Recreational Injury Interventions

Lacrosse

Background

Lacrosse is a physical sport that involves swinging sticks, high speed projectiles, and fast running. Because of the nature of the game, lacrosse athletes are particularly vulnerable to eye and head injuries. However, the use of protective equipment in scholastic women's lacrosse has been inconsistent. Head and face injury rates in the women's game, which is considered a non-contact sport have been higher than in the men's game which is considered a contact sport, Webster et al, 1999. All head and face injuries are potentially catastrophic, therefore concerns about safety and liability have increased in several states throughout the US. The study below reviews the use of protective equipment in New York state female high school lacrosse players.


Review of lacrosse studies:

Author

Webster, 1999

Study design and target population

Case control study.

Population: 693 players ages 13-18. High school girls lacrosse teams in New York Section III.

Intervention

Data collected prospectively through forms completed by coaches and athletic trainers for a 2 year period, 1995 and 1996.

Two types of goggles meeting ASTM impact standards were used in 51,376 athletic exposures.

Data based on 77,947 athletic exposures.

Outcomes

Use of protective eyewear, athletic exposure, number of games and practices, location of injury.

Results

Overall head/face injury rate was 0.71 injuries per 1000 exposures (including games and practices).

Injury rate 16.5% lower in goggle wearers, and 51% lower in goggle wearers in games alone, where more agressive play and stick use prevails.

Periorbit and forehead injuries among goggle users significantly lower compared to non-users, 6% and 13% respectively.

Study quality and conclusions

Protective eyewear substantially reduces head injuries in high school female lacrosse players.

Reductions in periorbit and forehead injuries among goggle users were severalfold.

Players not randomly assigned to use protective eyewear. Useage of eyewear increased during the study.

Athletic exposure or the number of games and practices an individual player participated in were not adequately controlled.

Only a few injuries appeared to be mediated by the goggles themselves and potentially could have been more serious if the goggles had not been present.

Summary of lacrosse studies

Use of protective eyewear or goggles appears beneficial, and may substantially reduce head injuries in high school female lacrosse players. Injury rates for high school girls lacrosse may be comparable to collegiate injury rates.

Recommendations on lacrosse

Standardized protective eyewear is becoming more widely available and should be utilized to reduce head injuries on all levels of lacrosse, including collegiate and scholastic. Recommendations extend to both female and male athletes.

Recommendations for future research

There is a definite need for well-designed, large-scale randomized controlled trials (RCTs) to evaluate the effects of protective equipment in reducing the incidence of injury in lacrosse players. This is the only way that all the other confounders can be controlled for. Additionally, there is a need for more epidemiologic studies to better understand lacrosse injury risk factors and to determine appropriate injury prevention interventions for all ages.