Youth boys’ lacrosse players have lower time-loss injury rates than older male lacrosse participants, but also have higher all-injury, concussion, and checking-related injury rates.

Those are among the findings from a new research study recently published in Pediatrics, the official journal of the American Academy of Pediatrics. Researchers compared injury incidence and mechanisms among youth, high school, and collegiate (NCAA) boys’ and men’s lacrosse athletes for three lacrosse seasons, 2015-2017.

The study noted that equipment contact-related injuries were more likely among youth boys, while high school players experienced the majority of time loss injuries in competitions, and NCAA players experienced the most time loss injuries from practices.

Multiple injury surveillance systems were used to capture 21 youth boys’, 22 high school boys’, and 20 NCAA men’s lacrosse team-seasons. Athletic trainers reported game and practice injuries and athlete exposures (AEs). Injuries included those occurring during a game or practice and requiring evaluation from an athletic trainer or physician. 

Among the findings, youth players averaged 10.3 overall injuries per 1,000 athlete exposures, high school boys averaged 5.3 injuries/1,000 AEs, and college players had 4.7 injuries/1,000 AEs.

“For younger kids playing youth lacrosse, it’s injuries due to contact with equipment such as the stick or ball,” said Zachary Kerr, the lead author from the University of North Carolina Chapel Hill. “For older athletes, it is a mix of chronic and acute injuries.”

Specific to concussions, youth boys averaged 0.7 concussions per 1,000 AEs, with 0.3 concussions among high school and college players.

The authors suggest that age-appropriate rules, coach training, and proper rules enforcement may help to further reduce injury risk across all three levels of play.

“Youth boys’ lacrosse should focus on skill development to reduce the risk of equipment-related contact injuries,” said co-author Andrew Lincoln, director of the MedStar Sports Medicine Research Center. “At the high school level, skill development should continue while considering modifying scheduling to ensure rest, recovery and mitigating risk of overuse injury.” 

Among older players, the researchers concluded that proper training could help curb injury rates.

“At the NCAA level, focus should be placed on preventing non-contact injuries through appropriate strengthening, flexibility and conditioning exercises,” Lincoln said.

US Lacrosse promotes a holistic approach in creating a safer game. In addition to appropriate rules and equipment interventions, USL strongly encourages the use of properly trained and certified coaches and officials.

“I think one of the primary takeaways is that we need to constantly evaluate the rules and make adjustments, dictated by research, that will make the youth game safer,” said Dr. Bruce Griffin, director of the Center for Sport Science at US Lacrosse. “As an example, the US Lacrosse boys’ youth rules for age-appropriate play outline limits for physical contact from body checks. But adhering to best practices for a safer game also includes properly educated coaches and officials.”

Among youth players, Griffin notes that parents have a responsibility to demand a safe playing environment. In addition to full adoption of the US Lacrosse youth rules, all youth leagues should have certified coaches, as well as a documented emergency action plan in place.

“We strongly encourage parents of youth athletes to be vigilant and proactive in ensuring that the highest standards of safety are being utilized by their local youth organizations,” he said.