Jan 29, 2015

Youth Lacrosse Injury Breakdown

By Dawn Comstock

Contributor Dawn Comstock, PhD, Principle Investigator at The Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital, takes a look at injury rates and trends for youth lacrosse players.

Almost 300,000 U.S. youth aged 2-18 play lacrosse every year. Lacrosse is a unique sport because playing styles differ drastically between males and females. No body checking is permitted among females, while males to body check, generally beginning at the sixth-grade level. Meanwhile, females are allowed to only stick check, and usually not until the seventh-grade level. Because of the heightened level of contact, males are required to wear extensive padding that includes a helmet, facemask, mouthguard, shoulder pad, arm pads, and gloves. On the other hand, females are only required to wear a mouthguard and eye goggles. Goaltenders, both male and female, wear specialized protective equipment.

A recent study published in the Journal of Athletic Training used data from the National Electronic Injury Surveillance System (NEISS) to examine lacrosse injuries. NEISS is a surveillance system that collects injury-related data from a nationally representative sample of 100 US emergency departments (EDs). This study estimated that 85,000 children presented to the ED for lacrosse-related injuries from 1990 through 2003. During this period, injury incidence has increased among females, likely a reflection of participation growth among females. As one might expect, due to playing style differences, injury patterns vary widely between males and females. Following is a highlight of these injury patterns:

Common Body Sites of Injuries:

• Males injured their hand/wrist (23 percent), shoulder/upper arm (15 percent), and lower leg/foot/ankle (14 percent) most commonly • Females injured their lower leg/foot/ankle (26 percent), hand/wrist (25 percent), and face (21 percent) most commonly • Compared to females, male injuries were five times more likely to be shoulder injuries • Compared to males, female injuries were two times more likely to be facial injuries • Compared to older children (aged 10-18), injuries among younger children (aged 2-9) were two times more likely to be facial injuries

Most Common Injury Diagnoses:

• Males and female both presented to EDs most frequently with contusions/abrasions (one in three injuries) and sprains/strains (one in four injuries) • Compared to females, male injuries were 50 percent more likely to be fractures

Facial injuries among female lacrosse players have been gaining much attention lately due to their potentially severe nature. The NEISS injury study found that eight in 10 female facial injuries were to the face, with the eye and mouth each accounting for one in 10 facial injuries. Although the most common types of facial injuries were contusions/abrasions (37 percent) and lacerations (28 percent), fractures made up 21 percent. Due to the limited bodily contact among competitors, female facial injuries resulted most commonly following contact with the ball (51 percent) or stick (42 percent). As with all other sporting injuries, understanding the patterns and mechanisms of lacrosse injuries helps researchers develop targeted preventive interventions. Although males wear protective equipment that covers their shoulder/upper arm area, this increased protective gear does not fully compensate for the heightened level of contact, as males sustained greater proportions of shoulder/upper arm injuries than females.

Further research should focus on decreasing the incidence of male shoulder/upper arm injuries, possible through improved protective equipment, additional functional strength training, or improved checking techniques. In addition, coaches and athletic trainers should make sure their athlete–particularly younger male athletes learning to check–are aware that their equipment will not prevent all injuries. Our previous research supports the 2005 regulation mandating eye protection among female high school lacrosse players, as it will likely decrease the incidence of serious eye injuries. However, the research shows that prior to 2005, eye injuries accounted for only one in 10 facial injuries presenting to an ED. Thus, requiring full-facial shields in female lacrosse and among younger participants will have a much great impact in reducing the incidence of serious facial injuries.

Referenced Article: Yard EE, Comstock RD. Injuries sustained by pediatric ice hockey, lacrosse, and field hockey athletes presenting to United States emergency departments, 1990-2003. Journal of Athletic Training. 2006 Oct-Dec;41(4):441-9.

Dawn Comstock, PhD, is a principle investigator at the Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital. She is also an assistant professor at The Ohio State University in the College of Medicine and the College of Public Health. Her research interests include the epidemiology of sports, recreation, and leisure activity-related injuries among children and adolescents as well as the life-long health benefits associated with an active childhood. She can be reached at [email protected]. FEEDBACK I am a lacrosse coach and a sports injury doc… The most common injury I see in my girls, bar far: shin splints. 2^nd : tracking problems in the knee (strong lat quad. Weak medial, resulting in chondromalacia patella. I find that proper training in the weight room can improve or prevent either…

-Jen Milus www.bluedoglax.com www.girlslax.org