Enforcing rules may help prevent lacrosse injuries

By Anne Harding

NEW YORK (Reuters Health) - Tougher enforcement of the rules of play could help bring down the rate of head, neck and face injuries seen in high school and college lacrosse players, which appear to higher among young women than young men, the authors of a four-year study of the sport say.

Their analysis of more than one million exposures by players to a game or practice found girls were most likely to suffer injuries to the head, eye and face, while boys were more likely to sustain concussions.

"There's been a long-term issue and concern about inadvertent eye and face and head injuries in the women's game," Dr. Richard Y. Hinton of Union Memorial Hospital in Baltimore, one of the study's authors, told Reuters Health.

The boy's game is full-contact, and players wear helmets, but the girls' game is incidental contact only, and until recently girls wore no protection for the face. United States Lacrosse, the governing body of the sport, has mandated goggles for girls and women at all levels of play since 2005.

To characterize the nature of head, neck and face injuries in lacrosse, the researchers reviewed data for lacrosse players over four seasons, from 2000 to 2003.

The girls experienced significantly more head, neck and face injuries than the boys at both the high school and college levels, the researchers found, and college women were more likely to suffer these injuries than high school girls. But concussions were more common among males, accounting for 73 percent of injuries for boys and 40 percent of injuries for girls in high school. Among the college students, concussions accounted for 85 percent of injuries in men and 41 percent of women's injuries.

In the girls and women's game, rules dictate that no sticks or balls enter an invisible protective "bubble" surrounding a player's head, Hinton notes. But many of the injuries in the current study were due to stick-to-body contact or to balls striking the face. He suggests that the girls' and women's game may be becoming increasingly aggressive, making strict enforcement of rules more important than ever.

Hinton also points out that the sport is becoming much more popular, with many players who are new to the sport, so better training on skills for stick handling and passing could also help bring down the injury level.

Having referees make sure that contact is not gratuitous and overly violent could also reduce the rate of concussions in boys' and men's lacrosse, the researchers add. Lincoln points out that the helmets male players wear are not designed to prevent concussions. "There may be a false sense that the boys wearing the helmets are not going to get concussions, which is not what we found," he said.

Hinton and his team are planning continuing research to determine if the introduction of goggles for female players will result in fewer injuries to the face. A long-term, high quality research trial is underway to "make lacrosse as safe a sport as possible," said Hinton, who serves on US Lacrosse's Sports Science Safety Subcommittee.

SOURCE: American Journal of Sports Medicine, February 2007.