Male youths who play lacrosse suffer more injuries and concussions than their counterparts in high school and college, a recently published national study comparing injury rates and their causes found.
The study, which was published online this month and in the June issue of Pediatrics, “Injury Incidence in Youth, High School, and NCAA Men’s Lacrosse,” was co-authored by 14 researchers from around the country using data collected from the 2015, 2016 and 2017 lacrosse seasons.
“This is the first study that used nationwide injury surveillance at the three different levels of play,” said Dr. Andrew Lincoln, one of the study’s researchers and director of the sports medicine research center for the MedStar Health Research Institute.
“We’ve had all of these at different places, but we’ve never really looked at them together in national samples at the youth level, the high school level and the collegiate level. So this really gave us a chance to do more of an apples-to-apples comparison of the injury rates and mechanism of injury and severity of injury across those three levels.”
The study examined injuries per minute of athletic exposure for 21 youth teams, 22 high school teams and 20 men’s college teams covering games and practices over the three lacrosse seasons. The results showed most of the injuries among the younger players were equipment and body-contact related. And while the overall concussion rate in lacrosse is low compared with other sports, the study showed the youth level experienced a higher rate.
Researchers found high school and college players are more likely to experience inflammatory injuries because of overuse that require time off for rest and recovery.
Among the significant findings, Lincoln said the group conducting the study was surprised there was a higher rate of concussions at the youth level — 0.7 per 1,000 minutes of exposure compared with 0.3 in high school and college.
“I think the biggest thing going forward is that we have to look at these games in a context of the age groups. The game is played very differently and the risks are different with the different age groups,” he said.
The authors suggest the higher amount of injuries to the younger group could be a result of players still learning the basic skills of the game — body positioning and stick play, for example. As they develop the essential skills, the injury risk decreases.
It puts an emphasis on coaches stressing the proper fundamentals and the benefit of age-related rules.
US Lacrosse, the sport’s governing body, has a recommended set of youth rules for all levels of play for kids 14 years old and under that either limit or do not permit body checking, depending on the age group. However, the overwhelming amount of youth club leagues do not follow them. Instead, most follow high school and college rules.
“It’s great to see research published,” said Bruce Griffin, director of the US Lacrosse Center for Sport Science. “It’s good to see the outcomes, learn a little more. It’s interesting that some of the conclusions focusing on better coaching education and age-appropriate rules were outcomes and those are things we focus on as an organization.”
Griffin hopes the study can help sway organizations to use US Lacrosse’s age-appropriate rules more across the country.
“I hope people look at the facts, the scientific evidence that is being presented and say, ‘OK, now we do know there is a reason we shouldn’t have body checking at younger ages,’ ” he said.
Many believe it’s a tough sell.
Ryan McClernan, the founder and owner of the Baltimore Crabs, said concussions have been low in his club program over the past five years.
His teams compete in the Greater Howard Club Lacrosse Conference, which has limited body checking through elementary school grades and the uses NCAA rules for middle school ages. His coaching staff has played lacrosse at the high school and college level and stresses the proper way to check.
“You talk about getting the check and the head of the stick onto the gloves, you want to stay off the shoulders and obviously the neck and head, and you want to get a poke check or a lift check on the glove,” he said. “It’s a contact sport and I think most coaches and programs do a good job of teaching kids to keep your head up, hit what you can see and keep it clean. I really do think a lot of people do a good job with that.”
Others in the sport disagree.
National Lacrosse Hall of Famer Mark Millon, who operates the Team 91 Maryland club program that also plays in the Howard County league, has long advocated the need for more safety measures in the youth game. He said hitting, stick swinging and slashing is prevalent. This year, he has had one seventh-grader with a broken wrist, another with a broken arm and had a father ask him if more pads are needed for his fifth-grader because his son was so bruised.
With most of the leagues across the country self-governed and choosing to play by high school and college rules, US Lacrosse has its hands tied on the age-appropriate rules they suggest.
“It would be great if all clubs would adopt and play under US Lacrosse rules,” Millon said. “The biggest issue is that everyone would have to do it collectively. If USL would come to me and say, ‘Will you adopt our age and rules of play initiatives?’ And Mark Millon says, ‘Yeah, we’ll do it,’ and then the other clubs, leagues and tourneys don’t comply, I can’t really do it.”
He thinks it is important to be proactive.
Lincoln agrees and said the study reinforces the need.
“At the youth level, I think this speaks to the adoption of the youth rules rather than the high school or collegiate rules for the younger kids,” he said. “And with the youth rules, that involves getting the coaches and the officials up to speed on those and limiting the checking associated with the different ages.”
Lacrosse is a contact sport and with that comes the chance of concussions at all levels.
In the second half of Calvert Hall’s win against Loyola Blakefield in the Maryland Interscholastic Athletic Association A Conference playoffs, Wayne McPartland watched his son, Ham, lie motionless after taking a hit in the middle of the field.
A sigh of relief didn’t come for a minute or so until Ham finally moved his legs. The junior midfielder suffered a severe concussion and missed a week of school.
McPartland, 54, recalled a different time when he played lacrosse in the early 1980s, aware he suffered concussions that were never diagnosed when equipment wasn’t as safe, medical attention wasn’t as immediate and awareness wasn’t there.
“They’d drag you off the field, throw some cold ice on you and then you’re back on the field,” he said. “But now I think with the concussions these professional athletes have had in football, it’s just more understood. It’s the same way why we don’t put lead in our paint anymore because now we know it’s bad for you.
“So I think as far as safety measures go, I think the industry is looking out for these injuries and making the kids as safe as possible. And now, with any kind of hit in lacrosse these days, it’s usually a flag even when it may be a clean hit. So they are just trying to take away that part of the game, which I appreciate because there will be less injuries. I do think everyone is trying to keep the kids as safe as possible. There’s just more awareness.”