Head Impact Biomechanics Differ Between Girls and Boys Youth Ice Hockey Players

The influence of sex on head impact biomechanics is unknown for youth ice hockey. We sought to determine sex differences in head impact severity and frequency in youth ice hockey players. Male (n = 110) and female (n = 25) players (13-16 years old) were recruited from a local hockey organization. Players wore helmets instrumented with the Head Impact Telemetry System for all competitions and practices throughout the season. Seven team-seasons were captured. Random intercepts general mixed linear models determined whether linear acceleration and rotational acceleration differed by sex. Linear regression models evaluated the relationship between sex and impact frequency. All head impact biomechanics were natural log-transformed as their distributions were right-skewed. Females sustained fewer impacts per player than males (27 fewer impacts per player-season, p < 0.0001) even when analysis was limited to games only (21 fewer impacts per player-season, p < 0.0001). The linear acceleration was higher among females (1.07 g; 95% CI 1.00, 1.13; p = 0.04). There were no other meaningful sex differences in head impact severity. Female players are not permitted to body check, and this likely explains why they sustain fewer head impacts than males. However, as a result, females likely sustain a higher proportion of head impacts through illegal or unintentional head contact, and these impacts may result in more force being delivered to the head.