Four Tips to Prevent Injuries in Youth Lacrosse

Four Tips to Prevent Injuries in Youth Lacrosse

Lacrosse is one of the oldest sports in North America and is also one of the fastest growing sports in the United States. In 2021, there were more than 40,000 collegiate and more than 450,000 youth lacrosse players. Boys’ and girls’ lacrosse follow different rules and require different equipment, which may impact the types of injuries seen in these young athletes.

“Lacrosse is an intense and demanding sport,” orthopedic surgeon John E. Arvesen, M.D., says. “Athletes who are prepared can dramatically reduce the risk of injury.” Coaches and parents can use these tips to guide young athletes in the right direction.

FOUR WAYS TO REDUCE INJURY RISK IN LACROSSE

Wear proper equipment. Protective gear that meets standards and fits correctly will provide the most benefit. Poor-fitting equipment may not offer the same protection or support.

Perform a dynamic warm-up. This involves continuous movement to raise the body’s core temperature in preparation for training or competition. Perform this before each practice or game to increase elasticity in the muscles, tendons and ligaments around the joints.

Learn and implement effective hydration strategies. Mild dehydration can worsen performance. Ideally, players should drink water every 15 to 20 minutes. Add a sports drink during intense activities lasting longer than one hour or in very hot environments to replace electrolytes lost through sweat.

Plan for rest and cross-training. Early sport specialization increases an athlete’s risk of injury and inhibits their athletic development. Focusing on one sport at an early age may lead to movement imbalances, an increased risk of injury and overtraining. A one- or two-month break between seasons and a day or two of rest each week in-season is recommended.

Some injuries in lacrosse are more difficult to prevent, such as those that occur from sticks, collisions and falls. Non-contact injuries are considered to be more preventable. As a sports physical therapist and youth lacrosse parent and coach, Michael Losito teaches young athletes the importance of learning fundamental movements to prepare their bodies for non-contact injuries. “When an athlete has control over the trunk and lower extremities, he or she can produce more power, which may help to protect the joints from minor and serious injuries,” Losito says.

Common Injuries in Lacrosse

Despite efforts to reduce the risk of injury, some accidents are going to happen. Make sure you recognize and respond to injuries promptly. Many conditions can be treated with rest and a short round of rehabilitation if they are recognized early.

SPORT-RELATED CONCUSSIONS
Concussions in girls’ lacrosse players are often the result of stick contact, or a blow with a stick to the head. Boys’ lacrosse has a higher risk for concussion due to player-to-player contact. An athlete with any concussion symptoms, including change in behavior, thinking or performance after a collision or a blow to the head, neck or body, should be removed from play immediately and not return to play the same day. A medical professional with experience managing concussions should determine when it is safe to return to play.

KNEE AND ANKLE INJURIES
Sudden changes in direction, stopping and jumping can place a lot of stress on the knee.  This can stretch and tear ligaments, such as the anterior cruciate ligament (ACL) and medial collateral ligament (MCL). A swollen knee is a sign of a joint injury that needs to be evaluated.

In lacrosse, sudden direction changes, stepping on another player’s foot or landing from a jump can result in an ankle injury. Ankle sprains and injuries to the growth plate are common in growing athletes and should be evaluated to optimize treatment and return to sport.

BACK AND CHEST INJURIES
Player-to-player collisions or falls may cause back injuries. Powerful and repetitive rotation while running, cradling, shooting and passing is more likely to cause activity-related pain in lacrosse. Overuse injuries, such as stress fractures (spondylolysis), are also common in young athletes. Persistent back pain from overuse injuries needs to be evaluated by a medical professional. The equipment and high-speed movements in lacrosse increase the risk of a rare injury from a direct blow to the chest from the ball, a stick or player collisions. The condition, called commotio cordis, can be life-threatening. Chest protectors may reduce the impact and risk of this injury.

ARM INJURIES
The design of lacrosse protective gear allows the arm to move freely but leaves the shoulder open to injury. Clavicle (collar bone) fractures and ligament injuries, or “separated shoulders,” may occur. A change in the appearance of the shoulder, pain, swelling or limited motion after a collision or fall should be evaluated.
Body checks, stick checks and slashing may cause hand and wrist injuries. Soft tissue injuries such as ligament sprains may heal with rest and ice. Others may need a brace or other treatment.

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Sports Preparticipation Physical Evaluations: Why Are They Important?

Sports Preparticipation Physical Evaluations: Why Are They Important?

Overview of presentation from a Coffee, Kids and Sports Medicine lecture. 

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Every year, almost 60 million children and adolescents run onto their respective fields, courts and rinks to participate in organized sports in the United States. To ensure the safety of these young athletes, almost all states require some level of sports Preparticipation Physical Evaluation (PPE), which is meant to screen athletes for injuries, illnesses or factors that may put them or others at risk.

“The primary objective is to screen for conditions that may be life-threatening, disabling or may predispose to injury or illness,” says Shane M. Miller, M.D., a sports medicine physician at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. “A PPE can also serve as a valuable health care entry point for many young athletes and help the physician determine the general health of the child.”

Miller says an extremely important aspect of a PPE is a thorough medical history for the athlete and his or her family. An accurate medical history can be instrumental in detecting 88% of medical conditions and 67% of musculoskeletal conditions. Without a reliable medical history, the source of an issue may be more difficult to identify. It is estimated that less than 40% of forms completed by an athlete correlate with those completed by their parents. Therefore, the parent or guardian should contribute to the history every time.

Questions to enhance a medical history discussion during the PPE:

  • Have you ever had an injury to a bone, muscle, ligament or tendon that caused you to miss a practice or a game?
  • Have you ever had a head injury or concussion?
  • Has anyone in your family died of heart problems or passed away suddenly before age 50?
  • Have you or anyone in your family had a heart condition diagnosed?
  • Have you ever passed out or nearly passed out DURING or AFTER exercise?
  • Have you ever had discomfort, pain, tightness or pressure in your chest, or does your heart ever race or skip beats (irregular beats) during exercise?

Many organizations and schools require a PPE or health clearance for youth formally participating in sports. Since the intent is to enhance the safety of sports participation, it should become an integral part of the health screening exams for any active patient. Miller reports that a very small number of athletes are denied participation from their sport following a PPE.

“The PPE is a screening tool based on the principles of prevention and education,” Miller says. “It is okay to require further evaluation prior to clearance—that evaluation can establish the foundation for a trusting relationship between physician and athlete that can help keep the athlete healthy and safe throughout their athletic career.” In fact, 3-13% of athletes will require further evaluation.

Common reasons for further evaluation:

  • Chronic ankle sprains or other previous injury
  • Signs or symptoms of overuse injury
  • Recent or multiple concussions
  • Concerns of under fueling for sports participation
  • Recurrent stress injuries or fractures
  • Cardiac – concerning heart murmur, symptoms or family history

The fifth edition of the American Academy of Pediatrics’ text on Preparticipation Physical Evaluation is available now on the AAP website. The fifth edition includes new chapters on transgender athletes, female athletes, mental health and incorporating PPE into routine health supervision care.