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Objective: Canada's national winter sport of ice hockey has high youth participation; however, research surrounding female ice hockey is limited and the injury burden remains high. This study compared rates of head contact (HC), body checking (BC; highintensity player-to-player contact), and suspected concussion between female and male youth ice hockey. Design: Crosssectional. Setting: Game video-recordings captured in Calgary, Canada. Participants: Ten female (BC prohibited) and 10 male (BC permitted) U15 elite AA (13-14-year-old) game video-recordings collected in the 2021 to 22 seasons and 2020 to 21, respectively. Assessment of Risk Factors: An analysis of player-to-player physical contact and injury mechanisms using videoanalysis. Main Outcome Measures: Videos were analyzed in Dartfish video-analysis software and all physical contacts were coded based on validated criteria, including HCs (direct [HC1], indirect [HC2]), BC (levels 4-5 on a 5-point intensity scale), and videoidentified suspected concussions. Univariate Poisson regression clustering by team-game offset by game-length (minutes) were used to estimate incidence rates and incidence rate ratios (IRR, 95% confidence intervals). Results: The female game had a 13% lower rate of total physical contacts (IRR 5 0.87, 0.79-0.96) and 70% lower rate of BC (IRR 5 0.30, 0.23-0.39). There were however no differences in the rates of direct HC (IRR 5 1.04, 0.77-1.42) or suspected concussion (IRR 5 0.42, 0.12-1.42) between the cohorts. Although prohibited in the female game, only 5.4% of HC1s and 18.6% of BC resulted in a penalty. Conclusions: The rates of HC1s and suspected concussions were similar across youth ice hockey. BC rates were lower in the female game, yet still prevalent despite being prohibited.

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 = 18 ringette, n = 18 hockey) revealed a 19% lower rate of PCs in ringette than ice hockey {IRR = 0.81 [95% confidence interval (CI), 0.73-0.90]}, but a 98% higher rate of body checking [IRR = 1.98 (95% CI, 1.27-3.09)] compared to ice hockey. Ringette had a 40% higher rate of all HC1s [IRR = 1.40 (95% CI, 1.00-1.96)] and a 3-fold higher rate of suspected injury [IRR = 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.