A new study analyzing a decade of national emergency department data reveals a troubling trend in pediatric ice hockey injuries in the United States. Published in Injury, the research identifies a post-pandemic rise in serious head and shoulder injuries among young athletes, with an associated increase in hospitalizations. The findings could have far-reaching implications for youth sports safety guidelines, equipment standards, and injury prevention protocols.

Conducted by Luca M. Valdivia, MS, a medical student at the Icahn School of Medicine at Mount Sinai, and Dr. Sheena Ranade, an associate professor of orthopedics and pediatrics at the same institution, the study is the first of its kind to assess recent trends in pediatric ice hockey injuries using the National Electronic Injury Surveillance System (NEISS) through the end of 2023.

“This research underscores critical shifts in how and when injuries are occurring,” said Valdivia. “We’re seeing a concerning rise in high-energy impacts—especially head and shoulder trauma—since the pandemic, and our hope is that this data leads to targeted interventions.”

Using data collected from 2014 to 2023, the researchers examined ice hockey-related injuries in players under the age of 18. The NEISS database, maintained by the U.S. Consumer Product Safety Commission, draws from a nationally representative sample of roughly 100 hospitals with 24-hour emergency departments.

Key findings indicate that while the overall injury rate in pediatric ice hockey remained steady over the ten-year period, the nature of injuries changed notably after 2020. There was a marked increase in head and shoulder trauma, as well as a rise in upper-extremity fractures. Hospitalization rates also climbed, suggesting either more severe injuries or changes in how injuries are being treated.

“We believe this may reflect not only an increase in injury severity but potentially a shift in youth hockey culture toward more aggressive play,” said Dr. Ranade. “Our hope with this paper is to draw attention to the types of injuries that occur in hockey and highlight the importance of well-fitting gear to prevent such injuries.”

One unexpected trend was an increase in injuries among female players. The study’s authors suggest this may correlate with the growing popularity and accessibility of girls’ and women’s hockey in recent years, necessitating tailored safety considerations.

For clinicians, the study highlights the importance of thorough concussion assessments, careful documentation, and proactive communication with families regarding proper protective equipment and return-to-play protocols. As the sport becomes more competitive, the need for medical oversight and injury surveillance grows even more critical.

For parents, coaches, and young athletes, the message is clear: stronger protections are needed to keep hockey safe. The data may help guide future rule changes aimed at reducing high-risk play and improving protective gear standards.

Looking ahead, the researchers hope to conduct further studies incorporating more granular data—including hours played, position, and competition level—to better understand risk factors and evaluate the effectiveness of specific safety interventions.

“Our study highlights critical trends in pediatric ice hockey injuries across a decade of national emergency department data, with a concerning rise in head and shoulder trauma after 2020,” said Valdivia. “As youth participation in hockey grows, so too does the responsibility to protect these athletes through improved safety equipment and education.”

The authors emphasize that while hockey remains a beloved and beneficial sport for many youth, ensuring its future requires a commitment to science-based safety improvements that allow players to compete without compromising their well-being.