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Vancouver Canucks' Keith Ballard (front) hip-checks Minnesota Wild's Warren Peters during the second period of their NHL hockey game in Vancouver, British Columbia March 14, 2011.BEN NELMS

In his latest study on hockey injuries, Michael Cusimano has zeroed in on an old debate: can allowing bodychecking at a younger age improve safety by teaching kids to hit properly?

The study, published Tuesday in the journal Open Medicine, centred around the 1998-99 youth hockey season, when Hockey Canada lowered the legal age for body contact to include Atom-level players. The rule change introduced boys as young as nine to the hits. (Previously, only those aged 12 years and older could bodycheck. The rules have since been reversed so the earliest age of allowable body contact is with 11-year-old Pee Wee players.)

Dr. Cusimano, a neurosurgeon and researcher at St. Michael's Hospital in Toronto, and his colleagues found that the Atom-aged kids were more than two times as likely to be injured from bodychecking after the rule changes took effect. Interestingly, the rate of head injuries increased by 26 per cent overall, including in the older age groups. Head and necks were among the body parts that saw the biggest jump in injury rates.

The results were based on a total of 8,552 hockey-related injuries reported at five Ontario hospitals during a 10-year period beginning in 1994. Injuries reported before the rule change were compared to those suffered after the rule change in players ages nine to 17.

The take-home message: "If we want to protect kids' brains, then we need to seriously consider what is the value of allowing bodychecking in youth hockey," Dr. Cusimano says.

Dr. Cusimano detailed the findings for The Globe and Mail from Toronto.

You found that the odds of being injured increased in all age groups after the rule change, but the most significant increase happened with Atom players, when kids were first exposed to bodychecking. Why do you think that is?

As soon as you expose a person to a risk, then you see a big jump. But the risk doesn't go down later. It stays up. In fact, in some of the older age groups, the risk was also higher as well.

So is it possible that the increased risk of injury from bodychecking has nothing to do with age?

That's right. If [body checking was first allowed at]age 18, [the increase] would probably have occurred when they were 18. If it was six, it probably would have occurred when they were six.

Can you continue that thought? Are you saying that bodychecking is just inherently dangerous, no matter how old you are?

I think there's some truth in that. If you've got three-year-old kids who are doing it, there's probably no intention in the three-year-olds to hurt each other. They haven't developed that culture yet … they just want to have fun. Whereas by the time they get to 10, 11 years old, they're starting to understand the culture of winning and the culture of what they're supposed to be doing out there. So it would manifest there.

In your paper, you point to several other studies that have showed that "learning to bodycheck at a younger age does not reduce a player's odds of injury." You add that allowing kids to start bodychecking earlier only prolongs their exposure to risk. But some people still argue that you can prevent injuries by teaching kids to bodycheck properly. Why do you think that idea persists?

I think it's just a lack of understanding of what the data says. Who do you think are the best bodycheckers are in the world?

NHL players?

And who do you think has the highest rate of concussion in the world?

NHL players?

Well, if they knew how to give and take a check the best of anybody, why wouldn't their rates be one of the lowest rates? It doesn't have to do with learning to give or take a bodycheck. Look at Sidney Crosby. Is there any player in the world who has more skill than Crosby? Maybe [Alexander] Ovechkin. Maybe not. That's like putting the blame on the player who receives the bodycheck. That's a total misunderstanding of the inherent risk of the practice.

Maybe what they're saying is that the people who are doing the bodychecking don't know how do it properly.

Well, the same argument goes for the NHL then. Those guys know how to give a bodycheck. Those guys certainly know how to put Sidney Crosby out. And [Zdeno]Chara certainly knows how to put out [Max]Pacioretty. They know how to give it and they know how to take it, but the fact is, people are still getting injured. And ultimately the game is getting injured and damaged. Because if you're a mother or father with a young child, you're going to think twice … the kids are leaving the sport.

You've been sounding the alarm about violence in hockey for a long time, but have you noticed that the conversation has changed in the past year?

I think things are shifting. I think things like the Sidney Crosby event is sort of shifting the whole focus as well. People are coming around to recognizing: What's the value in this practice of allowing kids to get their brains injured? And really, brains are our most precious resource. So why should we tolerate that?

NOTE: The script of this conversation has been edited and condensed.

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