Concussions in the National Hockey League (NHL): The Video Analysis Project

Abstract

Hockey is a popular sport, and at its highest levels, it is a complex contact game characterized by physical strength, speed, and skill. The interaction of these characteristics contributes to the inherent risk of injury athletes must face while playing. Among hockey injuries, concussions are one of the most commonly sustained by athletes across all levels of play and age groups. Significant public attention, combined with poorly understood long-term effects, indicates the importance of tangible preventive strategies. The main goal of this thesis was to understand, through video analysis, how playing characteristics and mechanism of injury contribute to concussions in the National Hockey League (NHL). In the first study, the development and validation of an observational recording tool used to code and analyze NHL concussions observed via video analysis was described. The second study attempted to synthesize the description of players’ characteristics, antecedent events, and contextual variables associated with events leading to concussion at the NHL level. Several specific risk factors for concussion in NHL players were identified, including position, body size, specific locations on the ice, and particular situations based on a player's position. The final study systematically analyzed how concussions occur to identify potential pattern(s) of concussions. A common specific injury mechanism characterized by player-to-player contact and resulting in contact to the head by the shoulder, elbow, or gloves, was also identified. When the principal mechanism was refined further, several important characteristics were discernable: (i) contact was often to the lateral aspect of the head; (ii) the player who suffered a concussion was often not in possession of the puck; and (iii) no penalty was called on the play. Collectively, these studies served to address gaps in the literature; the implications for informing prevention and management strategies are also discussed.