BY DAVID MARSHALL, M.D.
Medical Director, Sports Medicine Program, Children’s Healthcare of Atlanta and Clinical Assistant Professor, Emory University School of Medicine
Almost 300,000 children play lacrosse, making it one of the fastest-growing sports in the U.S. While both boys and girls participate in the sport, the style of play for each gender is different.
Overall, participation in lacrosse is safe and the injury rate among young athletes is actually very low. Because of rules differences for the boys and girls games, some injury patterns in male and female players differ as well.
In the boys game, body checking is allowed. Male lacrosse players wear protective equipment—helmets, facemasks, mouthguards, padded gloves and pads on their shoulders, ribs, arms and elbows. The goalkeeper is also required to wear a throat protector and chest protector.
Conversely, female lacrosse players wear only mouthguards and eye goggles, as body checking is not allowed. Goaltenders must wear a helmet with face mask, separate throat protector, chest protector, abdominal and pelvic protection, goalie gloves, and leg padding on the shins and thighs.
The most common injuries among boys playing lacrosse are contusions, abrasions, ligament sprains and muscle or tendon strains. Girls playing lacrosse most often experience facial injuries from being struck by a stick or ball. All of these injuries can be treated by applying the R.I.C.E. concept (Rest, Ice, Compression and Elevation). If swelling is severe, or if there is little improvement after several days of R.I.C.E., the child should see his or her pediatrician.
Other types of injuries are commonly seen in young lacrosse players of both genders. Two of the most prevalent are growth plate injuries and shin splints. Growth plates are the areas of a child’s body, made of cartilage, which either contribute to growing or serve as anchor points for muscles and tendons.
One of the most common growth plate injuries found in young lacrosse players involves inversion or rolling of the ankle. This motion causes the growth plate to widen. Treatment calls for the child to wear a cast for 2-3 weeks.
Other growth plate injuries found in lacrosse players involve the knee and heel. There are two anchor points in the knee—one at the bottom tip of the kneecap and the other on the top of the shinbone. These growth plates serve as anchor points for the knee tendon and thigh muscles, respectively. During prolonged running, the muscles and tendons can pull on these growth plates, causing irritation and tiny micro-fractures which result in pain and inflammation. Injury to the growth plate at the top of the shin bone is known as Osgood-Schlatter Disease, while injury to the bottom of the kneecap is called Sinding-Larsen-Johansson syndrome or “jumper’s knee.”
The growth plate in the heel attaches to the calf muscle and Achilles tendon. Repetitive running, jumping and cutting can cause a traction injury at the heel, known as Sever’s Disease. Most growth plate injuries are best treated with rest, ice cup massage, and a 10-14 day course of anti-inflammatory medication, such as ibuprofen or naproxen.
Both male and female lacrosse players can also suffer from shin splints, an overuse injury to the inside of the shin. Shin splints often result in pain while running, and swelling also may be present. Shin splints can be treated with rest, ice, anti-inflammatory medication and correction of pronation (flat feet) if present.
If the measures described above don’t relieve your child’s pain or swelling, consult your pediatrician or a pediatric sports medicine specialist.