girls had concussion from a bodycheck.”

Post-concussion syndrome symptoms can include fatigue, irritability, difficulty concentrating, memory problems and sometimes depression. The syndrome can lead to behaviours such as impulsiveness, easy frustration, poor social judgment and dramatic personality changes.

Tator said the study is the first to examine the long-term consequences of brain trauma in young hockey players.

“…these young hockey players often change teams and locations, especially those wishing to pursue college or professional play, and also, they may be reluctant to admit the occurrence of concussion and persistence of symptoms,” the study said. “The importance of longitudinal studies of concussion and PCS is that such studies help to detect and treat the early and long-term consequences of concussion including mental health issues of anxiety, depression and PTSD, cognitive decline, and catastrophic conditions such as the second impact syndrome…”

Most leagues within Hockey Canada permit bodychecking in boys’ hockey beginning at age 13, the study said.

In 2013, Hockey Canada raised the minimum age for bodychecking from 11 to 13. Four years later, in 2015, The Globe and Mail quoted a University of Calgary study that reported the policy change contributed to a 50 per cent drop in injuries among 11- and 12-year-old players in Alberta.

Also in 2015, the Greater Toronto Hockey League, the largest minor hockey league in world, voted to eliminate bodychecking for all players under 18 at the Single-A level. There is also a moratorium on bodychecking in house league and select leagues. In the more competitive Double-A and Triple-A programs, bodychecking is allowed when players are 14.

Tator said that leagues should commit to a ban on bodychecking for all players under the age of 18 – even if it impacts those who might want to play major-junior hockey, where bodychecking is permitted between players typically aged 16 to 20.

“Delay players going to the Canadian Hockey League for two years until they are 18 then,” Tator said. “It’s a small price to pay. How much is one brain worth?”