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MUSC Health Blog

Keyword: lacrosse

By Michael J. Barr, PT, DPT, MSR
Sports Medicine Manager
MUSC Health Sports Medicine

MUSC Health Stadium

Major League Lacrosse is coming to Charleston and MUSC Health Stadium! MLL announced in April that the Charleston Battery will host the 2018 MLL Championship at MUSC Health Stadium on August 18. Luckily, we do not have to wait until August to see Major League Lacrosse in action, as the first-ever MLL game in the state of South Carolina is right around the corner on June 30 at MUSC Health Stadium. This inaugural game is a match between the Charlotte Hounds and the Atlanta Blaze.

The buzz around the Charleston lacrosse community is the excitement about the upcoming matches. Over the past 10 years, lacrosse has been one of the fastest-growing sports in the Lowcountry and throughout the United States. According to USA lacrosse’s 2016 survey, there are over 825,000 players participating in organized lacrosse throughout the country, which is an increase of over 225 percent compared to their first survey completed in 2001.

As the game grows in popularity and participation, the topic of injuries always comes up. Parents are concerned for their children’s well being, as they are with participation in all sports. A study completed by Xiang et al., and published in the American Journal of Sports Medicine in 2014, examined the number of high school lacrosse injuries (male and female) from 2008 to 2012. The top injury type was sprains/strains (38.3 percent) followed by concussions (22.2 percent) and abrasions/contusions (12.2 percent). The majority of the injuries were to the lower extremities (foot/ankle, knee, and thigh). In approximately 40 percent of the injuries that occurred, the players were able to return to play within 1 to 6 days and only 6.6 percent of the total injuries were serious enough to require surgical intervention.

So just like in all sports, injuries can occur in lacrosse, but there are also ways to minimize this risk through injury prevention techniques. Stop Sports Injuries has a full list of injury prevention guidelines for lacrosse players.

To prevent most prevalent injuries, sprains/strains, and concussions, here are my suggestions:


  1. Proper warm-up prior to play: This should include active movement in addition to both dynamic and static stretching.
  2. In season strengthening program: Focus on balance, dynamic stability, and core strengthening.
  3. Offseason training: Fitness training in the offseason can be the most important step to injury prevention. This should include a combination of cardiovascular training, strengthening and flexibility programs, plyometric training, and agility training.


  1. Know the rules and follow the rules: In boys’ lacrosse, when played correctly, unprotected hits should not occur, and in girls’ lacrosse there should be no head/face contact. Unfortunately, rules are not always followed or taught to players, so this is where experienced coaching comes into play.
  2. Wear the proper equipment: Lacrosse equipment is designed to be protective, but if helmets, facial equipment, and mouth guards are worn out or the wrong size, they may not be doing their job, which can lead to increased injuries.
  3. Know the signs and symptoms: If a hit occurs and there is a suspicion of a concussion, players should be held out of play until assessed by a health care professional trained in concussion management. Athletic trainers are your best resource for on-field management. If a concussion does occur, follow return-to-play guidelines to minimize the risk for escalated symptoms or future issues.

In lacrosse, just like in all other sports, there is a risk for injury, but the overall benefits of sports participation significantly outweigh the risks.

If you have read this far, you must be interested in the game, see how the elite do it, and come out to the game on June 30 and all of the festivities surrounding the Major League Lacrosse Championship at MUSC Health Stadium in August.

Guest Post by:
Kathleen Choate, ATC, CSCS, CEAS
Athletic Trainer
MUSC Sports Medicine

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. 

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1. SCAT3. Br J Sports Med. 2013;47(5):259.
2. Vennum Jr. T.  The History of Lacrosse. Accessed April 19, 2015.


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