Skill-based conditioning games as an alternative to traditional conditioning for rugby league players

This study investigated the effects of skill-based conditioning games and traditional conditioning for improving speed, agility, muscular power, and maximal aerobic power in rugby league players. Sixty-nine subelite rugby league players performed either a skill-based conditioning games program (N = 32) or a traditional conditioning (i.e., running activities with no skill component) program (N = 37). Each player participated in a 9-week in-season training program, performed over 2 competitive seasons. Players performed 2 organized field-training sessions each week. Players underwent measurements of speed (10-m, 20-m, and 40-m sprint), muscular power (vertical jump), agility (L run), and maximal aerobic power (multi-stage fitness test) before and after the training period. Skill-based conditioning games induced a significant improvement (p < 0.05) in 10-m, 20-m, and 40-m speed, muscular power, and maximal aerobic power, whereas traditional conditioning activities improved 10-m speed and maximal aerobic power only. No significant differences (p > 0.05) were detected between the traditional conditioning and skill-based conditioning games groups for changes in 10-m speed, agility, and maximal aerobic power. Both groups won 6 of 8 matches played within the training period, resulting in a win-loss ratio of 75%. However, on average, the skill-based conditioning games group scored more points in attack (p < 0.05) and had a greater (p < 0.05) points differential than the traditional conditioning group. The results of this study demonstrate that skill-based conditioning games offer an effective method of in-season conditioning for rugby league players. In addition, given that skills learned from skill-based conditioning games are more likely to be applied in the competitive environment, their use may provide a practical alternative to traditional conditioning for improving the physiological capacities and playing performance of rugby league players.     

Influence of playing position on the site, nature, and cause of rugby league injuries

This study investigated the influence of playing position on the site, nature, and cause of injuries in rugby league. The incidence, site, nature, and cause of playing injuries was prospectively studied in 156 rugby league players over 2 seasons. An injury was defined as any pain or disability suffered by a player during a match that resulted in the player missing a subsequent match. The hooker (101 per 1,000 playing hours) and prop (92 per 1,000 playing hours) positions had the highest incidence of injury. Injuries sustained by the fullback (32 per 1,000 playing hours) and halfback (44 per 1,000 playing hours) positions were less common. Compared with other individual playing positions, props had a significantly higher incidence of overexertion injuries (22 per 1,000 playing hours), thigh and calf injuries (47 per 1,000 playing hours), and hematomas (19 per 1,000 playing hours), whereas the five-eighth position (31 per 1,000 playing hours) and the hookers and halves positional group (17 per 1,000 playing hours) had a significantly higher incidence of falling and stumbling injuries. These results demonstrate that the hooker and prop positions have higher injury rates than other rugby league positions. Furthermore, the site, type, and cause of injuries are different among individual playing positions and playing groups. These findings suggest that individual position training for injury prevention is warranted in rugby league.     

Do skill-based conditioning games offer a specific training stimulus for junior elite volleyball players?

This study investigated the specificity of skill-based conditioning games and compared the effectiveness of skill-based conditioning games and instructional training for improving physical fitness and skill in junior elite volleyball players. Twenty-five junior volleyball players (mean age +/- SE, 15.6 +/- 0.1 years) participated in this study. Heart rate data were collected on all players during the Australian Junior Volleyball Championships. After the competition, players were randomly allocated into a skill-based conditioning games group (n = 12) or an instructional training group (n = 13). Each player participated in a 12-week training program that included 3 organized court training sessions per week. No significant differences (P > 0.05) were detected between competition and skill-based conditioning games for the percentage of time spent in low-intensity, moderate-intensity, and high-intensity activities. Skill-based conditioning games induced improvements in vertical jump, spike jump, speed, agility, upper-body muscular power, and estimated maximal aerobic power, whereas technical instruction improved only spike jump and speed. Conversely, instructional training induced meaningful improvements in all measurements of skill, whereas improvements in technical skill after skill-based conditioning games were uncommon and typically small. The results of this study show that skill-based conditioning games offer a specific training stimulus to simulate the physiological demands of competition in junior elite volleyball players. Although the improvements in physical fitness after training were greater with skill-based conditioning games, instructional training resulted in greater improvements in technical skill in these athletes. These findings suggest that a combination of instructional training and skill-based conditioning games is likely to confer the greatest improvements in fitness and skill in junior elite volleyball players.     

Performance changes following a field conditioning program in junior and senior rugby league players

This study investigated training loads, injury rates, and physical performance changes associated with a field conditioning program in junior and senior rugby league players. Thirty-six junior (16.9 [95% confidence interval: 16.7-17.1] years) and 41 senior (25.5 [23.6- 27.3] years) rugby league players participated in a 14-week preseason training program that included 2 field training sessions each week. Subjects performed measurements of standard anthropometry (height, body mass, and sum of 7 skinfolds), muscular power (vertical jump), speed (10-, 20-, and 40-m sprint), agility (L run), and maximal aerobic power (multistage fitness test) before and after training. Improvements in agility, muscular power, and maximal aerobic power were observed in both the junior and senior players following training; however, the improvement in maximal aerobic power and muscular power were greatest in the junior players. Training loads and injury rates were higher in the senior players. These findings demonstrate that junior and senior rugby league players adapt differently to a given training stimulus and that training programs should be modified to accommodate differences in training age.     

A skill-based conditioning games approach to metabolic conditioning for elite rugby football players

The purpose of this study was to evaluate changes in endurance fitness of elite-level rugby union players (n = 35) undertaking skill-based conditioning games for a 9-week preseason training period. Metabolic conditioning was conducted exclusively in the form of skill-based conditioning games in conjunction with heart rate (HR) telemetry. Two markers of cardiorespiratory fitness were assessed at weekly intervals via the recording of HR responses to an intermittent multistage shuttle test. Significant differences post-training were observed for the percentage of maximal HR (% HRmax) reached during the final test stage and the percentage of HR recovery (% HR recovery) from the end of the final stage to the end of the final 1-minute rest period. Significant improvements were demonstrated for % HR recovery at week 7 (p < 0.05) and week 9 (p < 0.01), and % HRmax in the final test stage was significantly lower at weeks 4, 5, and 7 (p < 0.05) and week 9 (p < 0.01). Further improvements from mid-preseason to the end of the preseason training period were observed for % HR recovery scores in week 8 (p < 0.01) and week 9 (p = 0.012) and for % HRmax reached in the final test stage at week 9 (p < 0.05). These results indicate skill-based conditioning games were successful at improving markers of cardiorespiratory endurance for the duration of a 9-week training period in the elite-level professional rugby union players studied. The HR monitoring was demonstrated to be an effective and practical means of quantifying intensity in the conditioning games format and of tracking changes in cardiorespiratory fitness.     

Performance changes following training in junior rugby league players

The purpose of this study was to investigate the time course of adaptations to training in young (i.e., <15 years) and older (i.e., <18 years) junior rugby league players. Fourteen young (14.1 +/- 0.2 years) and 21 older (16.9 +/- 0.3 years) junior rugby league players participated in a 10-week preseason strength, conditioning, and skills program that included 3 sessions each week. Subjects performed measurements of standard anthropometry (i.e., height, body mass, and sum of 7 skinfolds), muscular power (i.e., vertical jump), speed (i.e., 10-m, 20-m, and 40-m sprint), agility (505 test), and estimated maximal aerobic power (i.e., multistage fitness test) before and after training. In addition, players underwent a smaller battery of fitness tests every 3 weeks to assess the time course of adaptation to the prescribed training stimulus. During the triweekly testing sessions, players completed assessments of upper-body (i.e., 60-second push-up, sit-up, and chin-up test) and lower-body (i.e., multiple-effort vertical jump test) muscular endurance. Improvements in maximal aerobic power and muscular endurance were observed in both the young and the older junior players following training. The improvements in speed, muscular power, maximal aerobic power, and upper-body muscular endurance were greatest in the young junior players, while improvements in lower-body muscular endurance were greatest in the older junior players. These findings demonstrate that young (i.e., <15 years) and older (i.e., <18 years) junior rugby league players adapt differently to a given training stimulus and that training programs should be modified to accommodate differences in maturational and training age. In addition, the results of this study provide conditioning coaches with realistic performance improvements following a 10-week preseason strength and conditioning program in junior rugby league players.     

Injuries of the spine sustained in rugby.

Between 1952 and 1982, 67 rugby players (63 rugby union, two rugby league, and two American football) sustained serious injuries of their spine. The injuries fell predominantly on the lower cervical spine. Forty eight of the players sustained serious injuries of the spinal cord, leading to paralysis and total incapacity. The incidence of such injuries appears to have increased in recent years, particularly those incurred in tackles and mauls and rucks, and particularly among schoolboys. Changes in the laws of the game and in the attitudes of the players over the past few years should improve play and lead to a lower incidence of injuries.     

Injuries in Rugby Union football.

In a prospective study of 185 players attached to 10 British rugby clubs, 151 injuries were recorded among 98 of them (53%) during a single season. Forwards sustained significantly more injuries than backs. The standard of rugby, players'' body weights, degree of fitness, and presence of joint hypermobility did not affect the risk of injury. The leg was the most common site of injury. Head and neck injuries were significantly more common when play was static and on wet pitches. Scrummaging accounted for no neck injuries. Almost half the injuries occurred during the last quarter of games. Foul play might have caused as many as 47 (31%) of all reported injuries. Complete eradication of deliberately dangerous play would considerably reduce the high incidence of injuries in this sport.     

Changes in physiological and anthropometric characteristics of rugby league players during a competitive season

This study investigated the physiological and anthropometric characteristics of rugby league players during a competitive season. Sixty-eight rugby league players were allocated into training (n = 52) and nonexercise control (n = 16) groups. The training group participated in 2 field-training sessions per week, with training loads, match loads, and injury rates recorded. Subjects performed measurements of standard anthropometry (height, body mass, and sum of 7 skinfolds), muscular power (vertical jump), speed (10-, 20-, and 40-m sprint), agility (L run), and maximal aerobic power (multistage fitness test) in December (off-season), March (preseason), May (midseason), and August (end season). Increases in maximal aerobic power and muscular power and reductions in skinfold thickness were observed during the early phases of the season when training loads were highest. However, reductions in muscular power and maximal aerobic power and increases in skinfold thickness occurred toward the end of the season, when training loads were lowest and match loads and injury rates were highest. These findings suggest that high overall playing intensity and match loads in end-season matches increase in injury rates in the latter half of the season, and residual fatigue associated with limited recovery between successive matches may compromise the physical development of rugby league players.     

Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study

Objective To investigate whether a neuromuscular training programme is effective in preventing non-contact leg injuries in female floorball players.Design Cluster randomised controlled study.Setting 28 top level female floorball teams in Finland.Participants 457 players (mean age 24 years)—256 (14 teams) in the intervention group and 201 (14 teams) in the control group—followedup for one league season (six months).Intervention A neuromuscular training programme to enhance players’ motor skills and body control, as well as to activate and prepare their neuromuscular system for sports specific manoeuvres.Main outcome measure Acute non-contact injuries of the legs.Results During the season, 72 acute non-contact leg injuries occurred, 20 in the intervention group and 52 in the control group. The injury incidence per 1000 hours playing and practise in the intervention group was 0.65 (95% confidence interval 0.37 to 1.13) and in the control group was 2.08 (1.58 to 2.72). The risk of non-contact leg injury was 66% lower (adjusted incidence rate ratio 0.34, 95% confidence interval 0.20 to 0.57) in the intervention group.Conclusion A neuromuscular training programme was effective in preventing acute non-contact injuries of the legs in female floorball players. Neuromuscular training can be recommended in the weekly training of these athletes.Trial registration Current Controlled Trials ISRCTN26550281.     

Physiological and anthropometric characteristics of junior rugby league players over a competitive season

This study investigated the physiological and anthropometric characteristics of junior rugby league players over a competitive season. Forty-five rugby league players were allocated into training (n = 36) and nonexercise control (n = 9) groups. The training group participated in 2 field-training sessions each week with training loads, match loads, and injury rates recorded. Subjects performed measurements of standard anthropometry (height, body mass, and sum of 7 skinfolds), muscular power (vertical jump), speed (10-, 20-, and 40-m sprint), agility ('L run'), and estimated maximal aerobic power (multi-stage fitness test) in December (off-season), March (preseason), May (midseason), and August (end-season). Training loads progressively increased in the general preparatory phase of the season (preseason period), and declined slightly during the competitive phase of the season. Match intensity and match loads decreased throughout the season. Increases in estimated maximal aerobic power and muscular power and reductions in skinfold thickness occurred during the general preparatory phase of the season, and were maintained throughout the competitive phase of the season. These findings suggest that high training loads in the general preparatory phase of the season and low match loads in the competitive phase of the season allow junior rugby league players to maintain a high level of fitness throughout an entire competitive season.     

Relationship between running loads and soft-tissue injury in elite team sport athletes

Although the potential link between running loads and soft-tissue injury is appealing, the evidence supporting or refuting this relationship in high-performance team sport athletes is nonexistent, with all published studies using subjective measures (e.g., ratings of perceived exertion) to quantify training loads. The purpose of this study was to investigate the risk of low-intensity (e.g., walking, jogging, total distances) and high-intensity (e.g., high acceleration and velocity efforts, repeated high-intensity exercise bouts) movement activities on lower body soft-tissue injury in elite team sport athletes. Thirty-four elite rugby league players participated in this study. Global positioning system data and the incidence of lower body soft-tissue injuries were monitored in 117 skill training sessions during the preseason and in-season periods. The frailty model (an extension of the Cox proportional regression model for recurrent events) was applied to calculate the relative risk of injury after controlling for all other training data. The risk of injury was 2.7 (95% confidence interval 1.2-6.5) times higher when very high-velocity running (i.e., sprinting) exceeded 9 m per session. Greater distances covered in mild, moderate, and maximum accelerations and low- and very low-intensity movement velocities were associated with a reduced risk of injury. These results demonstrate that greater amounts of very high-velocity running (i.e., sprinting) are associated with an increased risk of lower body soft-tissue injury, whereas distances covered at low and moderate speeds offer a protective effect against soft-tissue injury. From an injury prevention perspective, these findings provide empirical support for restricting the amount of sprinting performed in preparation for elite team sport competition. However, coaches should also consider the consequences of reducing training loads on the development of physical qualities and playing performance.     

Physiological and skill demands of 'on-side' and 'off-side' games

This study investigated the physiological and skill demands of 'on-side' and 'off-side' games in elite rugby league players. Sixteen male rugby league players participated in 'on-side' and 'off-side' games. Both small-sided games were played in a 40- × 40-m playing area. The 'off-side' game permitted players to have 3 'plays' while in possession of the ball. Players were permitted to pass backward or forward (to an 'off-side' player). The 'on-side' game also permitted players to have 3 'plays' while in possession of the ball. However, players were only permitted to pass backward to players in an 'on-side' position. Heart rate and movement patterns (via global positioning system) were recorded continuously throughout both games. Data were collected on the distance covered, number of high-acceleration and velocity efforts, and recovery between efforts. Video footage was also taken to track the performance of the players. Post hoc inspection of the footage was undertaken to count the number of possessions and the number and quality of disposals. In comparison to 'on-side' games, 'off-side' games had a greater number of involvements ("touches"), passes, and effective passes. However, the cognitive demands of 'on-side' games were greater than 'off-side' games. 'Off-side' games resulted in a greater total distance covered, greater distance covered in mild and moderate accelerations, and greater distance covered in low, moderate, and high-velocity efforts. There were also a greater number of short duration recovery periods between efforts in 'off-side' games. The results of this study demonstrate that 'off-side' games provide greater physiological and skill demands than 'on-side' games. 'Off-side' games may provide a practical alternative to 'on-side' games for the development of skill and fitness in elite rugby league players.     

Influence of field size on the physiological and skill demands of small-sided games in junior and senior rugby league players

The purpose of this study was to investigate the effect of changes in field size on the physiological and skill demands of small-sided games in elite junior and senior rugby league players. Sixteen elite senior rugby league players ([mean ± SE] age, 23.6 ± 0.5 years) and 16 elite junior rugby league players ([mean ± SE] age, 17.3 ± 0.3 years) participated in this study. On day 1, 2 teams played an 8-minute small-sided game on a small field (10-m width × 40-m length), whereas the remaining 2 teams played the small-sided game on a larger sized field (40-m width × 70-m length). On day 2, the groups were crossed over. Movement was recorded by a global positioning system unit sampling at 5 Hz. Games were filmed to count the number of possessions and the number and quality of disposals. The games played on a larger field resulted in a greater (p < 0.05) total distance covered, and distances covered in moderate, high, and very-high velocity movement intensities. Senior players covered more distance at moderate, high, and very-high intensities, and less distance at low and very-low intensities during small-sided games than junior players. Although increasing field size had no significant influence (p > 0.05) over the duration of recovery periods for junior players, larger field size significantly reduced (p < 0.05) the amount of short-, moderate-, and long-duration recovery periods in senior players. No significant between-group differences (p > 0.05) were detected for games played on a small or large field for the number or quality of skill involvements. These results suggest that increases in field size serve to increase the physiological demands of small-sided games but have minimal influence over the volume or quality of skill executions in elite rugby league players.     

Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial

Objective To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports.Design Cluster randomised controlled trial with clubs as the unit of randomisation.Setting 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months).Participants 1837 players aged 15-17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group.Intervention A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength.Main outcome measure The rate of acute injuries to the knee or ankle.Results During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1000 player hours; 0.3 (SE 0.17) in training v 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1000 player hours; 0.2 (SE 0.18) in training v 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) v (76 (8.6%); relative risk intervention group v control group 0.53, 95% confidence interval 0.35 to 0.81).Conclusion A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.     

Changes in skill and physical fitness following training in talent-identified volleyball players

This study investigated the effect of a skill-based training program on measurements of skill and physical fitness in talent-identified volleyball players. Twenty-six talented junior volleyball players (mean +/- SE age, 15.5 +/- 0.2 years) participated in an 8-week skill-based training program that included 3 skill-based court sessions per week. Skills sessions were designed to develop passing, setting, serving, spiking, and blocking technique and accuracy as well as game tactics and positioning skills. Coaches used a combination of technical and instructional coaching, coupled with skill-based games to facilitate learning. Subjects performed measurements of skill (passing, setting, serving, and spiking technique and accuracy), standard anthropometry (height, standing-reach height, body mass, and sum of 7 skinfolds), lower-body muscular power (vertical jump, spike jump), upper-body muscular power (overhead medicine-ball throw), speed (5- and 10-m sprint), agility (T-test), and maximal aerobic power (multistage fitness test) before and after training. Training induced significant (p < 0.05) improvements in spiking, setting, and passing accuracy and spiking and passing technique. Compared with pretraining, there were significant (p < 0.05) improvements in 5- and 10-m speed and agility. There were no significant differences between pretraining and posttraining for body mass, skinfold thickness, lower-body muscular power, upper-body muscular power, and maximal aerobic power. These findings demonstrate that skill-based volleyball training improves spiking, setting, and passing accuracy and spiking and passing technique, but has little effect on the physiological and anthropometric characteristics of players.     

Relationship between physical fitness and playing ability in rugby league players

This study investigated the physiological, anthropometric, and skill characteristics of rugby league players and determined the relationship between physical fitness and playing ability in these athletes. Eighty-six rugby league players (mean +/- SD age, 22.5 +/- 4.9 years) underwent measurements of standard anthropometry (height, body mass, and sum of 4 skinfolds), muscular power (vertical jump), speed (10-, 20-, and 40-m sprint), agility (L run), and estimated maximal aerobic power (multistage fitness test). In addition, 2 expert coaches independently assessed the playing ability of players using standardized skill criteria. First-grade players had significantly greater (p < 0.05) basic passing and ball-carrying ability and superior skills under fatigue, tackling and defensive skills, and evasion skills (i.e., ability to beat a player and 2 verse 1 skills) than second-grade and third-grade players. While no significant (p > 0.05) differences were detected among playing levels for body mass; skinfold thickness; height; 10-, 20-, or 40-m speed; agility; vertical jump height; or estimated maximal aerobic power, all the physiological and anthropometric characteristics were significantly (p < 0.05) associated with at least 1 measure of playing ability. The results of this study demonstrate that selected skill characteristics but not physiological or anthropometric characteristics discriminate between successful and less successful rugby league players. However, all physiological and anthropometric characteristics were related to playing ability. These findings suggest that while physiological and anthropometric characteristics do not discriminate between successful and less successful rugby league players, a high level of physical fitness contributes to effective playing ability in these athletes. A game-specific training program that incorporates both physical conditioning and skills training may facilitate a greater transfer of physical fitness to competitive performances in rugby league.     

Comparison of lower body strength, power, acceleration, speed, agility, and sprint momentum to describe and compare playing rank among professional rugby league players

Success in rugby league football seems heavily reliant on players possessing an adequate degree of various physical fitness qualities, such as strength, power, speed, agility, and endurance, as well as the individual skills and team tactical abilities. The purpose of this study was to describe and compare the lower body strength, power, acceleration, maximal speed, agility, and sprint momentum of elite first-division national rugby league (NRL) players (n = 20) to second-division state league (SRL) players (n = 20) players from the same club. Strength and maximal power were the best discriminators of which players were in the NRL or SRL squads. None of the sprinting tests, such as acceleration (10-m sprint), maximal speed (40-m sprint), or a unique 40-m agility test, could distinguish between the NRL or SRL squads. However, sprint momentum, which was a product of 10-m velocity and body mass, was better for discriminating between NRL and SRL players as heavier, faster players would possess better drive forward and conversely be better able to repel their opponents' drive forward. Strength and conditioning specialists should therefore pay particular attention to increasing lower body strength and power and total body mass through appropriate resistance training while maintaining or improving 10-m sprint speed to provide their players with the underlying performance characteristics of play at the elite level in rugby leagues.     

Epidemiology of training injuries in amateur taekwondo athletes: a retrospective cohort study

The objectives of this study were to estimate the incidence and describe the pattern and severity of training injuries in taekwondo, and to compare pattern and severity of training injuries with competition injuries. One hundred and fifty-two active Australian amateur taekwondo athletes, aged 12 years or over, completed an online survey comprising questions on training exposure and injury history over the preceding 12 months. The main outcome measures were: overall injury incidence rate per athlete-year; training injury incidence rate per athlete-year, per 1000 athlete-training-sessions, and per 1000 athlete-hours of training; injury severity; and injury proportions by anatomical region and by type of injury. Injury incidence rates were calculated with 95% confidence intervals using standard methods, while injury proportions were compared using Fisher''s exact test. The vast majority (81.5%) of taekwondo injuries in an average athlete-year occurred during training. The training injury incidence rate was estimated to be 1.6 (95% CI: 1.4, 1.9) per athlete-year, 11.8 (95% CI: 10.4, 13.4) per 1000 athlete-training-sessions, and 7.0 (95% CI: 6.1, 7.9) per 1000 athlete-hours of training. Among athletes with five or fewer injuries, the severity and injury pattern of training injuries were, by and large, the same as for competition injuries. Approximately sixty percent (60.3%) of training injuries required treatment by a health professional. Considering the burden of training injuries exceeds that of competition injuries, taekwondo governing bodies and stakeholders are encouraged to devote more efforts towards the identification of risk factors for, and prevention of, training injuries in the sport of taekwondo.     

Bodychecking Rules and Concussion in Elite Hockey

Athletes participating in contact sports such as ice hockey are exposed to a high risk of suffering a concussion. We determined whether recent rule changes regulating contact to the head introduced in 2010–11 and 2011–12 have been effective in reducing the incidence of concussion in the National Hockey League (NHL). A league with a longstanding ban on hits contacting the head, the Ontario Hockey League (OHL), was also studied. A retrospective study of NHL and OHL games for the 2009–10 to 2011–12 seasons was performed using official game records and team injury reports in addition to other media sources. Concussion incidence over the 3 seasons analyzed was 5.23 per 100 NHL regular season games and 5.05 per 100 OHL regular season games (IRR 1.04; 95% CI 1.01, 1.50). When injuries described as concussion-like or suspicious of concussion were included, incidences rose to 8.8 and 7.1 per 100 games respectively (IRR 1.23; 95% CI 0.81, 1.32). The number of NHL concussions or suspected concussions was lower in 2009–10 than in 2010–11 (IRR 0.61; 95% CI 0.45, 0.83), but did not increase from 2010–11 to 2011–12 (IRR 1.05; 95% CI 0.80, 1.38). 64.2% of NHL concussions were caused by bodychecking, and only 28.4% of concussions and 36.8% of suspected concussions were caused by illegal incidents. We conclude that rules regulating bodychecking to the head did not reduce the number of players suffering concussions during NHL regular season play and that further changes or stricter enforcement of existing rules may be required to minimize the risk of players suffering these injuries.