Frequency and Location of Head Impacts in
Division I Men’s Lacrosse Players.

Miyashita T, Diakogeorgiou E, Marrie K, & Danaher R. Athletic
Training and Sports Health Care
. 2016;8(5):202-208.

Take Home Message: Player position and session
type such as practice or game are the main factors that influence head impact
frequencies and magnitudes for lacrosse athletes.

The number of concussions
continues to rise, and one of the sports with the greatest increase is men’s
lacrosse. Men’s lacrosse is an equipment-intensive and high contact sport;
however, little research has been conducted to identify the frequency of head
impacts lacrosse athletes sustain over a season. Therefore, the authors collected
head impact data from 42 Division I men’s lacrosse athletes to investigate the
frequency and location of head impacts. The athletes wore an accelerometer in
the jaw guard of their helmets during 17 games and 40 practices to track the
frequency and location of head impacts. The athletes sustained a total of
11,403 impacts with an average of 52.8 g of linear acceleration. During
practices, the athletes experienced 5,759 impacts (144 impacts per practice)
resulting in 3.4 impacts per player per practice. In addition, out of the 17 games,
the athletes sustained 5,644 impacts (332 impacts per games) resulting in 7.7
impacts per player per game. While there were 2.3 times more impacts occurring
during games than practices, the average magnitude of these impacts were lower
during games. The authors also found that midfielders sustained the most
impacts and goalies suffered the greatest magnitude of impacts. Impacts to the
front of the head were the most common and generated the highest magnitudes of

The results show that
player position, and session types were largely determinant of head impact
frequencies and magnitudes for these athletes. These findings are beneficial to
healthcare providers, helmet manufacturers, and lacrosse officials, to
familiarize them with the characteristics of repetitive head impacts in the
sport of lacrosse. Further, these findings have the potential to aid in injury
prevention and promote safer rule changes in college lacrosse. While this study
did not report concussion incidence, it does describe the commonality of head
impacts in the sport. This study has some limitations, primarily due to a lack
of video validation for the impacts recorded by the accelerometers. This suggests
that some of the head impacts recorded may not have been directly related to
game or practice scenarios, but rather from dropping their helmets or post-goal
celebrations. Many of the magnitudes reported were under 50g, which calls to
question if these impacts are large enough to cause a pathophysiological
disturbance to the brain, and if research is any closer to understanding the
impact thresholds that result in concussion. Although there were a lot of impacts
reported in this study, many of them resulted in low magnitudes and none of
them were validated through video analysis. This suggests that the true head
impacts the athletes actually sustained during participation may be lower than
what the authors report. Despite these limitations, this study represents an
important step in the need to better understand the biomechanical
characteristics of repetitive head impacts in college lacrosse.

for Discussion: Do you diagnose more concussions in lacrosse goalies and
midfielders compared to other positions? What do you notice are most common
mechanisms of concussions in the sport of lacrosse? Do you think these sensors
are a clinically useful tool? Do you think that the placement of the
accelerometer in the jaw guard as opposed to in the helmet itself, affects the
results of this study?

Written by: Patricia
Kelshaw, MS, LAT, ATC
Reviewed by: Jane McDevitt

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Miyashita, T., Diakogeorgiou, E., Marrie, K., & Danaher, R. (2016). Frequency and Location of Head Impacts in Division I Men’s Lacrosse Players Athletic Training & Sports Health Care, 8 (5), 202-208 DOI: 10.3928/19425864-20160503-01