Hockey Fistfights Rarely Cause Injuries, Study Claims

Punches thrown on solid ground pack more power, researchers say

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By Randy Dotinga
HealthDay Reporter

FRIDAY, Oct. 21 (HealthDay News) -- Brawls on the ice are a staple of professional ice hockey games, but are they as vicious as they look? A new study suggests that few punches thrown during National Hockey League games end in significant injury.

The study claims that fighting on skates isn't particularly dangerous, possibly because it's hard to get traction for a powerful punch on the ice, said co-author Dr. David Milzman, an associate professor of emergency medicine at Georgetown University School of Medicine.

"They get a lot more injuries being checked into the boards, being hit from behind," he said.

Milzman went even further: "I've watched enough hockey that I can tell you clearly that if you take the release valve of fighting out of it, you'd have a lot more dirty playing, and probably more injuries would result from players not being able to blow off steam by fighting."

Professional hockey allows plenty of physical contact between players, from "checking" (skating into another player) to the routine fistfights that are part of the sport's appeal.

The NHL calls such fights -- when throwers discard their gloves and jab at each other -- fisticuffs. Critics say the fighting is dangerous, and in 1988 the Canadian Academy of Sport Medicine called for fighting's elimination, saying it hurts players and is an "endemic and ritualized blot on the reputation of the North American game." But more than 20 years later, the fights continue.

In the new study, researchers analyzed videos of more than 1,200 preseason and regular hockey games from the NHL 2010-11 season. They watched 710 fights, taking notes about what happened, and analyzed what happened to the players who fought. To determine if fighting on skates was more or less hazardous than fighting on solid ground, they also looked at injuries sustained by non-hockey players treated for fights at emergency or trauma centers.

The study findings were scheduled to be released this week at a meeting of the American College of Emergency Physicians in San Francisco. The research is considered preliminary because it hasn't gone through the peer review required before studies are published in medical journals.

The hockey fights only caused 17 reported injuries, five of them to the knuckles. The non-players treated for fighting had a much higher rate of knuckle injuries -- 81 percent, the researchers found.

The risk of concussion in a fight was much lower for brawling hockey players (0.39 percent) compared to the per-game risk for those who checked one another (nearly 4.5 percent).

Even roundhouse punches to the jaw seemed to lack the power to injure. "If you're hitting somebody outside a bar on the ground, more than 50 percent of the time that's going to break a jaw," Milzman said. "We saw no jaw fractures in over 1,400 fights."

The ice appears to be protective because it's harder to gain traction on it during a fight, he said. In the big picture, he said, "maybe there is a place for fighting in hockey."

Alison Macpherson, an assistant professor in kinesiology and health science at York University in Toronto who has studied hockey injuries, won't go that far. She's skeptical of the findings, noting that teammates and referees are on the scene to prevent hockey fights from becoming extremely violent, while that's not the case in fights elsewhere.

Also, she said, it's not clear whether players reported all hockey injuries resulting from the fights. "They might not let someone know if they had an injury, and it would keep them from playing," she said.

Questions linger about the long-term risks of hockey fights. Derek Boogaard, a 28-year-old "enforcer" for the New York Rangers, was found dead in his Minneapolis apartment last May, five months after a season-ending concussion. His family decided to donate his brain to a Boston University project that found that another NHL tough guy, Bob Probert, had signs of brain trauma resulting from blows to the head, the Associated Press reported.