OBJECTIVE: To compare physical contacts (PCs), including head contacts (HCs), suspected concussion, and nonconcussion injury incidence rates between youth ringette and female ice hockey. DESIGN: Cross-sectional. SETTING: Alberta ice arenas. PARTICIPANTS: Players participating in 8 U16AA (ages 14-15 years) ringette and 8 U15AA (ages 13-14 years) female ice hockey games during the 2021 to 2022 season. ASSESSMENT OF RISK FACTORS: Dartfish video-analysis software was used to analyze video recordings. MAIN OUTCOME MEASURES: Univariate Poisson regression analyses (adjusted for cluster by team-game, offset by game minutes) were used to estimate PCs (including HCs) and suspected injury (concussion and nonconcussion) and concussion-specific IRs and incidence rate ratios (IRRs) to compare sports. Proportions of all PCs that were body checks (level 4-5 trunk PC) and direct HCs (HC 1 ) penalized were reported. RESULTS: Ringette had a 2.6-fold higher rate of body checking compared with hockey (IRR = 2.63, 95% CI: 1.59-4.37). Ringette also had a 2-fold higher rate of HC 1 compared with hockey (IRR = 2.08, 95% CI: 1.37-3.16). A 3.4-fold higher rate of suspected injury was found in ringette (IRR = 3.37, 95% CI: 1.40-8.15). There was no significant difference in suspected concussion IRs in ringette compared with hockey (IRR = 1.93, 95% CI: 0.43-8.74). Despite being prohibited in both sports, only a small proportion of body checks (Ringette = 18%
Hockey = 17%) and HC 1 (Ringette = 6%
Hockey = 6%) were penalized. CONCLUSIONS: Higher rates of body checking, HC 1 , and suspected injuries were found in ringette compared with female ice hockey. Body checking and HC 1 were rarely penalized, despite rules disallowing them in both sports. Future research should consider other youth age groups.