Descriptive epidemiology of collegiate women's lacrosse injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004

Abstract

Objective: To review 16 years of National Collegiate Athletic Association injury surveillance data for women's lacrosse and identify potential areas for injury prevention initiatives.

Background: Women's lacrosse is a fast-paced, primarily noncontact sport. Participation in collegiate women's lacrosse almost doubled between the 1988-1989 and 2003-2004 seasons. Lacrosse equipment consists of sticks made of wood or a synthetic material and a hard rubber ball. Until recently, mouth guards were the only required protective equipment.

Main results: Collegiate women's lacrosse game injury rates increased over the 16-year study period. More than 60% of all severe game injuries were lower extremity sprains and strains and knee internal derangements, most frequently the result of noncontact incidents. The most common injury scenarios by injury mechanism and player activity were no contact while ball handling (16.4%) and contact from a stick while ball handling (10.5%). Contact from a stick or a ball accounted for 5.6% and 5.2% of injuries sustained during shooting activities, respectively. Approximately 22% of all game and 12% of all practice injuries involved the head and neck. Contact from a stick accounted for the majority (56.0%) of above-the-neck injuries in games; contact from the ball accounted for 20.0% of these injuries. Participants had 5 times the risk of sustaining a concussion in a game as in a practice (0.70 versus 0.15 injuries per 1000 athletic-exposures, rate ratio = 4.7, 95% confidence interval = 3.8, 6.5).

Recommendations: To reduce the lower extremity injuries that comprise the greatest injury burden in women's lacrosse, future researchers should evaluate proprioceptive, plyometric, and balance training interventions designed specifically for female players. Other research areas of great interest involve determining whether protective eyewear (mandated in 2004) reduces injuries to the eye, orbit, and nasal area and identifying any unintended consequences of the mandate, such as increased risk of injuries to other areas of the face or more aggressive play.

Figure 1. Injury rates and 95% confidence intervals per 1000 athlete-exposures by games, practices, and academic year, women's lacrosse, 1988–1989 through 2003–2004 (n = 1066 game and 2326 practice injuries). Game time trend P = .02. Average annual change in game injury rate = 2.4% (95% confidence interval = 0.4, 4.4). Practice time trend P = .08. Average annual change in practice injury rate = 1.6% (95% confidence interval = −0.2, 3.4)

Figure 2. Game and practice injury mechanisms, all injuries, women's lacrosse, 1988–1989 through 2003–2004 (n = 1066 game injuries and 2326 practice injuries). “Other contact” refers to contact from items such as sticks, balls, or the ground. Injury mechanism was unavailable for 1% of game injuries and 5% of practice injuries

Figure 3. Sport-specific game injury mechanisms, women's lacrosse, 1988–1989 through 2003–2004 (n = 1066)

Figure 4. Game player activity at time of game injury, 1988–1989 through 2003–2004 (n = 594, which does not include 472 other injuries recorded as “other” or with missing data)

Figure 5. Location at time of game injury, women's lacrosse, 1996– 1997 through 2003–2004 (n = 788). The goal area/circle is exclusive of the area within the 8-m arc on a regulation-size field