Abstract
Background:
Concussions in ice hockey remain a major concern, especially among young players. Current helmets mainly protect against skull fractures but offer limited shielding from brain acceleration forces.
Methods:
A narrative review of epidemiological studies, helmet safety research, and technological innovations in other sports like cycling, equestrian, and football was conducted to assess limitations of current helmets and the potential for advanced protective systems.
Results:
Concussion rates remain relatively high, with inconsistent diagnoses making comparisons difficult. Standard helmets show minimal performance differences and have limited ability to reduce rotational forces. Innovations like wearable sensors integrated into helmets offer notable protection benefits in other sports. However, hockey-specific concerns include repeated impacts, usability, and weight limits.
Discussion:
Smart technologies such as airbag helmets present a viable path toward enhanced protection in ice hockey. Translating these solutions requires engineering adaptation, interdisciplinary collaboration, and cultural acceptance, especially urgent in youth sport, where long-term risks are greatest.
Introduction
Concussion in ice hockey is an increasing concern across youth, elite, and international levels, with evidence showing rising incidence rates, longer recovery times, and lasting health effects (–). By raising awareness through education and modifying the hockey rink, such as introducing safety glasses, the environment can be made safer. However, these changes must be implemented carefully, as going too far could turn the sport from a contact game into a non-contact one. This paper discusses the potential of innovative technologies to prevent concussions in ice hockey, arguing that solutions like smart helmets are only a matter of time before they become viable.
Concussions in ice hockey
An ice hockey game is played on a white ice surface called the rink, surrounded by smooth, white boards with a yellow kick plate at the base. Rink dimensions vary from 56 to 61 m in length and 26 to 30 m in width, with rounded corners (radius of 7 to 8.5 m). Protective glass, ranging from 80 to 200 cm in height, is installed above the boards, especially at the ends and sides of the rink, to protect players. All doors swing away from the ice, and only designated markings and advertising are allowed according to official regulations. Helmets and eye protector shields (Figure 1) are mandatory in ice hockey to safeguard players from head injuries, including concussions and skull fractures, as well as to protect the eyes from pucks, sticks, and other potential hazards that can cause serious injury during high-speed play ().
Figure 1
Studies report higher concussion rates in North American leagues than in European ones, reflecting both contextual and methodological influences (). The more physical North American playing style (), greater player aggression (), and a smaller rink size () may contribute to these differences. Yet diagnostic inconsistencies, such as variations in how concussions are defined and recorded, complicate cross-regional comparisons and may obscure actual incidence patterns ().
It is estimated that 20%–25% of players in youth hockey sustain at least one concussion each season (, ). Similarly, concussions are common in the National Hockey League, occurring at a rate of 6 per 100 games, with concussions accounting for 14% to 30% of all hockey-related head injuries (). Based on a systematic review, the incidence of concussions in the NHL ranged from 0.54 to 1.18 per 1,000 athlete-exposures between the 2000–2001 and 2022–2023 seasons (). Based on this premise, the prevalence of concussions in hockey remains notably high across various levels, although inconsistencies in diagnosis hinder accurate comparisons.
Youth players face higher concussion risks than older players, as increased risk during early adolescence is due to the disparity in size, strength, and speed among boys at this age (). Additionally, the body checking at a younger age can lead to injuries caused by poor checking techniques and a lack of awareness on the ice, resulting in more collisions (). Games present significantly greater risks than practices, with illegal contact and bodychecking being significant factors (). Evidence suggests that stricter rule enforcement and flexible rink designs can help reduce these risks (). Biomechanical studies further reveal that long-duration, high-acceleration impacts are key injury mechanisms, highlighting the need for better helmet standards (). Emerging smart helmets that incorporate sensor technologies and adaptive materials are promising advancements, building on innovations from other sports like cycling and equestrian activities (–).
The limitations of current helmets
Recent research into helmet safety (Table 1) highlights several key advancements and challenges. Meehan et al. () developed realistic concussion-simulating tests for ice hockey helmets, urging improvements in testing standards. Champoux et al. () applied this protocol to three helmet models, finding minimal performance differences, suggesting a need for more innovative designs. Kolstad et al. () found that mouthguards significantly reduce the risk of concussion, while helmet age had no effect, supporting the mandatory use of mouthguards in youth hockey. Haid et al. () demonstrated that mechanical metamaterials offer design flexibility and superior energy management. Research by Tse and Holder () and Abderezaei et al. () has shown that airbag systems and rotational-damping technologies enhance protection, suggesting a potential application in hockey helmet integration. Giusti Gestri () and Goutnik et al. () emphasized the role of sensor-based feedback and cross-disciplinary approaches in advancing helmet safety and standards. Standard ice hockey helmets are primarily designed to protect against skull fractures and superficial head injuries. However, they provide limited protection against concussions (, , , ). They fall short in addressing concussions, which are caused not by direct impact to the skull but by the sudden acceleration or deceleration of the brain inside the cranium (). Modern helmet designs use foam padding to absorb energy. However, this static approach falls short in reducing rotational forces, which are recognized as playing a central role in concussion mechanisms ().
Table 1
| Study | Year | Helmet type | Testing method | Key metrics | Performance summary | Recommendations |
|---|---|---|---|---|---|---|
| Abderezaei et al. () | 2021 | Helmets with different technologies | Bicycle helmet drop tests | Peak rotational acceleration (PRA), peak linear acceleration (PLA), generalized acceleration model for brain injury threshold (GAMPIT) | Rotation-damping and collapsible technologies improved protection | Incorporate rotation management features in future designs |
| Tse and Holder () | 2021 | Airbag-integrated bicycle helmet | Simulated dynamic impacts | Head kinematics, brain injury metrics | Outperformed standard helmets, even when airbags did not deploy | Explore airbag systems for hockey helmet applications |
| Giusti Gestri () | 2023 | Jockey safety vests and sensors | Qualitative, user-informed design | Potential for real-time injury data | Sensor integration may enhance protective equipment design | Apply sensor-based feedback/diagnostics in helmets |
| Meehan et al. () | 2022 | Ice hockey helmets | Ice drop, angled board drop, pneumatic ram | Max Principal Strain (MPS) | Replicated realistic concussion-causing impacts | Use findings to improve helmet test standards |
| Champoux et al. () | 2024 | Ice hockey helmet designs | Meehan's protocol | Linear and rotational acceleration, Max Principal Strain (MPS) | Only small performance differences across helmet models | Designs may be too similar; greater innovation is needed |
| Kolstad et al. () | 2023 | Mouthguard, helmet age | Real-world cohort and injury surveillance | Concussion rate and odds ratio | Mouthguards significantly reduce concussion risk; helmet age is not a risk factor | Making mouthguards mandatory in youth hockey |
| Haid et al. () | 2023 | Mechanical metamaterial-based helmets | Structural and topology optimization | Linear and rotational acceleration | Provided design flexibility and energy management | Encourage the adoption of metamaterials in sports helmets |
| Goutnik et al. () | 2022 | Sports and military helmets | Literature review | Protection mechanisms, test standards | Highlighted helmet design gaps and injury mechanisms | Support cross-discipline innovation and updated standards |
| McGillivray et al. () | 2022 | Comparison of materials in helmet liners | Static and dynamic lab tests | Energy absorption, head acceleration | Thermoplastic polyurethane (TBU) outperformed vinyl-nitrile and was comparable/better than expanded polypropylene (EPP) | Recommend TPU/EPP combination for enhanced protection |
Summary of helmet safety studies.
Future technologies in concussion prevention
Ice hockey helmets still perform poorly compared to headgear used in other sports (). The most innovative head protection has emerged from sports such as horse riding, cycling (), and football (). Devices equipped with accelerometers and gyroscopes can measure the magnitude and direction of impacts in real-time, providing valuable data to coaches, medical staff, and researchers (). For instance, an Australian qualitative study recommended further research on wearable sensors to enhance the protection offered by jockeys' safety vests (). Research in equestrian sports has demonstrated the potential of embedding wearable sensors into protective gear, providing real-time injury feedback and diagnostic capabilities that could be applied to helmets (). These systems are already being tested in American football, where early detection has led to quicker removal and evaluation of potentially concussed players (). These findings suggest that adopting sensor technologies could substantially advance concussion prevention in ice hockey.
A more revolutionary concept is the use of smart technologies such as airbag systems in helmets. While this may sound far-fetched, prototypes already exist in other sectors. For example, airbag and rotation-damping helmets have been shown to significantly reduce the risk of brain injury in cycling (, ). An air-filled bicycle helmet for cyclists features an expandable airbag that protects the head, and an additional airbag designed to prevent neck injuries, both of which inflate within milliseconds upon activation (). The principle is sound: rather than passively absorbing force, these devices dynamically respond to impacts, reducing both linear and rotational acceleration. Beyond hockey, evidence from cycling highlights the protective benefits of rotational-damping technologies, which substantially reduce brain strain in oblique impacts ().
While airbag-integrated helmets have shown promise in other sports (, ), adapting such systems to ice hockey helmets presents engineering challenges. Unlike cycling, hockey involves frequent, multidirectional collisions in confined spaces, where both linear and rotational accelerations contribute to the risk of concussion (, ). Airbag systems, which rely on rapid inflation and increased helmet volume for protection, may be impractical in this context due to fit, weight, and mobility constraints, as well as their limited ability to manage rotational accelerations (). Moreover, hockey helmets must endure repeated impacts within a single game, a demand that single-deployment airbag designs cannot meet. Despite challenges (e.g., deployment speed, false positives, and comfort issues), advances in sensors, batteries, and artificial intelligence suggest that airbag helmets could become commercially viable within a few years.
To accelerate progress in ice hockey, researchers, engineers, and sports scientists must coordinate efforts to translate existing technologies into rink-ready applications. The ethical case for smarter head protection is particularly strong in youth hockey, where developing brains are more susceptible to long-term damage (). While professional athletes, such as those in the NHL, may accept a certain level of risk for their careers, younger athletes deserve better safeguards. Relying solely on rule changes or better coaching is not enough. Without a technological leap, we are simply accepting a baseline of injury that science may already have the tools to lower. Some scepticism exists around integrating complex tech into an already gear-heavy sport. Concerns include cost, weight, reliability, and whether players would accept such changes. But this resistance has historical precedent: when Jacques Plante first wore a goalie mask in 1959, the idea was ridiculed. Today, no goaltender would play without one. Similarly, carbon fibre sticks, once dismissed as fragile, are now ubiquitous. The trajectory of innovation shows that once safety technologies prove effective and scalable, acceptance follows.
Conclusion
The problem of concussion in ice hockey is not new, but the tools to address it are evolving rapidly. From sensor-embedded helmets to the potential of airbag systems, technology presents an unprecedented opportunity to transform the landscape of injuries. Integrating innovative materials, real-time data, and dynamic response systems could significantly reduce concussions in both professional and amateur hockey. As with many disruptive innovations, it is not a question of if these tools will be adopted, but when. The game can evolve without losing its identity. The only real obstacle is the common willingness to embrace the future.
Statements
Author contributions
AG: Funding acquisition, Resources, Supervision, Visualization, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that financial support was received for the research and/or publication of this article. This study was funded by the United Arab Emirates University (UAEU) (Grant no. 12D061), which had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Conflict of interest
The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that Generative AI was used in the creation of this manuscript. Figure 1 is AI generated.
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References
1.
PauelsenMNybergGTegnerCTegnerY. Concussion in ice hockey—a cohort study across 29 seasons. Clin J Sport Med. (2017) 27(3):283–7. 10.1097/JSM.0000000000000347
2.
ParizekAFerraroFR. Concussions in ice hockey. Curr Sports Med Rep. (2016) 15(1):23–6. 10.1249/JSR.0000000000000209
3.
PierpointLACollinsC. Epidemiology of sport-related concussion. Clin Sports Med. (2021) 40(1):1–18. 10.1016/j.csm.2020.08.013
4.
International Ice Hockey Federation. IIHF official rulebook 2024/25 (Version 1.0, May 2024). Available online at:https://stats.iihf.com/hockey/rules/img/sec1.pdf (Accessed September 10, 2025).
5.
RuheAGänsslenAKleinW. The incidence of concussion in professional and collegiate ice hockey: are we making progress? A systematic review of the literature. Br J Sports Med. (2014) 48(2):102–6. 10.1136/bjsports-2012-091609
6.
FlikKLymanSMarxR. American Collegiate men's Ice hockey: an analysis of injuries. Am J Sports Med. (2005) 33(2):183–7. 10.1177/0363546504267349
7.
GeeCLeithL. Aggressive behavior in professional ice hockey: a cross-cultural comparison of North American and European born NHL players. Psychol Sport Exerc. (2007) 8:567–83. 10.1016/j.psychsport.2006.06.006
8.
WennbergR. Collision frequency in elite hockey on North American versus international size rinks. Can J Neurol Sci. (2004) 31:373–7. 10.1017/s0317167100003474
9.
JohnsonLS. Concussion in youth ice hockey: it's time to break the cycle. CMAJ. (2011) 183(8):921–4. 10.1503/cmaj.110282
10.
RentonTHowittSMarshallC. Lifetime prevalence of concussion among Canadian ice hockey players aged 10 to 25 years old, 2014 to 2017. J Can Chiropr Assoc. (2019) 63(2):80–91.
11.
AndrewsEJildehTRAbbasMJLindsay-RiveraKBergusonJOkorohaKR. Concussions in the national hockey league: analysis of incidence, return to play, and performance. Orthop J Sports Med. (2022) 10(1):23259671211052069. 10.1177/23259671211052069
12.
ShlobinNAGoelKChenJKondziolkaD. Concussions in ice hockey: mixed methods study including assessment of concussions on games missed and cap hit among National Hockey League players, systematic review, and concussion protocol analysis. Neurosurg Focus. (2024) 57(1):E11. 10.3171/2024.4.FOCUS24103
13.
KontosAPElbinRJSufrinkoADakanSBookwalterKPriceAet alIncidence of concussion in youth ice hockey players. Pediatrics. (2016) 137(2):e20151633. 10.1542/peds.2015-1633
14.
MarchieACusimanoMD. Bodychecking and concussions in ice hockey: should our youth pay the price?CMAJ. (2003) 169(2):124–8.
15.
TuominenMHänninenTParkkariJStuartMJLuotoTKannusPet alConcussion in the international ice hockey World Championships and Olympic Winter Games between 2006 and 2015. Br J Sports Med. (2016) 51(4):244–52. 10.1136/bjsports-2016-097119
16.
PostAHoshizakiTBKartonCClarkJMDawsonLCournoyerJ. The biomechanics of concussion for ice hockey head impact events. Comput Methods Biomech Biomed Eng. (2019) 22(6):631–43. 10.1080/10255842.2019.1577827
17.
AbderezaeiJRezayaraghiFKainBMenichettiAKurtM. An overview of the effectiveness of bicycle helmet designs in impact testing. Front Bioeng Biotechnol. (2021) 9:718407. 10.3389/fbioe.2021.718407
18.
TseKMHolderD. A biomechanical evaluation of a novel airbag bicycle helmet concept for traumatic brain injury mitigation. Bioengineering. (2021) 8(11):173. 10.3390/bioengineering8110173
19.
Giusti GestriL. Wearable technology may assist in reducing jockeys’ injuries if integrated into their safety vests: a qualitative study. Front Sports Active Living. (2023) 5:1167110. 10.3389/fspor.2023.1167110
20.
MeehanAPostAHoshizakiTBGilchristMD. Investigation of an ice hockey helmet test protocol representing three concussion event types. J Test Eval. (2022) 50(1):465–78. 10.1520/JTE20200436
21.
ChampouxLPostAGilchristMDHoshizakiT. Comparison of three different ice hockey helmets using an ice hockey specific test protocol. Proc Inst Mech Eng P J Sports Eng Technol. (2024). 10.1177/17543371241290896
22.
KolstadATEliasonPHGalarneauJ-MBlackAMHagelBEEmeryCA. Protective equipment in youth ice hockey: are mouthguards and helmet age relevant to concussion risk?Br J Sports Med. (2023) 57:571–8. 10.1136/bjsports-2022-105585
23.
HaidDFosterLHartJGreenwaldRMAllenTSarehPet alMechanical metamaterials for sports helmets: structural mechanics, design optimisation, and performance. Smart Mater Struct. (2023) 32(11):113001. 10.1088/1361-665X/acfddf
24.
GoutnikMGoeckeritzJSabettaZCurryTWillmanMWillmanJet alNeurotrauma prevention review: improving helmet design and implementation. Biomechanics. (2022) 2(4):500–12. 10.3390/biomechanics2040039
25.
McGillivrayKPrzysuchaESanzoPLiuMZerpaC. Comparison of hockey helmet lining technologies in mitigating concussion risk during simulated horizontal head collisions. Int J Extrem Autom Connect Healthcare. (2022) 4(1):1–17. 10.4018/ijeach.316134
26.
RowsonSDumaSM. Brain injury prediction: assessing the combined probability of concussion using linear and rotational head acceleration. Ann Biomed Eng. (2013) 41(5):873–82. 10.1007/s10439-012-0731-0
27.
GuskiewiczKMMihalikJP. Biomechanics of sport concussion: quest for the elusive injury threshold. Exerc Sport Sci Rev. (2011) 39(1):4–11. 10.1097/JES.0b013e318201f53e
28.
Virginia Tech Helmet Ratings. Available online at:https://www.helmet.beam.vt.edu/index.html(Accessed April 15, 2025).
29.
PattonDAMcIntoshASKleivenS. The biomechanical determinants of concussion: finite element simulations to investigate brain tissue deformations during sporting impacts to the unprotected head. J Appl Biomech. (2013) 29(6):721–30. 10.1123/jab.29.6.721
30.
CriscoJJFioreRBeckwithJGChuJJBrolinsonPGDumaSet alFrequency and location of head impact exposures in individual collegiate football players. J Athl Train. (2010) 45(6):549–59. 10.4085/1062-6050-45.6.549
31.
McCroryPMeeuwisseWDvorakJAubryMBailesJBroglioSet alConsensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. (2017) 51(11):838–47. 10.1136/bjsports-2017-097699
Summary
Keywords
sports-related injury, head trauma prevention, protective equipment, athlete, health
Citation
Gråstén A (2025) Smart technologies and the future of concussion prevention in ice hockey. Front. Sports Act. Living 7:1646119. doi: 10.3389/fspor.2025.1646119
Received
12 June 2025
Accepted
29 October 2025
Published
12 November 2025
Volume
7 - 2025
Edited by
Filippo Brighina, University of Palermo, Italy
Reviewed by
Lisa Giusti Gestri, Monash University, Australia
Wenduo Liu, Jeonbuk National University, Republic of Korea
Updates
Copyright
© 2025 Gråstén.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Arto Gråstén agrasten@uaeu.ac.ae
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.