Lacrosse Injuries Among High School Boys and Girls in the United States

Abstract

Background:

Lacrosse is a fast growing youth sport in the United States. Although there have been published studies examining injuries associated with lacrosse, significantly less research has been conducted in high school lacrosse players than in older lacrosse players. The objective of this study was to compare high school lacrosse injury rates and patterns by type of athletic activity (ie, competition vs practice) and sex.

Hypothesis:

Lacrosse injury rates and patterns differ by type of athletic activity and sex.

Study Design:

Descriptive epidemiology study.

Methods:

Using the High School RIO (Reporting Information Online) database, lacrosse exposure and injury data were collected during 4 academic years, 2008-2012, from a large sample of high schools in the United States. Schools’ certified athletic trainers submitted exposure and injury information weekly.

Results:

During the study period, 1406 injuries occurred during 716,812 athlete exposures, for an injury rate of 1.96 per 1000 athlete exposures (AEs). Injury rates were higher in competition than in practice (3.61 vs 1.23 per 1000 AEs, respectively; rate ratio [RR], 2.94; 95% CI, 2.65-3.27). Boys had a higher injury rate than girls (2.26 vs 1.54 per 1000 AEs, respectively; RR, 1.47; 95% CI, 1.32-1.64). The most common injury diagnoses among both boys and girls were sprains/strains (boys: 35.6%; girls: 43.9%) and concussions (boys: 21.9%; girls: 22.7%). The most commonly injured body sites in competition were the head/face (32.0%), lower leg/ankle/foot (17.8%), and knee (12.2%), while in practice, the most commonly injured body sites were the lower leg/ankle/foot (34.9%), head/face (16.4%), and knee (12.7%). Among boys, the most common mechanisms of injury were contact with another person (40.9%) and no contact (21.1%). Among girls, the most common mechanisms of injury were no contact (26.2%), contact with a playing apparatus (24.0%), and overuse/chronic (17.7%). Most injured athletes (71.8%) returned to activity in ≤21 days, but 6.9% of all injuries required surgery.

Conclusion:

Lacrosse injury rates and patterns among high school athletes in the United States differ by type of athletic activity and sex. Future studies should continue to compare differences in injury rates and patterns in high school lacrosse, with particular emphasis placed on high-risk plays in competition and the prevention and management of concussions in both boys and girls.

Keywords

lacrosse epidemiology injury prevention

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References

Bowers

Horneff

Baldwin

Huffman

Sennett

. Thumb injuries in intercollegiate men’s lacrosse. Am J Sports Med. 2010;38(3):527-531.

Carter

Westerman

Lincoln

Hunting

. Common game injury scenarios in men’s and women’s lacrosse. Int J Inj Contr Saf Promot. 2010;17(2):111-118.

Caswell

Lincoln

Almquist

Dunn

Hinton

. Video incident analysis of head injuries in high school girls’ lacrosse. Am J Sports Med. 2012;40(4):756-762.

Covassin

Moran

Wilhelm

. Concussion symptoms and neurocognitive performance of high school and college athletes who incur multiple concussions. Am J Sports Med. 2013;41(2):2885-2889.

Covassin

Swanik

Sachs

. Epidemiological considerations of concussions among intercollegiate athletes. Appl Neuropsychol. 2003;10(1):12-22.

Daneshvar

Nowinski

McKee

Cantu

. The epidemiology of sport-related concussion. Clin Sports Med. 2011;30(1):1-17, vii.

Diamond

Gale

. Head injuries in men’s and women’s lacrosse: a 10 year analysis of the NEISS database. National Electronic Injury Surveillance System. Brain Inj. 2001;15(6):537-544.

Dick

Lincoln

Agel

Carter

Marshall

Hinton

. Descriptive epidemiology of collegiate women’s lacrosse injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train. 2007;42(2):262-269.

Dick

Romani

Agel

Case

Marshall

. Descriptive epidemiology of collegiate men’s lacrosse injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train. 2007;42(2):255-261.

10.

Dick

. Is there a sex difference in concussion incidence and outcomes? Br J Sports Med. 2009;43(Suppl 1):i46-i50.

11.

Gessel

Fields

Collins

Dick

Comstock

. Concussions among United States high school and collegiate athletes. J Athl Train. 2007;42(4):495-503.

12.

Hall

Friel

Dong

. Epidemiology of injuries in the elite level female high school lacrosse player. Res Sports Med. 2013;21(3):229-239.

13.

Hinton

Lincoln

Almquist

Douoguih

Sharma

. Epidemiology of lacrosse injuries in high school-aged girls and boys: a 3-year prospective study. Am J Sports Med. 2005;33(9):1305-1314.

14.

Hootman

Dick

Agel

. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007;42(2):311-319.

15.

Lincoln

Caswell

Almquist

. Effectiveness of the women’s lacrosse protective eyewear mandate in the reduction of eye injuries. Am J Sports Med. 2012;40(3):611-614.

16.

Lincoln

Caswell

Almquist

Dunn

Norris

Hinton

. Trends in concussion incidence in high school sports: a prospective 11-year study. Am J Sports Med. 2011;39(5):958-963.

17.

Lincoln

Hinton

Almquist

Lager

Dick

. Head, face, and eye injuries in scholastic and collegiate lacrosse: a 4-year prospective study. Am J Sports Med. 2007;35(2):207-215.

18.

Marar

McIlvain

Fields

Comstock

. Epidemiology of concussions among United States high school athletes in 20 sports. Am J Sports Med. 2012;40(4):747-755.

19.

Matz

Nibbelink

. Injuries in intercollegiate women’s lacrosse. Am J Sports Med. 2004;32(3):608-611.

20.

Mihata

Beutler

Boden

. Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players: implications for anterior cruciate ligament mechanism and prevention. Am J Sports Med. 2006;34(6):899-904.

21.

National Federation of State High School Associations. 2011-12 High School Athletics Participation Survey. Available at: http://www.nfhs.org/content.aspx?id=3282. Accessed August 15, 2013.

22.

Nelson

Collins

Yard

Fields

Comstock

. Ankle injuries among United States high school sports athletes, 2005-2006. J Athl Train. 2007;42(3):381-387.

23.

Newcombe

. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 1998;17(8):857-872.

24.

Otago

Adamcewicz

Eime

Maher

. The epidemiology of head, face and eye injuries to female lacrosse players in Australia. Int J Inj Contr Saf Promot. 2007;14(4):259-261.

25.

Rivara

Vavilala

Durbin

. Persistence of disability 24 to 36 months after pediatric traumatic brain injury: a cohort study. J Neurotrauma. 2012;29(15):2499-2504.

26.

Shankar

Fields

Collins

Dick

Comstock

. Epidemiology of high school and collegiate football injuries in the United States, 2005-2006. Am J Sports Med. 2007;35(8):1295-1303.

27.

Swenson

Collins

Best

Flanigan

Fields

Comstock

. Epidemiology of knee injuries among U.S. high school athletes, 2005/2006-2010/2011. Med Sci Sports Exerc. 2013;45(3):462-469.

28.

US Census Bureau. Census regions and divisions of the United States. Available at: http://www.census.gov/geo/maps-data/maps/pdfs/reference/us_regdiv.pdf. Accessed December 20, 2013.

29.

Yard

Collins

Dick

Comstock

. An epidemiologic comparison of high school and college wrestling injuries. Am J Sports Med. 2008;36(1):57-64.

30.

Yeates

Taylor

Rusin

. Longitudinal trajectories of postconcussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics. 2009;123(3):735-743.