Collegiate Lacrosse Research Articles

Intensity Classification of Drills for a Collegiate Women’s Lacrosse Team: An Observational Study

Background: Balancing training load helps prevent injury and maximize performance, but coaches do not often know the load or intensity of drills when making selections for practice. Objective: This study aimed to classify the drills of a women’s collegiate lacrosse team into low, moderate, and high intensity categories. Methods: Twenty-five participants wore global positioning system (GPS) devices and heart rate (HR) monitors daily during team practice and scrimmage matches. The data collected was trimmed to reflect only the time the players practiced and then organized by drill. Mean HR, distance rate, and training impulse (TRIMP) scores were used to classify drills into tertiles: low, moderate, and high intensity. Results: A total of 56 unique drills were analyzed over 33 training days, with 24 drills considered moderate intensity, 17 drills were high intensity, and 15 drills were low intensity. By position, 17 drills were low intensity for the midfielders, followed by 16 for the attacker, and 12 for the defenders and goalies. The defenders had the highest number of moderate intensity drills with 27, followed by the attackers with 24, midfielders with 21, and goalies with 17. Lastly, midfielders and goalies had the highest number of high intensity drills with 18, followed by attackers with 17, and defenders with 16. Conclusions: These results will help the coaching and training staff manage workloads and potentially reduce risk of injury and overtraining by giving insight into the demands of each drill they require of their athletes.

Frequency and Magnitude of Game-Related Head Impacts in Male Contact Sports Athletes: A Systematic Review and Meta-Analysis

Sensor devices have enabled estimations of head impact kinematics across contact sports. To quantitatively report the magnitude (linear and rotational acceleration) and frequency of game-related head impacts recorded in male contact sports athletes. A systematic review was conducted in June 2017. Inclusion criteria were English-language in vivo studies published after 1990 with a study population of male athletes aged ≥ 16years, in any sport, where athletes were instrumented with an accelerometer device for measuring head impacts. Study populations were not limited to players with a clinical diagnosis of concussion. Twenty-one studies met the inclusion criteria with 12 conducted on American Football athletes. Six of these studies were included for meta-analysis. At a threshold of 10g, amateur rugby players sustained the most impacts per player per game (mean = 77, SD = 42), followed by amateur Australian Football (mean = 29, SD = 37) and collegiate lacrosse athletes (mean = 11.5, SD = 3.6). At thresholds of greater than 14.4g, high school American Football athletes sustained between 19 (SD = 19.1) and 24.4 (SD = 22.4) impacts per player per game. Statistically significant heterogeneity was observed among the included studies, and meta-analysis of impact magnitude was limited. The frequency of "headacceleration events" was quantified and demonstrated substantial variation in methodology and reporting of results. Future research with standardised reporting of head impacts and inclusion of non-helmeted sports is warranted to enable more robust comparisons across sports. CRD42017070065.

Three-dimensional Multiple Object Tracking’s Role In Injury Incidence Reduction In Collegiate Athletics

Three-dimensional multiple object tracking (3D-MOT) has been proposed as a training tool for processing dynamic events such as sports activities, and has been hypothesized to reduce athletic injuries through increased awareness of player movement. PURPOSE: The purpose of this study was to determine if 3D-MOT is an effective intervention to minimize the risk of injury in collegiate ice hockey and lacrosse. METHODS: 78 NCAA Division III ice hockey and lacrosse players volunteered for a season-long investigation. Players were assigned to a 3D-MOT training intervention (3D-MOT; n=38) or a control group (C; n = 40). 3D-MOT training gains were measured by mean speed threshold (m/s) obtained from Core training sessions and were analyzed using paired t-tests. Athletic trainers (ATs) attended school-sanctioned team conditioning sessions, practices, and competitions from which injury data was collected. Repeated measures analysis of variance (RM-ANOVA) were performed to compare total number of injuries over time and between groups (3D MOT and C). Two additional RM-ANOVA were performed to explore if 3D-MOT training decreased the number of injuries over time based on injury mechanism (i.e., contact vs. non-contact). RESULTS: The mean speed threshold significantly increased from the first Core session to the last Core session (p=0.000). The total number of injuries significantly decreased over the course of the season (p=0.002). When comparing the 3D-MOT to C, there was no significant difference in the total number of injuries (p=0.293). For those injured at baseline, the total number of injuries also significantly decreased over time (p=.002) though the 3D-MOT intervention had no effect on the number of injuries in athletes injured at baseline (p=.204). The 3D-MOT intervention did not have an effect on mechanism of injury, however both contact (p=.016) and non-contact injuries (p=.013) significantly decreased over time (length of season). CONCLUSIONS: Motion perception training with 3D-MOT did not decrease injury incidence in NCAA Division III men’s and women’s ice hockey and lacrosse athletes compared to controls. NCAA Division III men’s and women’s ice hockey and lacrosse athletes experience fewer injuries, both contact and non-contact, as their seasons’ progress.

Effect Of 3d Multiple Object Tracking Training On Collegiate Ice Hockey And Lacrosse Game Performance

Effect Of 3d Multiple Object Tracking Training On Collegiate Ice Hockey And Lacrosse Game Performance

The Effects Of Subconcussive Impacts On The Neurocognitive Function Of Men's Collegiate Lacrosse Players From Pre-season To Post-season

The Effects Of Subconcussive Impacts On The Neurocognitive Function Of Men's Collegiate Lacrosse Players From Pre-season To Post-season

The Effects Of Subconcussive Impacts On The Neurocognitive Function Of Men's Collegiate Lacrosse Players From Pre-season To Post-season

The Effects Of Subconcussive Impacts On The Neurocognitive Function Of Men's Collegiate Lacrosse Players From Pre-season To Post-season

Changes in Lower Body Muscular Performance Following a Season of NCAA Division I Men's Lacrosse.

The tactical and technical components of training become a primary emphasis, leaving less time for targeted development of physical qualities that underpin performance during the competition phase of a training program. A deemphasis on physical preparation during the in-season training phase may make athletes more susceptible to injury and decrease performance on the field. Two weeks prior to the start and one week following the conclusion of the 16-week collegiate lacrosse season, lower body force production was assessed in eight National Collegiate Athletic Association (NCAA) Division I Men’s Lacrosse athletes. Lower body force production capabilities were determined via the performance of countermovement jumps (CMJ) and drop jumps (DJ) performed on a force plate and isokinetic strength testing of the quadriceps and hamstring muscle groups across three velocities. Isokinetic strength of the hamstrings and the hamstring to quadriceps strength ratio were maintained or increased over the course of the competition phase of training. Relative peak force obtained from the CMJ and the reactive strength index from the DJ decreased significantly over the season. The maintenance of isokinetic strength and the decrease in CMJ and DJ performance may indicate the presence of neuromuscular fatigue that accumulated over the course of the season.

The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Girls' Lacrosse (2008-2009 Through 2013-2014) and National Collegiate Athletic Association Women's Lacrosse (2004-2005 Through 2013-2014).

The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online (HS RIO) system and the National Collegiate Athletic Association Injury Surveillance Program (NCAA-ISP) has aided the acquisition of girls' and women's lacrosse injury data. To describe the epidemiology of injuries sustained in high school girls' lacrosse in the 2008-2009 through 2013-2014 academic years and collegiate women's lacrosse in the 2004-2005 through 2013-2014-academic years using Web-based sports injury surveillance. Descriptive epidemiology study. Online injury surveillance from high school girls' (annual average = 55) and collegiate women's (annual average = 19) lacrosse teams. Female lacrosse players who participated in practices or competitions during the 2008-2009 through 2013-2014 academic years for high school or the 2004-2005 through 2013-2014 academic years for college. Athletic trainers collected time-loss injury (≥24 hours) and exposure data. We calculated injury rates per 1000 athlete-exposures (AEs), injury rate ratios (IRRs) with 95% confidence intervals (CIs), and injury proportions by body site and diagnosis. High school RIO documented 700 time-loss injuries during 481 687 AEs; the NCAA-ISP documented 1027 time-loss injuries during 287 856 AEs. The total injury rate during 2008-2009 through 2013-2014 was higher in college than in high school (2.55 versus 1.45/1000 AEs; IRR = 1.75; 95% CI = 1.54, 1.99). Most injuries occurred during competitions in high school (51.1%) and practices in college (63.8%). Rates were higher during competitions compared with practices in high school (IRR = 2.32; 95% CI = 2.00, 2.69) and college (IRR = 2.38; 95% CI = 2.09, 2.70). Concussion was the most common diagnosis among all high school and most collegiate player positions, and the main mechanism of contact was with a playing apparatus (eg, stick, ball). Ligament sprains were also common (HS RIO practices = 22.2%, competitions = 30.3%; NCAA-ISP practices = 25.5%, competitions = 30.9%). Rates of injury were higher in college versus high school female lacrosse players and in competitions versus practices. Injury-prevention strategies are essential to decrease the incidence and severity of concussions and ligament sprains.

Body Composition Changes in Male Collegiate Lacrosse Players from Preseason to Post Season

Body composition changes differ in all sports due to specific training. In the off season most teams participate in strength training programs, however during the competitive season, training is often replaced with team sport training. Lacrosse players in previous studies showed better performance with decreased body fat percentage and increased lean body mass. However, its common during the competitive season to show an increased expenditure with more frequent practices and no adaptation to diet, which can lead to a decrease in lean body mass (LBM) along with rapid body fat percent loss in the competitive season. These changes can increase chances of injury, decrease performance, and slow recovery. PURPOSE: To examine body composition changes in male collegiate lacrosse players from preseason to post season METHODS: We examined 18 male NCAA Division II collegiate lacrosse players (age 19.6±1.72) pre -competitive season, and post -season (January and May). Subjects completed a body composition assessment using dual-energy X-ray absorptiometry. RESULTS: Using descriptive statistics and a 2 way t-test, there was a decrease in overall total mass of 8.7 lbs. (179.9±33.2 vs 171.2±28.2, p=0.42). Body fat % decreased by 2.5% (21.1±7.6 vs. 18.6±6.7, p=0.58). Lean body mass increased by 1.5 lbs. (133.9±16.44 vs. 135.3±15.3). CONCLUSION: Although these results were not significant, there was a decrease in % body fat and a minimal increase in lean body mass from pre to post season in Division II male lacrosse players. These changes do not demonstrate negative energy balance throughout the competitive season as previous research suggests.

Effect of Carbohydrate, Caffeine, and Carbohydrate + Caffeine Mouth Rinsing on Intermittent Running Performance in Collegiate Male Lacrosse Athletes.

Dolan, P, Witherbee, KE, Peterson, KM, and Kerksick, CM. Effect of carbohydrate, caffeine, and carbohydrate + caffeine mouth rinsing on intermittent running performance in collegiate male lacrosse athletes. J Strength Cond Res 31(9): 2473-2479, 2017-Recently, an interest has developed in the potential to rinse the oral cavity with key nutrients to impact various types of exercise and presumably sporting performance. Although multiple studies examining carbohydrate mouth rinsing have been completed, conflicting evidence surrounding caffeine mouth rinsing persists, and no research has explored its ability to impact high-intensity, intermittent running performance. This study investigated the independent and synergistic ability of carbohydrate and caffeine mouth rinsing to improve intermittent running performance. The Yo-Yo Intermittent Recovery Test-Level 1 (Yo-Yo Level 1) was completed in 10 collegiate (National Collegiate Athletic Association [NCAA] Division II) male lacrosse players after a 10-second mouth rinse with a solution of either carbohydrate (CHO), caffeine (CAF), carbohydrate + caffeine (CHO + CAF), placebo (H2O), or a no rinse control (CON). No significant improvements in Yo-Yo IRT-1 performance were found (p > 0.05). Perceptual indications of effort (i.e., rating of their perceived exertion [RPE]) were significantly lower (p ≤ 0.05) in CHO and CHO + CAF when compared with CON after speed level 11. Interestingly, RPE levels were nonsignificantly lower in all but one level of the Yo-Yo Level 1 for CHO in comparison with other groups. Carbohydrate and caffeine mouth rinsing seems to exert no impact on running performance before maximal intermittent running in a group of male collegiate lacrosse players.

Video analysis of high-magnitude head impacts in men’s collegiate lacrosse

Background/aimLacrosse is one of the fastest growing sports in the USA. Efforts to minimise head injuries focus on promoting safe play through player and coach education, rules enforcement and use...

HAMSTRINGS TRAINING EFFECT ON HIP AND KNEE JOINT FUNCTION, MORPHOLOGY OF HAMSTRING MUSCLES, AND INJURY PREVENTION

BackgroundThere is little information about the effect of hamstrings training on hip and knee joint function, morphology of each hamstring muscle, and the rate of injury incidence.ObjectiveTo clarify the effect...

Comparison of head impact location during games and practices in Division III men's lacrosse players

BackgroundHead impacts have been studied extensively in football, but little similar research has been conducted in men's lacrosse. It is important to understand the location and magnitude of head impacts during men's lacrosse to recognize the risk of head injury. MethodsDescriptive epidemiology study set on collegiate lacrosse fields. Eleven men's lacrosse players (age=20.9±1.13years, mass=83.91±9.04kg, height=179.88±5.99cm) volunteered to participate. We applied X2 sensors behind the right ear of participants for games and practices. Sensors recorded data on linear and rotational accelerations and the location of head impacts. We calculated incidence rates per 1000 exposures with 95% confidence intervals for impact locations and compared the effect of impact location on linear and rotational accelerations with Kruskal-Wallis tests. FindingsWe verified 167 head impacts (games=112; practices=55). During games, the incidence rate was 651.16 (95% confidence interval=530.57–771.76). The high and low incidence rates for head impact locations during games were: side=410.7 (95% confidence interval=292.02–529.41) and top=26.79 (95% confidence interval=3.53–57.10). For games and practices combined, the impact locations did not significantly affect linear (χ23=6.69, P=0.08) or rotational acceleration (χ23=6.34, P=0.10). InterpretationWe suggest further research into the location of head impacts during games and practices. We also suggest player and coach education on head impacts as well as behavior modification in men's lacrosse athletes to reduce the incidence of impacts to the side of the head in an effort to reduce potential injury.

Quantifying Head Impacts in Collegiate Lacrosse

Background: Concussion and repetitive head impact in sports has increased interest and concern for clinicians, scientists, and athletes. Lacrosse is the fastest growing sport in the United States, but the burden of head impact in lacrosse is unknown. Purpose: The goal of this pilot study was to quantify head impact associated with practicing and playing collegiate lacrosse while subjects were fitted with wearable accelerometers. Study Design: Descriptive epidemiology study. Methods: In a single year, a collegiate cohort of 14 women’s and 15 men’s lacrosse players wore mastoid-patch accelerometers to measure the frequency and severity of head impacts during official practices and games. Average impact severity, mean number of impacts, and cumulative acceleration were evaluated, stratified by sport and event type. Results: Men’s and women’s collegiate lacrosse players did not significantly differ in the number of head impacts received during games (11.5 for men vs 9.2 for women) or practices (3.1 vs 3.1). Men’s lacrosse players had significantly higher average head acceleration per impact during games compared with women (21.1g vs 14.7g) but not during practices (21.3g vs 18.1g). For both men and women, more impacts occurred during games than during practices (men, 11.5 vs 3.1; women, 9.2 vs 3.1), but impact severity did not significantly differ between events for either sport (men, 21.1g vs 21.3g; women, 14.7g vs 18.1g). Conclusion: The study data suggest a higher impact burden during games compared with practices, but this effect is driven by the quantity rather than severity of impacts. In contrast, sex-based effects in impact burden are driven by average impact severity rather than quantity. Data collected from larger multisite trials and/or different age groups could be used to inform ongoing debates, including headgear and practice regulations, that might appreciably affect the burden of head impacts in lacrosse. Clinical Relevance: While most head impacts do not result in a clinical diagnosis of concussion, evidence indicates that subconcussive head impacts may increase susceptibility to concussion and contribute to long-term neurodegeneration.

Shoulder Injuries in Men’s Collegiate Lacrosse, 2004-2009

Background: Men’s lacrosse has been one of the fastest growing team sports in the United States, at both the collegiate and high school levels. Uniquely, it combines both continuous overhead and contact activity. Thus, an understanding of its injury epidemiology and mechanisms is vital. Shoulder injuries have been shown to be common in the sport, but thus far there has been no dedicated analysis of these injuries with which to better inform injury prevention strategies. Study Design: Descriptive epidemiology study. Methods: All athlete exposures (AEs) and shoulder injuries reported to the National Collegiate Athletic Association (NCAA) Injury Surveillance System for intercollegiate men’s lacrosse athletes from 2004-2005 through 2008-2009 were collected. Type of injury was documented and the injury incidence per 1000 AEs was calculated. Event type, injury mechanism, specific injury, outcome, and time lost were recorded. Statistical analysis was performed using 95% CIs, calculated based on a normal approximation to Poisson distribution. Results: There were a total of 124 observed shoulder injuries during 229,591 monitored AEs. With weights, this estimates 1707 shoulder injuries over 2,873,973 AEs, for an incidence of 0.59 per 1000 AEs (95% CI, 0.56-0.62). The incidence of shoulder injury during competition was 1.89 per 1000 AEs (95% CI, 1.76-2.02), compared with 0.35 per 1000 AEs (95% CI, 0.33-0.38) during practice. Acromioclavicular joint injuries were most common (0.29 per 1000 AEs; 95% CI, 0.27-0.31). Labral injuries and instability events were also frequent (0.11 per 1000 AEs; 95% CI, 0.10-0.13). Player-to-player contact caused 57% of all shoulder injuries, with 25% due to contact with the playing surface. The average time lost was 11.0 days, with 41.9% of all shoulder injuries requiring ≥10 days. Clavicle fractures and posterior shoulder dislocation were particularly severe, with no athletes returning to play during the same season. Conclusion: Shoulder injuries are common in NCAA men’s lacrosse and are an important source of lost playing time. Acromioclavicular injuries were the most frequent injury in this series, but labral and instability injuries were also common. In this increasingly popular contact sport, an understanding of the epidemiology and mechanism of shoulder injuries may be used to improve protective equipment and develop injury prevention.

Kinematics of Shooting in High School and Collegiate Lacrosse Players With and Without Low Back Pain.

Background:Low back pain (LBP) and motion alterations can occur in athletes who engage in high-speed throwing motions. The relationship between LBP and shooting motion in lacrosse players is not yet known.Purpose:To quantify the effects of LBP on key kinematic parameters of the lacrosse shot and determine the contribution of the severity of LBP on specific kinematic parameters of the shooting motion.Study Design:Controlled laboratory study.Methods:High school and collegiate players (N = 24) were stratified into 2 groups based on back pain symptoms (LBP or no pain). Three-dimensional motion capture of overhead throws was used to collect data on knee, pelvis, trunk, and shoulder kinematics as well as crosse stick (the stick capped with a strung net) and ball speed.Results:Mean low back numeric pain rating scale (NRSpain) score was 2.9. Knee flexion at ball release was greater in the LBP than no pain group, indicating a more bent knee (P = .04). The LBP group demonstrated less angular velocity transfer from pelvis to trunk than the no pain group (P = .05). Total range of motion of the pelvis and shoulders during the shot and follow-through were less in the LBP group than the no pain group (83.6° ± 24.5° vs 75.9° ± 24.5°, P = .05). Age- and sex-adjusted regression analyses revealed that the low back NRSpain rating contributed 6.3% to 25.0% of the variance to the models of shoulder transverse rotation range of motion, trunk and shoulder rotation angular velocities, and knee flexion angle (P < .05).Conclusion:LBP severity significantly contributes to trunk and shoulder motion restriction during lacrosse shooting. Inclusion of lumbopelvic and core training and prehabilitation programs for high school and collegiate players may reduce pain in affected players as well as help them to attain appropriate motion parameters and avoid secondary musculoskeletal injuries.Clinical Relevance:This research identified a prehabilitation need in the understudied lacrosse population. Therapeutic strategies can be developed to strengthen the throwing motion, which could control mechanical loading patterns on the low back and minimize pain symptoms in players with chronic LBP.

Urine Pain

HISTORY: 19-year-old male collegiate lacrosse player presented to the training room with abdominal pain, emesis, and gross hematuria following a cross-check to his abdomen during a game one day prior. Symptoms cleared with a negative urine dipstick 48 hours after injury and he was cleared for competition. One week later, he was cross-checked again in the abdomen, resulting in similar symptoms including hematuria, abdominal pain, anorexia, and emesis. He denied significant medical history, denied taking medications, previous trauma, surgeries or smoking. He reported a history of split urinary stream. Symptoms persisted 4 days post injury at which time he was sent to the ER for further evaluation. PHYSICAL EXAM: Gen: No acute distress, well-appearing GU: uncircumcised penis, normal descended testes bilaterally, no mass/hernias, normal phallus, normal epididymis, normal scrotum, urethral meatus normal without blood. Abdomen: no ecchymosis, normal bowel sounds, abdomen tender to palpation in the LUQ, suprapubic area, and left flank. No rigidity, guarding, or organomegaly. DIFFERENTIAL DIAGNOSIS: Bladder wall hematoma/contusion/perforation Renal contusion Splenic injury Ureteral/urethral Injury FINAL/WORKING DIAGNOSIS: Abdominal pain, hematuria, and trace intraperitoneal free fluid status post blunt abdominal trauma without evidence of bladder, ureteral, urethral, or kidney injury TESTS AND RESULTS: CBC and BMP normal Urine analysis moderate blood with >50 RBCs FAST ultrasound - normal CT abdomen/pelvis with contrast - trace intraperitoneal free fluid behind bladder, no bladder injury CT/cystogram- negative for bladder rupture or injury TREATMENT AND OUTCOMES: Urology consulted in the ED and discharged following CT cystogram failed to show organ damage. At one week, he was asymptomatic and had a negative urine dipstick. Urology suggested cystoscopy if hematuria re-occurred. He was cleared for gradual return to play and recommended to use abdominal guarding in the future. While hematuria following abdominal trauma is not rare, subsequent free fluid spurs questions of whether there were predisposing factors (i.e. stricture) or if an acute injury resulted in the clinical and diagnostic findings. This is an unusual problem following such an injury and a unique workup with questions on his safe return to play.

Relationships Between Toe-Grip Strength and Static and Dynamic Balance During Single-leg Stance

Postural control deficit is considered a factor for lower limb injuries in athletes, such as knee and ankle joint injuries, and in recent years, relationships have been suggested between toe-grip strength and static and dynamic balance. Female athletes have a higher incidence of knee and ankle joint injuries than males, especially in soccer, basketball, and lacrosse. PURPOSE: The purpose of this study was to examine the relationships between toe-grip strength and static and dynamic balance during single-leg stance in female collegiate lacrosse players. METHODS: Thirty-three female collegiate lacrosse players (mean age 19.3 ± 0.9 years, mean height 159.2 ± 5.4 cm, mean weight 55.3 ± 5.1 kg) participated in this study. Static balance was tested using a stabilometer by having participants maintain a single-leg stance for 30 s, with outcome measures including total locus length, total locus length per unit area and per unit time, and circumference and rectangular area of body sway. Dynamic balance was evaluated using three directions on the star excursion balance test (anterior, posteromedial, and posterolateral). Correlations between toe-grip strength and static and dynamic balance were determined using Pearson’s correlation coefficient. The unpaired t-test was used to compare athletes with greater and lesser toe-grip strength. Significance level was p < 0.05. RESULTS: Toe-grip strength of the right foot was significantly negatively correlated with total locus length and total locus length per unit time (r = −0.354, p = 0.043, respectively), and athletes with a strong right-foot toe-grip had significantly shorter total locus length and total locus length per unit time compared with those with a weak one (p = 0.043, respectively). Athletes with a strong left-foot toe-grip had significantly longer normalized anterior reach distance (reach distance divided by leg length and multiplied by 100) on the star excursion balance test compared to those with a weak one (p = 0.020). CONCLUSIONS: This study suggests that toe-grip strength in female collegiate lacrosse players is related to static and dynamic balance ability in the single-leg stance and that its measurement and evaluation may contribute to the prevention of lower limb injuries, such as knee and ankle joint injuries, among female athletes.

Effect of Weight and an Increased Workload on Heart Rate and Blood Pressure

Previous studies have shown that personal protective equipment (PPE) is responsible for increases in heart rate (HR) and VO2max response in firefighters (FF), but has not been examined in collegiate lacrosse players. We have found that FF have exaggerated blood pressure (BP) responses to a treadmill test, and during recovery when wearing PPE (data unpublished). PURPOSE: To compare the effects of weight and an increased workload on BP and HR, between FF and lacrosse players. METHODS: Division III lacrosse players (5M, 20.4 ±0.5yrs) and volunteer firefighters (5M, 21.8 ±2.2yrs) who were matched by body size (FF BMI 26.9 ±3.7kg/m2; lacrosse BMI 26.3 ±3.5 kg/m2, p=0.79) came to the lab for two visits within two weeks for two symptom-limited maximal treadmill tests. The first treadmill test (Regular) was completed following Bruce Protocol in normal clothing; ECG, BP, and HR were continuously monitored. The second treadmill test (PPE) was completed following Bruce Protocol while participant was wearing full gear or PPE; BP and HR were monitored. Changes in HR and BP were compared within groups. RESULTS: Between FF and lacrosse players, gear weight (FF 54.2±4.5 lbs.; lacrosse 6.1±2.1 lbs.), reported number of times exercise/week (FF 1.8±1.5; lacrosse 5.2±0.4), Regular HRmax (FF 230.2 ±31.0 bpm; lacrosse 190.4 ±9.2 bpm), and Regular VO2max (FF 40.2±8.0 ml/kg/min; lacrosse 50.4±4.7 ml/kg/min) were different between groups (p<0.05 for all). For lacrosse players, there were no differences in the BP at each stage or HR at each minute - in Regular compared to PPE. However, for the FF there was a difference in the stage systolic BP and minute HR - in Regular compared to PPE (p<0.05 for all). CONCLUSION: Division III lacrosse players are not affected by the weight of their gear in the same way as FF. Future research should be done to verify the effect of different weights of gear and an increased workload on HR and BP responses.

Review of Lacrosse-Related Musculoskeletal Injuries in High School and Collegiate Players.

Context:Participation in lacrosse has dramatically increased since 2001. Changes in the game rules, sport equipment, and athlete characteristics have all contributed to the injury patterns in lacrosse over time.Objective:A summary of lacrosse-related musculoskeletal injuries.Data Sources:Medline, CINAHL, Scopus, and Web of Science were searched for articles relating to the epidemiology and mechanisms of lacrosse injuries in high school and collegiate lacrosse players.Study Selection:The search strategy used the following keywords: lacrosse, injury, musculoskeletal, high school, intercollegiate, knee, shoulder, fracture, ankle, foot, concussion, and surveillance. Studies were included if they reported injury risk, injury type, or injury mechanism in high school or collegiate lacrosse players.Study Design:Systematic review.Level of Evidence:Level 4.Data extraction:Injury type, frequency, and mechanism as well as population were extracted.Results:Thirteen cohort studies and an additional 15 case series and reports were included. For all lacrosse players, ankle, knee, and hand/wrist were key sites for acute injury. Among collegiate players, preseasonal play elicits more injuries than seasonal play. Female players incur more noncontact and overuse injuries than male players. Boys have 3 to 5 times the risk for sustaining a fracture compared with girls in competition and practice. Women experienced fewer concussions but more facial fractures than men. Injuries to the foot/ankle, head, face, and wrist/hand more often required surgery in girls than in boys.Conclusion:Male players incur more injuries than female players. However, because of the collisional nature of play, more shoulder, arm, and upper leg injuries occur in male players. Fractures to the head and hand occur relatively more frequently in female players. Injury risk can be modified with appropriate training regimens and by respecting the game rules.