Lacrosse gear should be left on after neck injury

NEW YORK (Reuters Health) - Lacrosse players with a suspected neck injury should leave their helmets and shoulder pads on until they can be removed "in a controlled fashion" by professionals because removal can cause a potentially a harmful shift in spinal alignment, according to a new study.

Dr. Paul S. Sherbondy from the Milton S. Hershey Medical Center, University Park, Pennsylvania, and colleagues studied 16 Division 1 lacrosse players to evaluate how helmet and shoulder pads affected their cervical spine alignment. Each player had a CT scan with equipment in place, with no equipment, and with the helmet removed.

While wearing the equipment, the researchers found, the athletes' cervical spines were extended. Removing the helmet caused the neck to flex forward, while the cervical spine was more flexed in athletes wearing shoulder pads only, compared with those wearing no protective equipment.

Studies of football and hockey players have found that while protective equipment didn't affect spinal alignment, removing equipment led to increased extension of the cervical spine, the researchers note in the American Journal of Sports Medicine. Based on those findings, the studies' authors recommended that football and hockey players with neck injuries be "immobilized with both the shoulder pads and helmets left in place."

Because any movement of the cervical spine can aggravate an injury, Sherbondy and colleagues conclude, the same approach should be used with neck injury in lacrosse players.

"We would therefore recommend that the helmet and shoulder pads be left in place until they can be removed in the controlled environment of an emergency department," they conclude.

SOURCE: The American Journal of Sports Medicine, October 2006.