Concussions and Injuries in Sledge Hockey: Grassroots to Elite Participation

Objective: To examine injury (including concussion) rates, location, type, mechanisms, and risk factors in sledge hockey players.

Design: Cross-sectional survey.

Setting: Sledge hockey players, worldwide, across all levels of play.

Participants: Sledge hockey players (ages ≥14 years) who played in the 2019 to 2020 season were recruited through email, social media, and word of mouth communication.

Assessment of risk factors: Participant characteristics (eg, age, sex, disability) were examined as potential injury risk factors.

Main outcome measures: Injury rates (IR) and incidence rate ratios (IRR) examining potential risk factors were reported based on univariate Poisson regression analyses. Injury proportions by type, location, and mechanism were described.

Results: Ninety-two players initiated the survey, and 77 (83.7%) provided some injury information. Forty-seven injuries included 16 concussions in 9 of 77 players (11.7%) and 31 non-concussion injuries in 20 of 77 players (26.0%) were reported. The overall IR was 13.2 injuries/1000 athlete-exposures [95% confidence interval (CI); 9.6-17.6]. The game IR (28.4 injuries/1000 game-exposures, 95% CI; 18.6-41.7) was higher than practice IR (4.4 injuries/1000 practice-exposures, 95% CI; 2.2-7.9) (IRR = 6.5, 95% CI; 3.1-14.5). The most common injury locations were the head (34.0%), wrist/hand (14.8%), and shoulder (10.6%). The most common significant injury types were concussion (36.2%) and bone fracture (8.5%). Body checking was the primary mechanism for injuries caused by contact with another player (42.1%) Age, sex, disability, and level of play were not found as injury risk factors.

Conclusions: Concussions and upper extremity injuries were the most common sledge hockey injuries reported, with body checking being the most common mechanism. This research will inform development of prevention strategies in sledge hockey.