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The fastest growing team sport

First appeared as a Baltimore Sun Column by Richard Hinton, MD, MPH

Lacrosse is the fastest growing team sport in America. Its combination of speed, sticks, ball and contact make for a unique set of injury types, mechanisms and priorities.  Growing nearly as fast as the game itself are the efforts of a group of health care professionals and lacrosse experts working in the exciting area of lacrosse specific sports medicine. This not only includes developing best treatments for lacrosse related injuries but also the broader areas of injury prevention, safety promotion and enhancing participation at all levels of play. Though national in scope these efforts are being led from right here in Baltimore by US Lacrosse the sport’s national governing body and its’ medical / research partner MedStar Sports Medicine. 

When US Lacrosse convened its first Sports Science and Safety Committee (USLSSSC) twelve years ago there were six of us around the table. The organization’s CEO, Steve Stenersen charged the grouped with determining the medical priorities facing the game, developing appropriate research infrastructure, and providing education and unbiased advice to the lacrosse community concerning health and safety issues.  Today there are over twenty five active members on the USLSSSC, each a national expert in areas ranging from neuro psychology to risk management; pediatric sports medicine to injury epidemiology.  In addition to its’ relationships with MedStar Sports Medicine, the committee also has working partnerships with the NCAA, the National High School Federations, American Orthopaedic Society for Sports Medicine, the American College of Sports Medicine and many other national sporting organizations. 

Research is being pursued on a number of fronts and having a tangible impact on the game.  Computerized injury surveillance programs are gathering data on thousands of scholastic and collegiate lacrosse athletic exposures. High speed video analysis is being utilized to determine the mechanisms of head and knee injuries in both the men’s and women’s game. Sensors embedded in mouthpieces; similar to those being used in football helmets, are shedding light on the mechanisms of lacrosse specific head injuries. Information from such studies have been integral in safety related rules and equipment changes; such as the woman’s eyewear mandate in 2004 and more recent decisions to curb purposeful body checking in both the youth and men’s game. Other initiatives are resulting in better direct medical care of lacrosse athletes.  White papers from the USLSSSC have helped games administrators develop better emergency medical plans, uniform standards for helmet and stick biomechanics, and better guides for youth participation.  Partnership with the Acompora Foundation on cardiac issues and the effective on field use of AEDs has literally saved several young lacrosse lives over the past couple of years. As Stenersen points out “US Lacrosse is regarded nationally as a best practices organization with regard to sports, science and safety”.

Priority issues facing the game are numerous, yet on some fronts very basic. Again, Steve Stenersen, CEO of US Lacrosse “I think the most fundamental issue that impacts player safety is the quality of coaching a young player receives. Nothing is more important to player safety and a consistently positive lacrosse experience than a coach who knows how to teach the game correctly and reinforces a positive culture of play.  Properly educated officials are also a necessity.  We should never assume that individuals are qualified to coach or officiate the game just because they have played.  Since its inception in 1998 US Lacrosse has prioritized the development and delivery of national standards of education for these important members of lacrosse community”. 

There are some “growing pains” related to the sports exploding popularity. Ann Kitt Carpinetti, Managing Director of Games Administration at US Lacrosse stresses the organization’s efforts in educating newcomers to the inherent differences in men’s, women’s and youth lacrosse; particularly how these differences affect the culture of the game, necessity for protective equipment and relative injury risk. Creeping into the youth game are secondary gain issues, earlier sports specialization and potential burnout in young players. The emphasis in youth play must continue to be fun, team work, and learning life’s lessons through sport.   

Priority injuries for the game are concussions, knee injuries, ankle sprains and hand trauma. Concussion because of their high visibility, potential long term consequences, and myriad of possible preventive strategies.  ACL and other knee injuries because they result in the greatest loss of game and practice time. Ankle sprains because they are the most frequent injuries in lacrosse and hand trauma because stick and ball contact mechanisms are somewhat unique to the game. 

In this weekly column we  will address a wide range of lacrosse medical, health, and safety issues.  Our goal is to provide prospective on hot button issues, share the latest findings in lacrosse specific medical research, raise awareness of available educational resources, and stimulate discussion. We welcome your comments and questions and will address these in future columns.


Richard Y. Hinton, MD, MPH

Director, MedStar Union Memorial / Washington Hospital Center Sports Medicine Fellowship

Team Physician, Women’s United States National Lacrosse Team

Team Physician, Towson University Men’s and Women’s Lacrosse Teams

Executive Member, US Lacrosse Sports Science and Safety Committee

Sports Orthopaedic Surgeon, Union Memorial Hospital


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