Injury Incidence Before and After the Introduction of Body Checking in Elite Women’s Ice Hockey: A 7-Year Prospective Insurance-Based Study

Objectives In 2022, the Swedish Women’s Elite Ice Hockey League (SDHL) became the first women’s league to introduce bodychecking. Using insurance data, this study examined injury incidence before and after the implementation of this rule. Method Since 2019, the SDHL has comprised 10 teams with 20–25 players on each. All players in SDHL have license insurance to take care of ice hockey injuries. All injuries that lead to contact with the insurance company are registered in a database. The insurance covers accidental injuries occurring during matches, organized team practices, hockey school sessions, and direct travel to and from these activities. Injury data from all seasons between 2019–2020 until 2024–2025 were analyzed. Injury rates (IR) per 1,000 player game hours were calculated and compared across seasons and between pre-implementation (2019–2022) and post-implementation (2022–2025) periods. Results A total of 120 injuries were recorded. IR per 1,000 player game hours increased sharply from 6.6 (95% CI 3.8–10.7) in season 2021–2022 to 16.7 (11.6–23.2) in 2022–2023, with moderately elevated rates remaining in subsequent seasons. When grouped by period before and after bodychecking implementation, IR increased from 6.0 (4.4–8.1) pre-implementation to 11.0 (8.6–13.7) post-implementation (p < 0.05). The injury incidence was highest during the first season with body checking and a decline in injury incidence was found post-implementation. Conclusions The introduction of bodychecking in the SDHL was associated with a significant increase in injuries recorded through the insurance system, indicating that this rule change may lead to a higher injury burden. Future studies should evaluate strategies for introducing body checking in women’s ice hockey in ways that minimize injury risk.