Lacrosse’s popularity has led to rise in injuries

Lacrosse is the oldest team sport in North America and the fastest growing team sport in the United States. There is also a rise in the number of injuries associated with this collision sport.

Male lacrosse players wear protective equipment that includes a helmet with a full facemask similar to those worn in hockey. They also wear shoulder pads, a mouth guard and arm pads with gloves.

Injuries in men’s lacrosse can be divided into two categories:

Injuries above the waist: These injuries are generally the result of direct contact. Rules allow for body and stick checking when players possess or are within 5 yards of the ball. Head injuries in the form of concussion are the most common above-the-waist injury. This is followed by shoulder and other upper extremity injuries.

Injuries below the waist: These account for approximately 40% of lacrosse injuries and are non-contact in nature. Lower extremity injuries result from pivoting and twisting and most often involve the ankle, upper leg and knee. Damage to ligaments in the form of sprains and tears are common along with muscle strains.

Women’s lacrosse is a non-collision sport. Despite the lack of contact, lower extremity injuries are similar to those seen in men.

The use of protective equipment in the women’s game is controversial. Eye protection only became mandatory three years ago.

“The use of protective goggles in women’s lacrosse has resulted in a dramatic decline in eye injuries,” said Janeen Beetle, head athletic trainer at Norwich Free Academy.

Impact injuries to the head and face from flailing sticks and balls moving at high velocity continue to cause contusions and lacerations. Requiring head protection has been proposed.

As the sport of lacrosse continues to increase in popularity, appropriate safety equipment must also be reconsidered.

Concussion bill would protect young athletes

Much has been written about the tragedies resulting from repetitive concussions in sports. Connecticut may soon be the third state to attack this growing problem.

Concussion is a physiologic disruption of brain function caused by biomechanical forces. There are about 3.8 million sports-related concussions in the United States each year. As youth sports participation rises, so have the number of concussions.

Typical symptoms include headache, confusion and unsteadiness. Resolution of symptoms varies between minutes to months. In more severe situations, these symptoms are permanent and may be accompanied by depression or learning disabilities.

There are two important steps necessary to treat concussion:

  • Recognition – Athletes, coaches and parents must be aware of the symptoms of concussion and responsibly report them to the athletic trainer or physician involved in the activity.

  • Return – Determining when it is safe for an athlete to safely return after a concussion is a complex decision that takes into account many factors. This decision should only be made by a qualified physician with experience treating brain injuries.

“We can easily teach the public about the signs and symptoms of concussion, but the decision of safe return is infinitely more complex,” said Dr. Jeffrey Kutcher, a sports neurologist who addressed the American Academy of Neurology at their recent annual meeting.

Connecticut Bill No. 456, introduced by state Senators Thomas Gaffey and Martin Looney, with local sponsorship from Senator Andrea Stillman, addresses these issues. If passed, the bill would require attendance at a certified course dealing with the recognition of concussion as part of obtaining a coaching permit. It would also require written clearance by a licensed health care professional trained in the evaluation and management of concussions.

Passage of this bill and its proper implementation represent a major step toward protecting young athletes.

Warm up before you ‘Play ball!’

Every spring like clockwork, athletes run to their closets and retrieve their baseball gloves to begin the summer ritual of tossing a baseball. Older participants in this time-honored ritual should proceed with caution or be faced with a possible career-ending injury.

Throwing a baseball or softball involves the coordinated movement of multiple joints.
Contracting and relaxing muscles control the bones that make up individual joints. The principal joints involved are:

• Shoulder — a ball and socket joint consisting of the humerus and scapula
• Elbow — a complex joint that contains three separate joints: the humerus-ulna, humerus-radial and radial-ulna
• Wrist — among the most intricate joints because of the interface of many bones.

Stressing these areas before stretching the appropriate muscles and tendons can result in tearing. Professional baseball players all have a program for stretching and strengthening the upper extremities that is followed religiously.

“A proper stretching routine should be performed with gentle movement and without pain. Bouncing or jerking movements must be avoided,” said Debbie Gardiner, a physical therapist and certified athletic trainer at Procare Physical Therapy in Willimantic. A short toss at half speed should follow stretching. Gradually increasing distance and power is advisable before throwing hard.

Baseball and softball coaches who throw long sessions of batting practice and warm up the pitchers can be particularly vulnerable to injury as they age. Coaches should stretch along with players.

Pain is the best indication that a problem exists and is most likely due to inflammation. Rest and ice are recommended. “Playing through” arm pain can have disastrous consequences.

Consultation with a certified athletic trainer to establish an arm program for any throwing athlete is a worthwhile investment. The program should be a year-round effort for optimal performance.

Health history crucial to treat young athletes

The Health Information Portability and Accountability Act (HIPAA) was enacted in 1996 to protect the privacy and confidentiality of patients’ health information. Unfortunately, it has also created a potentially deadly situation in sports medicine.

It is imperative that coaches, athletic trainers and team physicians have complete medical information on every athlete. HIPAA has unintentionally created an obstacle to the free exchange of health records.

Professional athletes agree to release all medical information as part of their contractual obligation. In boxing, a fighter must allow free access to medical data before being allowed to fight in any jurisdiction. The health records shared among various state boxing commissions have avoided many disasters.

College athletes are protected by the Family Educational Rights and Privacy Act (FERPA) that allows for the free flow of records within their educational institution.

Ironically, it is high school and youth sports athletes who are most impacted by this obstruction. In an effort to protect the rights of young athletes, many have been left vulnerable due to incomplete medical information regarding medical conditions, allergies and prescribed drugs.

Typically, the breakdown occurs between school health officials and athletic trainers. Athletic trainers are the conduit between coaches and health providers. Often, athletic trainers are employed by entities contracted to provide services to a school. This business relationship has mistakenly been interpreted as an obstacle.

“As we improve communication and protect patients’ privacy, HIPAA was never intended to compromise the communication among care givers,” said Glenn Stadnick, Corporate Compliance and Privacy Officer at Backus Hospital.

Penalties for violating HIPAA have only been levied when the information is used for malicious intent or financial gain.

Parents can protect their children by making sure they directly provide the athletic trainer or youth coach with accurate, complete medical information.