Most successful businesses would not accept spending $218 million on lost time, but that's the amount NHL owners pay out every year to players who miss games due to injury, according to new research.

More than 63 per cent of the 1,307 NHL players who laced up skates during the 2009-10, 2010-11 and 2011-12 regular seasons, missed at least one game due to a hockey-related injury.

"Employers are morally responsible for protecting their employees," said Dr. Michael Cusimano, a St. Michael's Hospital neurosurgeon and researcher. "The NHL owners need to do a better job of protecting their athletes -- if not for their players, then for their own pocketbooks."

Over the course of three seasons, $653 million was doled out to injured athletes who were unable to play. The findings were published in British Medical Journal's Injury Prevention.

"Most arguments against changing the game cite the connection between violence and revenue," said Dr. Cusimano. "But this research shows that preventable injuries - such as concussions, that are clearly related to violent acts in 88 per cent of cases - have an important economic burden in addition to the high personal health costs that players bear."

Dr. Cusimano's team, looked at the types of injuries and the location they're sustained to determine the most costly hockey injuries. Time lost to concussions alone accounted for $42.8 million each year.

During a 30-week sample, head and neck injuries, such as concussions, were the second-most common injury. These injuries also accounted for, on average, the most games missed (11 games) and were the single most expensive type of injury ($353,300 per injury).

Leg and foot injuries were the most common injury during that sample and accounted for 30 per cent of the total cost - roughly $68 million.

Groin ailments were the third-most frequent.On average, however, injuries to the groin were less costly ($203,900) than those to the shoulder ($306,600), arm/hand ($290,000) and chest/abdomen ($219,400).

In 2010 the NHL enacted Rule 48, banning blind side hits to the head. The following season, the rule was expanded to include targeted head shots from any direction. Both of these seasons were included in the study and Dr. Cusimano's findings show that despite these recent efforts, more needs to be done to curb head shots and prevent all forms of injuries.