A Ten-Year Nationwide Review of Youth Field Hockey Injuries in New Zealand

Abstract

Youth sport participation offers a range of physical, social, and psychological benefits, yet the associated injury burden remains an ongoing public health concern. To date, anecdotal concerns regarding increasing youth sport injury rates have not been confirmed with appropriate data. In New Zealand (NZ), field hockey (hockey) is a popular sport for youth and ranks fifth among team sports for injury insurance claims according to national data. However, unlike other popular youth sports (e.g. netball, football, rugby), it does not yet have a sport-specific injury prevention framework, despite evidence that such programmes effectively reduce injury risk. This thesis aimed to determine if injury rates in youth sport are increasing and to inform targeted youth hockey injury prevention strategies. It consists of a systematic review of lower quadrant injury incidence in youth team sports and an epidemiological analysis of lower extremity injuries in NZ youth hockey using national insurance data.

The systematic review synthesised evidence from 45 studies with data collected between 2013 and 2024 in youth aged 10–24 years. The eight team sports with the highest injury insurance claims in NZ were explored: rugby union, football, netball, basketball, field hockey, rugby league, touch rugby, and cricket. No consistent increase or decrease in injury incidence was observed over time across sports, although this was limited by considerable heterogeneity in data collection methods. However, sport-specific patterns emerged: over time injury rates increased in rugby union, fluctuated in football, remained stable in netball, and decreased in basketball. Injury location patterns varied by sport, with common injuries occurring in the knee and ankle in basketball, hip/groin/upper leg in football, and hip/groin/upper leg and knee in rugby union. Compared to other sports, more research is needed in netball, hockey, rugby league, and touch rugby.

The epidemiological study analysed 10 years of Accident Compensation Corporation (ACC) injury claim data for youth hockey players aged 10–24 years. Lower extremity injury rates significantly decreased over the 10-year period, with rates 35% lower in 2022/23 compared to 2013/14. Knee injuries were the most common and costly, followed by ankle and hip/upper leg/thigh injuries. Females had significantly higher knee and ankle injury rates than males, and injury rates and costs increased with age. Seasonal injury spikes were observed at the start of the season (May-June) and around tournament periods (August-September), particularly in 10–19-year-old players.

Together, these findings provide little evidence of an increase in youth sport injuries over the last 10 years. The evidence does support the need for age-, sex- and sport-specific injury prevention strategies in youth team sport. In youth hockey, prevention efforts should prioritise knee injuries, particularly in older youth players, and address seasonal risk periods through preparation and load management. The results also highlight the importance of consistent injury surveillance methodologies to enable meaningful comparisons across sports over time and better inform injury prevention efforts. This thesis provides a strong foundation to inform the development of hockey-specific injury prevention strategies in NZ and contributes to broader efforts to reduce youth sport injury burden.