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Youth Lacrosse Participation

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

In less than a generation we have gone from major league athletes having off-season jobs to young athletes often having no off- season at all; from parents sticking their heads out the backdoor to call their children home from play to rushing out the door to make the next officially sanctioned event. Historically, children have played sports for fun, with the wonderful byproduct of learning life’s lessons along the way. Today singular sports achievement seems to be the increasing focus. Some parents are choosing year- round, lacrosse- only participation for their children long before the child has experienced a wide range of other activities. What exactly is the goal? If it is to have all U - 13 players be able to shoot as easily with their left as their right, maybe the 10,000 hour concept makes a little sense. That is, start young enough and practice long enough and success will surely follow. However; Richard Ginsburg, US Lacrosse sports psychology consultant and Director of Harvard’s PACES Institute (Performance and Character Excellence in Sports warns “This is an oversimplified concept in youth sports, particularly in team sports. It goes without question that effective practice improves skills performance, but a positive lacrosse experience involves a myriad of other variables.” Let’s not kid ourselves, the same path of endless travel teams, personal coaching, and hours of game time that takes some young players into the spotlight of college careers takes others to the orthopaedist for overuse injuries or the psychologist for burnout. And it’s not just overuse; traumatic injuries such as ACL tears are two to three times higher in game than practice situations. Single sport, multi league participation results in such increased injury exposure. Psychologically, it’s estimated that ~ 50% of kids drop out of organized sports by age 14. Ginsburg’s experience is that most kids drop out because their sport is no longer fun and that interactions with involved adults had become increasingly negative.

There are a number of national medical and sporting organizations trying to make positive change in today’s youth sports culture. The American Orthopaedic Society for Sports Medicine (, The American Medical Society for Sports Medicine ( and The American Academy Pediatrics ( have issued position papers and educational campaigns promoting healthier behavior such as: encouraging early sports diversification rather than specialization, time away from sports 1 to 2 days a week and 2 to 3 months a year, focusing on sportsmanship / game integrity rather than individual achievement, and restricting play to one team at a time. Positive Coaching Alliance ( is a multifaceted national program (and organizational partner of US Lacrosse) that helps players, coaches, and parents work toward the goals of winning not just in the game, but in life. Incorporating best practices and research, US Lacrosse ( has recently made sweeping recommendations on youth lacrosse participation. This included the development of national standards for youth specific rules for both boys and girls lacrosse. For example; research has found that middle school athletes inefficiently incorporate peripheral vision queues while playing sports. Data also shows that the rates and severity of head injuries are increased when young players cannot anticipate and prepare themselves for contact, i.e. they don’t see it coming. Incorporating these concepts, new rules have banned purposeful body checking for U- 9, 11, and 13 boys and stick checking for U 9 and 11 girls. Take out checks, intended to drive another player to the ground are out at all levels of youth play. Multisource education will be provided on training appropriate checking skills, injury prevention techniques, and top ten youth healthy and safety tips The response from around the country has been exceedingly positive, but Bob Russell, Chair of the US Lacrosse Men’s Game Committee relays there has been some pushback. A few boys lacrosse tournament directors wanted to continue full contact even at the U - 11 levels. Bob’s response and I tend to agree, “That’s insane, for an 11 year old to play full NCAA contact. It’s an accident waiting to happen. “ US Lacrosse is also studying the use of “fair play “concepts in their youth leagues. Here, teams are awarded points for minimizing penalties, all - star selections and playoffs are deemphasized, and respectful regard of your opponents is promoted.

But is the genie out of the bottle? With its rapidly growing popularity, lacrosse is at a crossroads. Which way will we go? There is a growing cottage industry which is set on convincing parents that if their kids are not on the right club or playing at the right showcase they have no chance of moving up. Increasingly that is the model “moving up;" funneling talented kids from one level to the next where the process starts over again. It’s a pyramid which has turned elite athletes into entertainers and too many other kids into spectators. Might this be resulting in a higher level of lacrosse skills and performance than years gone by? Yes, but at what cost? The game needs to cultivate options for children to enjoy their current lacrosse experience without the constant pressure to take their game to the next level. An excellent player who sticks with his middle of the road high school team learns to be a leader, to work with others who may be less talented, to emphasis teamwork over self, or maybe even negotiate with school administration to be more supportive of the lacrosse program. That same special kid may be just another face on an all-star team which emphases lacrosse achievement above all else. It’s hard to resist, we all want what we think is best for our kids and if the Jones are doing it we have to keep up. Take some time and talk to your kids about their lacrosse aspirations and honestly see how they match with yours.

As a sports physician for the past 20 years in Baltimore, I’ve had the good luck of working with many great kids, families, and coaches involved with lacrosse. As a member of the US Lacrosse Sports Science and Safety Committee I’ve been fortunate to be part of a model organization with regard to promoting sports health and safety. As a team doc for one of our National Teams I’ve had the privilege of working with a group of world class athletes that are truly world class; athletes who are making any number of sacrifices to play for love of the sport, taking the time to instruct teammates who were literally competing against them for selection, and time after time putting team over self. There are some great models for our kids, let’s take the time to find them.

Richard 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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