Lacrosse-related Musculoskeletal Injuries

The popularity of lacrosse is evident by the rapid expansion in participation rates over the years, with US Lacrosse reporting an increase of over 225 percent over a 15-year timeframe and a total of 826,023 players in 2016**.

Considering the soaring popularity of the sport, there has been an influx of players with varying levels of skill and experience. In addition to this, the sport itself has undergone several amendments in terms of rules and equipment.

All these factors have contributed to a change in injury patterns observed in the sport through the years, making it necessary for clinicians to constantly update themselves on the types of injuries that occur most frequently in lacrosse players.

Zachary Kerr, from the Department of Exercise and Sport Science at the University of North Carolina, investigated the epidemiology of collegiate men’s lacrosse injuries during the 2009/10-2014/15 academic years.

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Based on the data collected from twenty-five men’s lacrosse programmes, the author determined that most injuries were found to occur in the lower extremity, particularly, the ankle, knee and upper leg.

Ankle sprains were reported to be the most common injury in both lacrosse competitions and practices while knee sprains comprised the largest proportion of injuries that were severe in nature.

Non-contact mechanisms were most associated with knee ligament sprains causing injuries to the ligamentous structure especially the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL).

The higher incidence of ACL injuries in female lacrosse players versus field hockey players was explored in detail by Braun et al. who assessed biomechanical risk factors in thirty-one Division I NCAA females.

A decreased knee flexion angle during landing, coupled with the occurrence of upright movements consistent in lacrosse, was established as an important component of the increased incidence of ACL injuries in lacrosse players.

On the basis of these findings, the authors recommend incorporating exercises that target sport-specific biomechanical risk factors in conditioning and ACL injury prevention programmes to reduce the loss of significant training time.

A re-evaluation of lacrosse rules is a positive development in the prevention of injuries such as the one enforced by the NCAA in 2015 which makes it illegal for a player to use a body part (upper or lower) while initiating contact with an opponent’s stick or his own stick.

Treatment and preventative strategies also need to focus on addressing underlying biomechanical disparities such as a hyperpronated foot that could increase an athlete’s predisposition to lower extremity injuries.

An abnormal internal rotation of the tibia, caused by hyperpronation, leads to excessive forces being transmitted upward in the kinetic chain to the knee joint, producing medial knee stresses, force vector changes in the quadriceps muscle, and lateral tracking of the patella.

Correction of hyperpronation and prevention of hyperextension of the knee are important considerations in the prevention of ACL injury.

MASS4D® custom foot orthotics work to support optimal foot posture and function, paying more attention to the factors contributing to the hyperpronation. This helps in reducing compensatory abnormal movements of the lower extremity and reduces stress on the injured ACL or MCL ligament.

Whether used on their own or as part of a more comprehensive rehabilitation program, these orthotics enhance the wearer’s neuroplasticity and prove to be a valuable treatment option for lacrosse injuries.

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Related Links
Acute and Recurrent Ankle Sprains
Passive to Active Protocol Progression for MCL Partial Tear
The Role of Orthotics in Treating Chondromalacia Patellae

**The US Lacrosse Participation Report 2016**

References:

1. Kerr, Z. Y., Quigley, A., Yeargin, S. W., Lincoln, A. E., Mensch, J., Caswell, S. V., Dompier, T. P. (2017) The Epidemiology of NCAA Men’s Lacrosse Injuries, 2009/10-2014/15 Academic Years. Injury Epidemiology: 2017, Vol. 4, No. 6. DOI 10.1186/s40621-017-0104-0
2. Braun, H. J., Shultz, R., Malone, M., Leatherwood, W. E., Slider, A., Dragoo, J. L. (2014) Differences in ACL Biomechanical Risk Factors Between Field Hockey and Lacrosse Female Athletes. Knee Surgery Sports Traumatology Arthroscopy: February 2014. DOI: 10.1007/s00167-014-2873-0

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