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Background:   Ice hockey has significant workload demands. Research of other sports has suggested that decreased rest between games as well as an increased workload may increase the risk of injuries.Purpose:   To evaluate whether condensed game schedules increase the frequency and severity of injuries in the National Hockey League (NHL).Study Design:   Descriptive epidemiology study.Methods:   Data were obtained from publicly available online sources on game schedules and injuries for all NHL teams for the 2005-2006 through 2018-2019 seasons. Injury rates (per team per game) and the proportion of severe and nonsevere injuries were determined. The game-spacing analysis assessed the risk of injuries in relation to the number of days between games played (range, 0-≥6 days). The game-density analysis assessed the risk of injuries in relation to the number of games played within 7 days (range, 1-5 games). Results were assessed by analysis of variance, the post hoc Tukey test, and the chi-square test of distribution.Results:   The game-spacing analysis included 33,170 games and 7224 injuries, and a significant group difference was found ( P = 1.44×10 –5 ), with the post hoc test demonstrating an increased risk of injuries when games were spaced with &lt;1 day of rest. There was no significant difference in the ratio of severe to nonsevere injuries. The game-density analysis included 33,592 games and 10,752 injuries, and a significant group difference was found ( P = 8.22×10 –48 ), demonstrating an increased risk of injuries with an increased number of games in all conditions except for the comparison between 4 versus 5 games in 7 days. There was also a significant difference in injury severity ( P = .008), indicating that the least dense condition had a higher ratio of severe to nonsevere injuries compared with the other game-density conditions. Finally, the game-density analysis was repeated after excluding games played with &lt;1 day of rest, and the finding of increased injury rates with increasingly condensed schedules remained significant ( P = 9.52×10 –46 ), with significant differences between all groups except for the comparison between 1 versus 2 games in 7 days.Conclusion:   We found that a condensed schedule and &lt;1 day of rest between games were associated with an increased rate of injuries in the NHL. These findings may help in the design of future game schedules.

Game Spacing and Density in Relation to the Risk of Injuries in the National Hockey League