Four years after body-checking was introduced, have injury rates in Swedish women’s ice hockey changed? Yes, markedly. Researchers at Lund University in Sweden have now been able to show that, in the short term, the number of insurance claims almost doubled.
In 2022, body-checking became permissible in the SDHL, the top-flight Swedish women’s ice hockey league. Sweden was thus the first country in the world to make this change, and the research is being followed with great interest by other ice hockey nations. Both the US and Canada have also recently started to allow body-checking and are keen to know what impact the change has had in Sweden. There are now two recent research studies from Lund University.
One of the studies is based on insurance data covering six seasons, in which all ice hockey-related injuries that led to a claim under the players’ licence insurance were recorded by the insurance company. During the first season after body-checking was introduced, the number of reported injuries soared. Having stood at 6.6 injuries per 1,000 player-hours in the season before the rule change, the figure rose to 16.7 injuries per 1,000 player-hours the following season. The number of injuries then fell slightly, but the average for the six seasons studied was 11. The average for the corresponding period before the rule change was 6.0.
“Injury rates may continue to fall as players adapt to the physical nature of play, but that remains to be seen. It is not possible to say with certainty that the higher injury figures are due to body-checking, but we speculate that this is the case, as everything else remains the same compared with previous seasons,” says Amanda Lahti, a researcher at the Centre for Primary Care Research, Lund University, and the lead author of both studies and the primary investigator (PI) for the research project.
Shoulder and knee injuries were the most common claims handled by the insurance company, which Amanda Lahti speculates may be because players take body-checks against the boards with their arms outstretched. According to her, the fact that the figures are levelling off could possibly be interpreted as the players learning to play a more physical game over time.
The second study identified injuries that resulted in absence from training or matches and were added to an injury register by the medical staff in the league. A total of 46 match-related injuries were recorded. The results show that body-checking is now the most frequent cause of injury and is often associated with concussion, the most common type of injury in the league. The study also showed that players often continued to play in the games despite being injured. In six out of ten cases of concussion, the player remained on the ice. Most of the injuries, including concussions, occurred in the third period, towards the end of the game. This could suggest that fatigue increases the risk of injury.
“Perhaps it’s not just a case of tiredness after a tough match. As female ice hockey players generally earn less than their male counterparts, many combine elite sport with paid work, which can limit their recovery and contribute to increased fatigue. I would like to go on and gain a deeper understanding of how sleep and recovery might affect the risk of injury,” says Amanda Lahti.
She emphasises that the study tracked the development of injuries over only two years and is based on a relatively small number of injury incidents, which means that the results should be interpreted with some caution. Nevertheless, the findings raise questions and form the basis for further research. Female athletes should not be regarded as “little men”. Biological, anatomical and social differences influence the risk of sports injuries. Yet only a small proportion of sports medicine research is carried out on women.
“This makes women-specific studies essential. Although this study has its limitations, it provides important insights and baseline data for the continued monitoring of the cohort and the progression of injuries over time,” says Amanda Lahti. As a specialist in general medicine and a sports doctor, she works on the prevention of injuries on a daily basis.
The results also show that the players themselves remain positive about body-checking – and that they do not believe it leads to more injuries.
“I will be examining this discrepancy between the players’ own perceptions and our objective injury data in more detail in a forthcoming paper. Amongst other things, I have sought the help of a gender researcher from the IOC (International Olympic Committee) to gain a better understanding of this,” says Amanda Lahti.
Hopefully, at least some of her questions will eventually be answered. She recently received a grant of SEK 1.2 million from the Dr P Håkansson Foundation.
“This is a very significant grant, which I hope will help generate more knowledge that promotes women’s participation in sport at both recreational and elite levels, as well as contributing to the development of the sport,” says Amanda Lahti.
Related publication
Injury Incidence Before and After the Introduction of Body Checking in Elite Women’s Ice Hockey: A Six-Season Nationwide Insurance-Based Study, Sports Medicine – Open
DOI: 10.1186/s40798-026-01063-4
European Journal of Sport Science
Case study
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Epidemiology of Injuries in Elite Female Ice Hockey Players Allowed Body Checking: A Two-Year Prospective Cohort Study
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