The weather is getting warmer, the days are getting longer, and the smell of fresh cut grass and barbecue is filling the air. This can only mean one thing, the beginning of another lacrosse season. Lacrosse was started by the Native Americans centuries ago.2 Since then, there have been changes to the equipment used to increase safety such as helmets, mouth guards, shoulder pads, elbow pads, and gloves; however, injuries will always exist. Some of the more common injuries sustained by lacrosse players involve the ankles, knees, and head.
A lateral ankle sprain is an injury almost every athlete suffers at some point. The most common of ankle sprains involve injury to one or more of the ligaments on the outside (lateral) of the ankle. Most athletes report rolling their ankle inwards and experiencing immediate pain over the lateral ankle. Swelling and bruising may develop as well. Initial management should include rest, ice, compression, and elevation (RICE). In addition to RICE, recovery should involve improving strength, flexibility, and balance. Most athletes with a mild ankle sprain are able to return to lacrosse within ten days of the injury.
Knee ligament sprains in lacrosse often include the anterior cruciate ligament (ACL), or the medial collateral ligament (MCL). Injury to these ligaments can occur with or without contact. With contact, the athlete is usually hit from the back or outside of the knee. Injury without contact usually involves a cutting or twisting motion such as with roll dodges, face dodges, and split dodges where quick fast movements are made. Athletes will usually notice sudden pain when the injury occurs and may also report a pop or difficulty walking. Depending on the severity, swelling will occur within hours of the injury. Immediate care for these injuries should include RICE. With MCL and ACL injuries, the knee can quickly become very unstable. While the length of time to return to play varies greatly depending on the severity of the injury, a full tear of the ACL usually means the end of the season for a lacrosse player.
Concussion should be considered the most serious of the common lacrosse injuries since it involves an injury to the brain. In lacrosse, concussions are commonly suffered as a result of contact from another player, stick, or ball. Unlike more severe traumatic brain injuries, concussions cannot be confirmed with any imaging technologies. They can be very easy to overlook, misdiagnose, and hide. Mismanaging even the mildest of concussions can lead to long-term disability or death if there is a second trauma before the injury has completely resolved. Concussion symptoms can include headache, “pressure in head,” neck pain, nausea/vomiting, dizziness, blurred vision, balance problems, sensitivity to light or noise, feeling slowed down, feeling “in a fog,” “don’t feel right”, difficulty concentrating, difficulty remembering, fatigue/low energy, confusion, drowsiness, trouble falling asleep, more emotional, irritability, sadness, and nervous/anxious.1 Other signs that may be observed include a loss of consciousness, loss of memory, confusion, or abnormal behavior.1 If there is even one mild and short lived concussion symptom after a hit to the head, this athlete should be immediately removed from play and evaluated by a healthcare professional that is well versed in the most recent evaluation and management criteria. One common phrase used for concussion management is, “when in doubt, sit them out.”
With lacrosse quickly growing in popularity in the United States, safety always needs to be in the front of our minds. It’s difficult for any lacrosse athlete who suffers an injury that results in lost playing time, but caring for them early and with the help of your Athletic Trainer or Physician will guarantee a return to the field as quickly and safely as possible.
1. SCAT3. Br J Sports Med. 2013;47(5):259.
2. Vennum Jr. T. The History of Lacrosse. http://www.uslacrosse.org/about-the-sport/history.aspx. Accessed April 19, 2015.