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June 8th, 2010
04:00 PM ET

Youth hockey players: Too young to body check?

By Stephanie Smith
CNN Medical Producer

Youth hockey does not look so different than adult hockey, besides the obvious differences in stature among the players. The essential elements of the game are there: The skates' clatter on the ice; the smoothly sliding puck; and, oh yes, that tousling and hitting they call body checking.

The question: Are 11 and 12-year-olds - still engaged in that complex dance called brain development - ready for body checking?

A new study in the Journal of the American Medical Association does not attempt to answer that question, but it does provide some fodder for discussion. As it turns out, in youth hockey leagues where body checking is allowed, there is a three-fold increase in severe injuries, including mild-to-severe concussions.

The study examined youths in Canadian hockey leagues, but the implications of the study spread well beyond hockey, to other contact sports, says one brain injury expert.

"The simple fact is, the more risky the behavior, the more you increase the chance of concussion," said David Hovda, director of the UCLA Brain Injury Research Center, who was not involved with the study. "The brain is not like a muscle so that when you pull it, it swells up and (the injury) goes away. When the brain gets hurt, it's a very bad thing. The problem is you can't see it."

At issue when it comes to children, those invisible injuries - even when they are mild - may have dangerous implications for their still-developing brains. Last year, two studies published by the American Psychological Association found that children who sustained severe brain injuries had more problems academically, with learning and memory, and with behavior over the long-term.

"Let's say a child is playing hockey and had repeated head injuries," said Hovda. "That kid grows up and becomes a first class car repairman, but maybe he was supposed to be a first class doctor. The problem is, we don’t know how much those repeated blows to the head could have compromised that child's brain to reach its full capacity."

Hovda calls concussion an epidemic in the United States - it results in 435,000 emergency department visits per year among children, according to the National Center for Brain Injury and Control - but confesses that he, like many, is a sports fan.

"We don't necessarily need to change the nature of sports," said Hovda. "But since we don't know how devastating this can be for a child, it's better to restrict activities in sports where children may be exposed to repeat concussions."

Where many brain injury experts seem to agree is that children should be protected from concussion - by adults. That includes having experienced trainers and medical staff on hand at all games and coercing children, in situations where there is even a suggestion of a concussion (even if the child doth protest), to stay on the sidelines to heal.

The question that lingers is, is all of that enough? Is there some credence to the argument that there should be an age limit on body checking (or tackling, or any major contact in youth sports)? These are questions that may take years - even decades - to sort out.

Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.


soundoff (17 Responses)
  1. David

    I am from near the Canadian border and have been playing hockey since I was three (20 years). In the USA kids are allowed to body check at the PeeWee level which corresponds to roughly 12 years of age. In Canada, kids are not allowed to body check until age 16 or so. Health issues aside, it is interesting to note that not allowing kids to check so early helps promote their vision of the game and passing abilities. Maybe if we didn't let our kids hit so early they would be better players in general.

    Either way, body checking is a very important part of a physical game and should not be outlawed entirely. However, there are benefits associated with both health and skill that could be reaped by moving the minimum age for body checking up a couple years.

    June 9, 2010 at 09:01 | Report abuse | Reply
  2. Michael

    Playing at a high level of hockey for over 12 years, I know that I had at least 2 diagnosed concussions, probably a few more undiagnosed. But I still laced up the skates and went back out there to play. When you play the sport you know the risks that come along with it and unless you are going to play golf or tennis, expect some sort of injury to happen. They are not going to be able to limit the age to "body check," it's just not possible.

    June 9, 2010 at 09:09 | Report abuse | Reply
  3. Fusion

    One Canadian "icon" (I say "icon" because the man is a redneck fool and is an embarrassment to all Canadians) called Don Cherry who advocates this type of playing (Bruins fans might know who he is).

    Many Canadian kids listen to and look up to Don Cherry and he thinks violence in hockey is a wonderful thing, oh and apparently only sissy French speaking players (he's anti French Canadian) and Europeans (he's anti European) wear visors ("real men" don't need them), mix that with his pro violence stand and you have a disaster. It's naturally not up to him to choose what type of hockey kids play, but if Canadians are stupid enough to vote him one of the greatest Canadian ever, he should be a better role model.

    One of my favorite quote is the old "I was watching a fight when a hockey game broke out". I don't expect hockey to be violence free, but what happens nowadays is ridiculous – boys, keep your testosterone under control! Also those fans who encourage these types of fights are just as small minded as those goons who pick fights with every player on the ice – I know because I am from Montreal and we have some of the worse offenders. Here's hoping the next generation can keep some kind of civility on the ice

    June 9, 2010 at 09:47 | Report abuse | Reply
  4. s

    Give it a rest already! Anyone studying the impact of full-contact sports on youth development has clearly never played sports as a youth. This is becoming a sad trend in America. Its called a sport, i.e. physical activity engaged in for pleasure. Obviously engaging in physical activity increases your risk of injury.

    June 9, 2010 at 09:52 | Report abuse | Reply
  5. Paddy

    @ David. Canadian kids begin body checking at 11yrs as well. The fact that hitting increases the chance of injury is obvious, what the root cause is as simple as players are not properly trained in how to deliver a body check and more importantly how to take/receive a hit.

    June 9, 2010 at 10:25 | Report abuse | Reply
  6. AceRider

    Generations of kids have come of age playing football, heading soccer balls, rugby, lacrosse, etc. Are there so many brain damaged people walking around? Of course some kids will be hurt/disabled, some permanently. There are risks in sporting.

    Keep your kid home reading if you are afraid of injury. I didn't play football and I'm a genius!

    June 9, 2010 at 10:30 | Report abuse | Reply
  7. Aldo Pignotti

    I've been wondering if USA Hockey should put in some sort of weight limits or categories to the different levels, rather than the levels being set strictly by age, like they do with Pop Warner football. That would go a long way towards reducing injuries. I should note I've found youth hockey to be an oddly safe sport for my kids. I've seen a lot more baseball injuries than I have hockey injuries,

    The mention of Don Cherry makes me laugh. Yes, we know who Don Cherry is and yes, he is a blowhard but he does make some good points. Hockey is a violent sport and it should be, and that's coming from the parent of a very slender 12 year old girl who plays full check hockey against boys.

    Actually, I think the kids should be taught to check from day one. It takes a lot of skill to throw a good check. By holding back on checking, it greats a aura of fear, like it's a big deal and it really isn't.

    The injuries I've seen come almost exclusively from size mismatches.

    June 9, 2010 at 11:11 | Report abuse | Reply
  8. joe

    I started playing hockey about the same time I could walk. Playing hockey as a kid I was never seriously injured or had a concussion. Even though youths are able to check, around the age of 12, doesn't mean they do. Checking was almost non existent until I reached the high school level at age 14. Even still at the high school level hard hits only occurred in varsity, which meant kids were in their junior and senior years.

    With proper hitting drills, shoulder to shoulder contact, and coaching one can gravely diminish the chances of getting seriously injured or injuring others. Anything resembling a hit from behind has been outlawed in youth hockey for the past decade. If you were like me, a defenseman who blocked many shots, you had a better change at getting injured by a puck than by a hit.

    June 9, 2010 at 11:38 | Report abuse | Reply
  9. Candi

    I have a 7 year old who will be playing his 3rd year of Mite hockey this winter. He's played against a few teams that are far more aggressive than this age level should be (there is not suppsed to be any sort of hitting at all). Unfortunately, the coaches of these teams are not quick to pull kids off the ice when they blatently trip or check like our coaches do (usually it's not until the parents start yelling after the 3rd or 4th time). It's very frustrating since the kids in this age group aren't trained in how to take hits and are still not steady on their skates, When kids learn that they can play "dirty" without consequences, they continue to do so. USA Hockey and local districts need to crack down on the coaches that allow this and they need to train the refs (who are often just kids themselves) to step in and get these kids off the ice for a shift or two.

    June 9, 2010 at 11:55 | Report abuse | Reply
  10. Arturo

    @David

    Actually in Canada its also at Pee Wee level as well.

    @Fusion

    Don Cherry should be respected as a great hockey icon. He knows exactly what he's talking about. You've probably never played the sport before in your life. When you say that he promotes "violence", I'm guessing you mean fighting and checking. They have both been part of the sport since it began. When has he ever promoted a player being injured??? When somebody gets injured from a dirty hit he calls out the one that did it. How is that promoting violence??? NEVER!!! Since you're French Canadian I'm guessing that if you actually did play you were a "finesse" type player. Thats why you don't like hitting and fighting. Go play roller hockey if you don't like it. You'll see the difference and its not a good thing. If Don Cherry didn't know what he was talking about then nobody would like him. Keep cheering for Montreal because their "playoff run" is about as far as they're going to get for a very long time. GO LEAFS GO!!!

    June 9, 2010 at 12:10 | Report abuse | Reply
  11. Sandman

    Fusion,
    If you don't like Grapes then fine, but he's personally funding the STOP decals for helmets and has been a HUGE advocate for trying to stop hits from behind ( which are in my opinion the most dangerous hit of all). I assume that means he's actually DOING a whole lot more to promote kid safety than you or I.

    Making blanket statements like he's anti-french and anti-european serves no purpose, he likes players who play a certain way. And even if you disagree with what he says ( often times for effect) he's forgotten more about the game than you or I know.

    So cherry is a xenophobe because you claim he does not like french canadiens or or europeans, and you call him an embarrassment and a redneck fool. What does that make you ?

    June 9, 2010 at 12:24 | Report abuse | Reply
  12. Kmcg

    It's important to teach kids how to hit and be hit... and the size leagues are probably a great idea.

    On another note... how is auto repair a "dumb" job compared to being a doctor? That's just a US cultural assumption that is not valid! I know a lot more about bodies and thank God my boyfriend knows about engines because I'd be lost in one. Don't stereotype legitimate (and VERY successful) occupations.

    More people should go to trade school and stay away from college, BAs are becoming a joke.

    (Sorry, had to put it in there!) 🙂

    June 9, 2010 at 23:57 | Report abuse | Reply
  13. Mike B

    Just like practicing or taking soccer headers, even one hit to the brain can cause significant brain damage. Exposing children to this will cause brain damage. For every hit, children's academic performance drops. Sometimes the hit affects the emotional centers of the brain, causing PTSD & changing the childs personality forever. We can stop exposing our children to brain damage.

    June 10, 2010 at 11:12 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.