By Dr. Eric W. Edmonds
Having gone to college at Johns Hopkins University, lacrosse is a sport near and dear to my heart, even though, I never had a chance to play. In fact, I had never even heard of it prior to college, having grown up here in San Diego. But, it is amazing to see the growth of the sport in the region and the country. It’s the fastest growing sport in the nation. With its popularity, though, comes an increase in the number of lacrosse injuries seen.
Lacrosse is a Native American-derived game played with a stick that houses a small net on one end and a small rubber ball just smaller than a baseball. For those that are unfamiliar with the sport, it may appear as a combination of both soccer and hockey; but, the original game was often played with no “out of bounds” and there could be hundreds of players per team. It was often played to settle disputes. Over the centuries, the game has evolved into the present sport that includes the use of pads and helmets for boys, face guard and mouth guard for girls. Contact is allowed and encouraged in boys play, but not allowed in girls play.
Acute injuries are related primarily in non-contact situations, and can include ankle sprains and knee injuries, predominately. Injuries to the shoulder, elbow and wrist are not uncommon from direct contact and concussions are also common and likely underrecognized in the sport. Muscle contusions to the thigh and leg are not uncommon, but rarely require any medical attention. It is also not uncommon for goalies to have traumatic injuries with the ball achieving speeds of over 100 mph. Although difficult to prevent these acute injuries, improvement in skill and endurance of a young player can help keep their hand-eye coordination well-timed and reduce the risk.
Both the knees and shoulders are at risk for chronic injuries, especially if the young athlete attempts to do too much too soon. There is a risk to develop tendinitis and growth plate-related injuries due to the excessive activity. The best treatment is prevention.
Cross-training for strength and stamina can limit the risk of overuse injuries and help improve the skill level of the player to also reduce the risk of traumatic injury. Once an injury has occurred, rest may be the best course of action. Medical treatment should be sought for an injury that lasts more than two weeks. Physical therapy can solve most of these problems by focusing on the training of the joints. However, if that fails to improve the function of the afflicted extremity, then it may be an indication that there is something torn that may require surgical intervention.
As with any sport, it is important that the players, coaches and parents understand the rules and recognize that this nearly 1,000-year-old game has been refined to the present sport in order to keep it exciting and challenging for the players; but also safe for modern competition. Moreover, the protective equipment should be appropriately sized to the youth player and the equipment should not be modified for personal comfort.
A game of speed, quick change of direction and potential contact, lacrosse can be exciting to experience and watch. If injury occurs, then it is important to identify the problem and allow recovery to prevent future calamity. But, remember that prevention is the best medicine.
Dr. Eric W. Edmonds is a pediatric and adolescent orthopedic sports medicine specialist at Rady Children’s Hospital-San Diego and an assistant professor of orthopedics at UC San Diego. He can be reached at sports@rchsd.org.