Almost every week during the regular hockey season a player (amateur or professional) suffers a serious spinal injury. From 1982 - 1996, Canada reported 252 hockey related major spinal cord injuries, followed by Sweden with 54 and the United States with 36. Most of those injuries were sustained by players 16 to 20 years of age who were playing in supervised games, reinforcing the necessity of targeting the minor hockey community with the message of skilled and respectful play.

The Canadian Medical Association Journal published a report titled "Hockey injuries of the spine in Canada, 1966-96". Dr. Charles Tator of the division of neurosurgery at the University of Toronto, Dr. James Carson of Women's College Hospital, and Dr. Robert Cushman, a medical officer of health in Ottawa, all contributed to the report in which 1965 physicians received a questionnaire in 1997. Other cases were added to the report through the Canadian Hockey Association and a study of catastrophic recreational injury in Ontario.

In Canada, there were 243 spinal injuries reported from 1966-1996 by non-professional hockey players. Half of those injured were between the ages of 16 and 20. Six players were known to have died as a result of their injuries. Of the cases with enough data to assess the level of injury, 184 (85%) of the 216 injuries were at the cervical level.

The study defines a spinal injury as a fracture of dislocation of the spine with or without injury to the spinal cord of nerve roots.

In an accompanying article, "Preventing spinal cord injuries: Is this the best we can do?" Dr. Barry Pless of the Montreal Children's Hospital calls for a complete ban on body checks against the boards and from behind at non-professional levels.

A push, or check from behind accounted for 74 (40%) of the 184 of cases of injury for which there was adequate information to determine the cause of the injury. Injuries caused by an impact with the boards numbered 157 (77%) of the 204 cases where their was sufficient documentation.

Dr. Pless says the research "is a useful reminder that our national sport may also be an important cause of catastrophic injury.

"To learn that there have been close to 250 such injuries in the past 30 years is shocking," he said.

Another surprising statistic from the report is that the number of injuries from Ontario was significantly higher than any other province. Ontario accounted for 52% of the injuries, whereas only 9% came from Quebec.

Pless believes that this is partly due to Quebec not allowing body checking at the peewee level (ages 12 and 13), as players are permitted to in Ontario.

In response to the need for prevention, the American and Canadian Spinal Research Organizations (ASRO and CSRO) have developped an innovative program called Play it Cool to help generate awareness and prevention of spinal cord injuries in hockey. The vision of the CSRO and the ASRO is to equip minor hockey players who play recreational or organized hockey in Canada or the U.S. with the knowledge and skills that may prevent a hockey-related spinal cord injury. The CSRO and the ASRO plan to work collaboratively with the hockey community to instill the belief in players, coaches, trainers, families and fans that skill enhancement is the key to injury prevention.