Mechanisms and Trends in Women's Lacrosse Head and Musculoskeletal Injuries: A 15-Year Review of National Injury Data

Background: Head injury rates in lacrosse may be higher among women compared with men. Understanding these trends can guide appropriate injury prevention for female athletes. Hypotheses: Injuries most commonly involve the head, with no significant decline over the study period; contact with other players would be the most common injury mechanism. Study Design: Descriptive epidemiological. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System (NEISS) was queried (January 1, 2008 to December 31, 2022) for women's lacrosse injuries presenting to United States (US) emergency departments (EDs). Patient demographics, injury diagnosis, body part injured, disposition, and clinical narrative were extracted. The provided narrative identified the mechanism of injury. Linear regression analysis assessed trends over time. Results: An estimated 57,635 women's lacrosse injuries occurred during the study period extrapolated from 1899 evaluated NEISS cases. The mean age was 15.81 +/- 5.35 years, with 68.3% of injuries sustained by high school (14- to 18-year-old) players. Over one-third of all injuries were to the head (national estimate [NE], 19,358; 33.6%), followed by the ankle (NE, 10,475; 18.2%), then the knee (NE, 6969; 12.1%). Strain/sprains were most common (NE, 19,402; 33.7%) followed by closed head injury (CHI)/sports-related concussion (SRC) (NE, 11,794; 20.5%) and contusion/abrasion (NE, 10,605; 18.4%). ED presentations of CHIs/SRCs and fractures remained elevated with no significant decline over the study period (P > 0.05), despite a significant decrease in strains/sprains and contusions/abrasions (P < 0.01 and P = 0.01, respectively). The most common injury mechanism was collision/contact with another player (NE, 10,664; 18.5%). Conclusion: An estimated one-third of women's lacrosse players in the study sample had a head injury. CHIs and SRCs accounted for 20.5% of all injuries. Clinical Relevance: Given the high proportion of contact-related head injuries, headgear mandates and improved player safety protocols may be warranted.