# Nonsteroid Anti‐Inflammatory Drug Use in Female Elite Ice Hockey Players With and Without Previous Concussions and Musculoskeletal Injuries

## TL;DR

This study found that nearly 20% of female elite ice hockey players use NSAIDs weekly, with those having persistent concussion symptoms more likely to use them frequently.

## Contribution

The study provides baseline NSAID usage data in female ice hockey players after body checking was introduced.

## Key findings

- Approximately 18% of players used NSAIDs at least once weekly.
- Players with persistent post-concussion symptoms were five times more likely to use NSAIDs weekly.
- NSAID use was not significantly higher in players with previous concussions without persistent symptoms.

## Abstract

Ice hockey is a high‐intensity sport with high rates of concussions and musculoskeletal injuries. To manage pain, players may (over) use nonsteroid anti‐inflammatory drugs (NSAIDs) which can have adverse health effects. In 2022, the Swedish Women's Elite League (SDHL) became the first women's league to introduce body checking, potentially increasing injury risks and NSAID use. This study examines NSAID consumption among SDHL players and its associations with concussions and musculoskeletal injuries. All 224 players registered in SDHL 2023/2024 were invited to participate. The data of 158 included players (71%) aged (mean ± standard deviation) 23.4 ± 4.5 years were analyzed. NSAID use, concussions and musculoskeletal injury rates were assessed through a self‐reported questionnaire. In all players, 18% used NSAID at least once weekly, 15% used them one to three times per week, and 3% used them four to seven times per week. Players with previous concussions without persistent symptoms or musculoskeletal injuries did not have significantly higher odds of using more NSAIDs than those without. Players with persistent symptoms after concussion(s) were approximately five times more likely to use NSAIDs weekly than those with previous concussion(s) but without persistent symptoms (Odds Ratio (95% confidence interval): 4.9 (1.1, 21.3)) (p < 0.05). In conclusion, almost one‐fifth of female ice hockey players used NSAIDs weekly. Players with persistent post‐concussion symptoms are a subgroup that should be monitored more closely to prevent excessive NSAID use. The observed NSAID usage rates presented in this study represent important (baseline) reference values in female ice hockey players allowed to body check.