Ice hockey

Is ice hockey safe?

Ice hockey rarely kills, but it is one of the roughest sports most people will play. US records from the National Center for Catastrophic Sport Injury Research (NCCSIR) show about 0.84 deaths per 100,000 high-school boys a season from 1982 to 2025, split almost evenly between trauma and heart or other medical causes. That is about 8 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary a season and, over about 70 practices and games, 0.12 micromorts each, on our estimate. It is close to American football on the same data.

The daily risk is injury. Players hit each other, the boards and the ice at speed, with sharp blades and a hard rubber puck.

How ice hockey players die

The NCCSIR counted 5 traumatic deaths in US high-school hockey in 43 years. That sounds small, but with relatively few players it gives a traumatic death rate of 0.38 per 100,000 a season, among the highest of any school sport and slightly above football's. College hockey has had no traumatic deaths in the same records. Medical deaths, mainly cardiac, added 0.46 per 100,000 high-school players a season.

Three things cause most of the traumatic deaths and disasters:

• Spinal injuries. A Canadian registry recorded 355 spinal injuries in hockey from 1943 to 2011, nearly all in men and boys, and 79% in the neck. Hitting the boards caused 64%, and a check or push from behind was the most common cause. Rates have fallen since the peak years of 1982 to 1995.
• Skate cuts. On 28 October 2023, Adam Johnson, a 29-year-old American playing for the Nottingham Panthers, died after an opponent's skate cut his neck in a game in Sheffield. Within weeks the IIHF announced neck guards would become mandatory at every level of its competitions.
• Blows to the chest. A puck or stick to the chest at the wrong instant of the heartbeat can stop the heart, a rare event called commotio cordis. In the US registry, survival rose from 10% of cases before 1994 to 58% in 2007 to 2012 as defibrillators spread.

How often players get injured

National surveillance in US high schools and colleges counted injuries that kept a player out for at least a day.

Games were six to eight times riskier than practice for boys and men. The head, face and shoulder were hit most, and concussions, bruises and ligament sprains were the top diagnoses. Women's college hockey, which does not allow body checking, had a lower rate than men's.

Emergency department data show what the bad injuries look like. Of 230 adult hockey players treated at a Swiss Level-1 emergency centre from 2013 to 2019, 28% had a fracture and 13% a cut, and 31% of injuries were to the face. Player contact caused 37% and the puck 24%.

Body checking and youth hockey

The clearest evidence on prevention comes from Canada. In 2011, Ontario removed body checking from non-elite hockey for 11- and 12-year-olds while Alberta still allowed it. Researchers who followed both groups found about three times as many game injuries and three times as many concussions where checking was allowed. Elite players, who could check in both provinces, showed no difference. Hockey Canada then delayed checking until Bantam (ages 13 to 14) across the country in 2013, and in Calgary game injuries halved and concussions fell by almost two-thirds the following season.

How to play more safely

1. Wear a cut-resistant neck guard and, at youth and amateur level, a full face cage or visor. Many leagues now require them; they are cheap compared with the injury they prevent.
2. Never hit from behind, and teach players to keep their head up near the boards. Coaches and officials who enforce the rule protect spines.
3. Choose non-checking leagues for children and recreational adults unless the player wants elite hockey.
4. Wear a mouthguard and well-fitted helmet, and replace cracked or loose gear.
5. Leave the ice after any head knock and follow a graded return to play.
6. Check your rink has a defibrillator and someone trained to use it, and know where the first-aid kit with pressure dressings is.

How we scored it

Fatality risk (94) is low, at about 0.1 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary per high-school session. Serious injury risk (45) is the weakest factor: injuries are frequent, games are far riskier than practice, and catastrophic neck injuries are more common than in most school sports. Controllability (60) reflects strong evidence for checking rules and protective gear. Rescue (85) is good in staffed rinks. Hockey scores above rugby and American football, and below basketball.