This year, the research agenda for the US Lacrosse’s Sports Science and Safety Committee includes: partnering with the NCAA to study gender differences in ACL injury rates in lacrosse as compared those seen in soccer and basketball; utilizing mouthpiece implanted, biomechanical sensors to determine direct impact and rotational stresses players receive to their head during practice and game situations; and analyzing game video to determine rules enforcement in youth tournaments. Recently published papers from our group include the Evaluation of the women's lacrosse protective eyewear mandate. Through their impact on rules adoption, equipment design, and officiating priorities Information gained from these types of projects is changing the game you play.
A major goal of such efforts is to bring objective, unbiased information to the decision process concerning health and safety issues facing lacrosse. Andy Lincoln, ScD, Research Director of MedStar Orthopaedic and Sports Medicine and consultant to US Lacrosse points out, “research does not exist in a vacuum, but is important in tempering passionate opinion and preconceived notions.” “Put them in men’s helmets and let um play”. How many times has that been proposed as an answer to head, face, and eye injuries in the women’s game? Well, men are wearing men’s helmets and have higher concussion rates than women. Again, Dr. Lincoln: “Our research findings suggest that women in men’s helmets playing a game more similar to men’s lacrosse would significantly increase the overall injury burden in the game.” Yes, there may be a place for evolving head gear in the women’s lacrosse but it needs to be game specific. Research shows us that the answers to problems are rarely as simple as we would like them to be. Real world injuries are related to multiple, complex risk factors which not only involve the athlete but the environment in which they are playing. A parent reading about the tragic commotion cordis (a rare condition in which blunt contact to the chest results in heart arythmia) related death of a 12 year old lax player in upstate New York would reasonably ask, “ Why aren’t field players required to wear some type of chest protectors?” Unfortunately, research to date has not found such devices to decrease the risk of this condition and in the few lacrosse related incidents the involved player has indeed sometimes been a goalie wearing chest protection. This is important because rushing out to buy unproven equipment may take attention and effort away from currently more effective interventions such as having AEDs and emergency medical plans for all lacrosse events.
The base of most our current lacrosse specific medical research is formed by injury surveillance studies. Such programs involve the computerized, ongoing collection of injury and background information on large groups of athletes. They provide the who, what, where, when, and how of injuries. Lacrosse specific information is being gathered by the NCAA Datalys System on collegiate players, the Fairfax County Virginia and Columbus Children’s RIO Injury Surveillance Programs on scholastic athletes, and US Lacrosse is working with local rec departments, national youth tournaments, and possibly USA football to develop surveillance program for younger players. These systems include information on literally tens of thousands of lacrosse game and practice exposures. Through these systems we know that the most common injuries in men’s lacrosse are We know that most injuries occur during transitional play and ground ball situations. We know that game injury rates are two to three times higher than practice situations. We understand that lacrosse is a relatively safe sport with overall injury rates for the women’s game being in the lower one third and the men’s in the middle one third of American team sports. Dr. Lincoln’s et al recent paper on the eyewear mandate in women lacrosse is a great example of utilizing such injury systems. Though taken for granted now, the introduction of mandatory protective eyewear nearly ten years ago was quite controversial. Would the goggles be effective? Would other injuries increase? Would it led to a more aggressive style of play? His research done in conjunction with US Lacrosse and the NCAA has found that men's lacrosse generally has a 30% to 40% higher game injury rate and similar practice injury rates as compared with the women's collegiate game although HFE injuries constitute a substantially larger percentage of injuries in women's games than in men's games. Most of the women's HFE injuries are minor in terms of days lost from play, but there is a real potential for significant damage to the unprotected face with a hard ball being thrown at eye level at speeds up to 60 mph.
Another exciting research area is combing the injury surveillance approach with high tech biomechanical tools such as video analysis and motion sensor devices. Defined injury events can be analyzed as to specific player/ team activity and energy being absorbed by a player during injury situations. Utilizing such tools, Dr. Lincoln’s et al recent paper Head, face and eye injuries in scholastic and collegiate lacrosse, studied data on 507 000 girls' and boys' high school and 649 573 women's and men's college lacrosse athletic exposures using sport-specific injury surveillance systems over 4 seasons. They identified the most common scenarios for head, face, and eye injuries. This information has already been incorporated in rules changes banning takeout hits on unprotected players in the men’s game and will have a vital role in the discussion of concussion prevention for both men’s and women’s lacrosse.
You can find the latest on lacrosse sports medicine research at the US Lacrosse web site under the SSSC heading and the organization’s coaching and officiating programs incorporate many of these recent findings. Medical professionals and game’s administrators can contact the organization concerning continuing education opportunities, such as the Instructional Course Lecture on Lacrosse Sports Medicine being presented at this July’s American Orthopaedic Society for Sports Medicine annual meeting being held right here in Baltimore.