A recent study published online in the Journal of Pediatrics finds that young hockey players who are less physically mature have a greater risk of prolonged symptoms from concussion. The study’s authors conclude that skilled high schoolers who are still in the earlier stages of puberty should not be encouraged to “play up” on teams with older, more mature players.
The study looked at 196 male and female hockey players aged 13 to 18 who were seen at one of three outpatient sports concussion clinics in Massachusetts and Rhode Island between September 2012 and March 2015. Researchers found that almost half (48.3%) of the adolescent hockey players experienced concussion symptoms for longer than 21 days and that 13.1% had symptoms lasting longer than 90 days. Importantly, they also found that the less physically mature players took longer to recover – on average 54.5 days compared to 33.4 days for more physically mature players.
“Our findings have important implications for policy decisions related to grouping for high school ice hockey players,” says Dr. Peter Kriz of Hasbro Children’s Hospital and lead author of the study. “The results support efforts to provide peripubertal collision sport athletes competition in leagues grouped by relative age and discourage the permission of highly skilled peripubertal athletes to ‘play up’ at the varsity level with postpubertal competitors.”
Researchers found that roughly two-thirds of the freshmen (14 year-olds) involved in the study were still in the early stages of puberty, and thus, they concluded that in order to prevent lasting concussion symptoms in this age group, participation by 14 year-olds in collision sports should be restricted.
Currently, Hockey Canada allows bodychecking at the bantam level (14 years and under) but not in peewee (12 and under).
Concussions in minor league hockey have been a growing concern. The University of Alberta’s Injury Prevention Centre recently published its findings which showed that concussions are the most common hockey injury for boys aged five to nine.
Concussions received in collision sports can have a uniquely damaging effect on the still-developing adolescent brain, causing what one researcher described as “subtle changes” in the cerebral cortex, the outer layer of the brain controlling higher-level reasoning and functioning.
Dr. James Hudziak, director of the Vermont Center for Children, Youth and Families, says, “We believe that injury to a developing brain may be more severe than injury to an adult brain.”
In a recent interview with the Providence Journal, Dr. Kriz said the impetus for the study came from seeing a number of young hockey players of similar maturity level coming into his Providence sports medicine clinic. “It was like a broken record. He had peach fuzz and weighed 140 pounds soaking wet and he was going into the corner to dig out a puck.”
The study also found that lighter weight male players and heavier weight female players were more likely to experience prolonged concussion symptoms. As well, more than two-thirds (68%) of reported concussions were sustained by those playing forward (wing and centre) over those playing defense and goal.