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According to new research published in the British Journal of Sports Medicine, football beats hockey and soccer for the dubious distinction of the sport most likely to cause neck injury. The study is the second in a series examining the risk of injury in community-based sports with a view to improving safety. The potential dangers of neck injury in football were highlighted last weekend by the death of Arena Football lineman Al Lucas from a presumed spinal cord injury sustained during a match.

"Football, hockey and soccer are three of the most popular contact sports in North America," says Dr. Scott Delaney, research director of the Department of Emergency Medicine at the ³ÉÈËVRÊÓƵ Health Centre (MUHC) in Montreal. "Each sport has been recognized as a high-risk activity for head injuries, but very little research has been conducted on the risk of neck injuries for recreational athletes competing in these sports."

Researchers combined hospital emergency department data with sport participation figures from across the US during the 1990s to determine the relative risk of neck injury for football, hockey and soccer. The study included all types of neck injuries, ranging from serious fractures, dislocations and lacerations to concussions, strains and sprains. Overall, researchers discovered those playing football suffered significantly more neck injuries than those playing hockey or soccer.

"Although high energy impacts occur in all three sports, only football tackles are designed to completely impede the motion of opposing players," notes Dr. Delaney, who is a physician for the Montreal Alouettes, Montreal Impact and Cirque du Soleil.

Overall, serious injuries that result in paralysis or death declined slightly towards the end of the decade; Dr. Delaney believes this decrease may have been triggered by improved safety equipment and rule changes that outlawed dangerous tackles in football and hitting from behind in hockey.

Neck lacerations requiring a visit to the emergency department — an injury believed to be more common in hockey than football or soccer — dropped to zero after 1994, according to the study. "The introduction of neck protectors may have played an important role in preventing these serious injuries in ice hockey," says Dr. Delaney. "It always pays to play it safe."

The ³ÉÈËVRÊÓƵ Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at ³ÉÈËVRÊÓƵ — the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.