It is vitally important that all lacrosse programs provide the tools necessary to create a safe environment for all athletes. US Indoor Lacrosse takes the safety of players and participants very seriously. We have developed this guide to explain what is needed to prevent injuries and improve medical coverage at local events, league competition, and all other development activities. This guide also serves to provide information to athletes and parents so they feel comfortable with lacrosse.
When working to establish safety standards, local lacrosse administrators and coaches must consider:
Injury Prevention
Emergency Action Plan Development
Return to Play Procedures after Injury
A wealth of documentation focusing on safety in sports is available to all lacrosse enthusiasts. This guide consolidates information to encourage every program to follow a baseline of safety considerations. With preventative measures in place, athletes and parents can find security in knowing the risk of injury is significantly reduced through responsible preparation
Injury Prevention:
Injuries in lacrosse are no different from those in other sports. The key to prevention is identifying associated risk factors. Lacrosse programs can work towards decreasing the rate and seriousness of lacrosse-related injuries by implementing research-based preventive interventions. The first step towards making lacrosse safer is addressing the following key factors:
Coaching/Officiating
Medical Equipment & First Aid Supplies
Medical Documents
Facilities & Playing Conditions
Physical Conditioning
Player Education
Pre-Participation Examination
Bio-mechanical or Functional Movement Screening
Coaching/Officiating:
As lacrosse is a contact game, those who manage participation must possess a necessary knowledge base. Coaches and officials must be proficient in communicating information to athletes which will transfer over into competitive situations. Lacrosse coaches need to be aware of their athletes sport background. Cross over athletes from sports such as Football, Soccer, Baseball, etc., pose a challenge for coaches as these athletes need special instruction in lacrosse specific skills such as catching, throwing, how and when to make contact. The best way to learn how to properly instruct all athletes is to become a US Indoor Lacrosse certified coach. The certification process concludes with a face-to face workshop featuring the practical application of coaching athletes. It is also strongly recommended that coaches and officials seek CPR and First Aid certification which can be achieved through the Red Cross.
Contact us at info@usindoorlacrosse.com, if you are interested in learning more about the USIL Coaching Certification.
Proper officiating in lacrosse is a great responsibility as referees must learn to manage imbalances in strength, technique and level of experience. Coaches and officials must work together to ensure a fun and safe competition takes place. Officials can gain tools needed to mediate varying circumstances on the field through educational channels similar to those of coaches offered by US Indoor Lacrosse. It is the responsibility of all volunteers to seek proper certification and important for athletes and parents to demand this level of expertise.
Medical Equipment & First Aid Supplies:
With proper education comes the need for the proper tools. Lacrosse requires a moderate level of start up cost as only a few essential pieces of equipment are needed to participate. A program priority should be to ensure that equipment for personal or team use during games and training sessions is safe and USIL approved. A complete list of accepted equipment required is:
For Runners:
Helmet (Box or Field Helmet)
Shoulder pads (with Cap suggested) & Bicep or Flare pad attached
Rib Pads – (with Back and Kidney protection - Hard Shell recommended)
Elbow Guards
Lacrosse Gloves
Athletic Supporter w/Cup
Complete Stick
Mouth Guard
For Goalies:
Helmet – with throat guard
Upper pads – Shoulder and Chest Pads
Hip Pads – Pants with pads (Indoor Goalie)
Leg Guards – with Toe Caps (Indoor Goalie)
Optional (Thigh Pads)
Goalie Lacrosse Gloves
Goalie Stick
Athletic Supporter w/Cup
In addition to these regulations, a fully stocked medical kit should be available for use by all participants. Generally, the medical kit should include a general first aid kit, medical tape and electrical tape. All USIL events held in facilities are expected to have an AED available – AED Suggested: Automated External Defibrillator by Cardiac Science.
USIL recommended First Aid Kit Contents: The kit should be a waterproof container that can handle a lot of banging around and still be easy to open the lid. It should be ready and easily assesible at every practice and game. Along with the kit should be a container of ice; cooler of cold water and cups/individual water bottles with names marked on the bottles. Medical information, parent contact phone numbers, allergy information should be available. No medication, including over-the-counter aspirin, ibuprofen, Tylenol products shall be kept in the kit. 1. Contents card – taped on the lid of the kit. 2. Emergency contact numbers (ER, EMS) – taped on the lid of the kit. 3. Wound Care Items: a. Bandaids: strips, XLarge, – flexible (12 of each) b. Appropriate antiseptic such as bacitracin or Neosporin (1) c. Sterile water to clean the wound (1) d. Non-latex disposable gloves (12) e. Sterile gauze – regular (12) and non-adherent (6) 4. Hypoallergenic tape (3) 5. Antiseptic Wipes (box of 12) 6. Sunscreen (water repellent) (1) 7. Thermometer (1) 8. 3-inch elastic bandage (2) 9. Scissors (1) 10. Tweezers (1) 11. Zip-loc type baggies (6) 12. Flashlight (small & working) (1) 13. Paper/Pen (1)
Clean out the kit prior to each game so that it is fully stocked. Team should have a working cell phone.
Medical Documents:
A complete medical and safe practice binder should be included with the medical kit.
Necessary paperwork consists of:
Physician Evaluation Documentation
Liability & Eligibility Waiver
Injury Incident Report
Participant Roster
Emergency Information/Medical Release Form
Facility specific Emergency Action Plan
Photocopy of Insurance and ID card
Medical History Questionnaire
In addition to these items, physician notes, training attendance records, game rosters and other documents may also be included. All of the information within the binder provides everything needed to properly treat an injured athlete.
Facilities & Playing Conditions:
Securing a safe area for training sessions and games is important. Programs should make every effort to use adequately turf, grass or smooth cement surfaces to prevent injuries. Fields must be void of hazards such as broken glass, protruding rocks, cracks, turf overlaps and holes. When examining playing surfaces, size, availability, access for emergency vehicles, available parking, lights, and usage requirements should also be considered. As you become a part of US Indoor Lacrosse, all teams and players have access to liability insurance which provides protection in case of property damage or bodily injury to third parties. These parties may include the venue owner, coaches, referees, sponsors, spectators and others. Most venue owners will require this type of insurance before a club, team or event is allowed to step on the field of play.
Beyond the actual playing field conditions, programs must be conscious of the impending weather even being indoors the weather can be a factor and of course if you are outdoors. If it is hot and humid coaches must plan to compete early in the morning or later in the evening to avoid the heat. Having ample fluids and water breaks in cooler areas helps to lessen the incidence of heat exhaustion and heat stroke. Coaches must know the signs and symptoms of these conditions and take them seriously. In cold weather coaches must consider the conditions. Impact on a cold field or turf can increase the severity of any injury. Awareness of the signs of hypothermia in extreme conditions is also important. Proper clothing, warm up, and cool down activity is crucial to injury prevention and optimum performance.
If outdoors, in case of lightning everyone must evacuate the area to a safe location. A large building is the best location while sheds, dugouts and bleachers are to be avoided. If a sturdy building is not available, a vehicle with closed windows will work instead. The recommended method to help determine when cover should be taken is the flash-to-bang method. To use this method, begin counting on the lightning flash, and stop counting when the associated thunder is heard. Divide this number (in seconds) by 5 to determine the distance (in miles) to the lightning flash. For example, if the time in seconds between the lightning being spotted and the thunder being heard is equal to 30, divide that by 5, and you get 6 (30/5=6). Therefore, that lightning flash was approximately 6 miles away from the observer. If a game, practice, or other activity is suspended or postponed due to lightning activity, it is important to establish criteria for resumption of activity. Waiting at least 30 minutes after the last lightning flash or sound of thunder is recommended. Each time lightning is seen or thunder is heard the 30-minute clock should be reset. If the game is being played outdoors.
Physical Conditioning:
It is recommended that player’s receive a physician’s evaluation and clearance prior to participating in lacrosse. This is standard procedure for all interscholastic sports and lacrosse should not be an exception. Competing in the best possible physical condition not only prevents injuries, it also makes the game more enjoyable. Pre-season conditioning programs can help prevent fatigue related injuries such as sprains and strains. Weight training with special attention on the neck and shoulders should be applied. An emphasis on stretching of all muscle groups decreases the incidence of injury. Even fitness testing can be applied to assess the condition of the athletes and help better their game performance. Competitive games between high school and adult clubs or younger players vs older should be discouraged. Discrepancies in size, strength and experience may result in mismatches leading to injury. Common sense should be applied to avoid unequal competition. If athletes perform at their physical best they are more likely to be safe and successful.
Emergency Action Plan Development:
Each program needs an established emergency plan unique to each place of assembly. The action plan includes naming the individual trained to assess the situation, secondary assessment, 911 involvement protocol, parental contact responsibility, directions/contact information for the nearest hospital, and notation of a volunteer responsible for accompanying the injured athlete to the hospital. A detailed emergency action plan should be drafted prior to any activity, reviewed by all medical staff and made available on-site as a reference. In developing an action plan, it is important to recruit all necessary medical staff and volunteers. Finding the right medical personnel can pose a challenge in terms of financial constraints and availability. Developing a strong relationship with local area sports medicine and physical therapy clinics can help solve this issue. A program might offer to refer all players and family members who need treatment in exchange for services from dedicated medical professionals. By any means necessary a program should aspire to provide at minimum a Certified Athletic Trainer and ideally an appointed Medical Director, ATC and EMT at all major events.
Head and Neck Injuries:
Severe injuries to players from programs who safely address the risk factors of the sport are rare. Everyone involved should learn to recognize the signs and symptoms of players who have suffered a concussion and how best to treat the condition. Concussions are classified as mild/first degree, moderate/second degree and severe/third degree depending on their symptoms.
A mild/ first degree concussion causes the athlete to be confused dazed and experience slight amnesia. Asking the athlete questions such as time of day and how he/she got to the field can help detect the injury. Hesitation in answering is a good indication of concussion. If a player experiences unconsciousness for a few seconds or several minutes the athlete has a moderate/second degree concussion.
A severe/third degree concussion means any lapse of consciousness for more than five minutes. The degree of concussion is determined by the force of impact. In case of a head injury, if there is any doubt about the severity of a concussion, it must be treated as a third degree/severe concussion. This is classified as an emergency situation and the athlete must not be moved until a spinal cord injury is ruled out. Pulse and breathing rate should be checked while an ambulance is called to the site. If vital signs are normal, wait for the athlete to regain consciousness. Do not remove any head gear or move the athlete if complaints of neck and back pain or numbness in the extremities are voiced. If none of these symptoms are present, wait until the player is ready and help them to a kneeling position and eventual standing to move away from the activity. Carefully watch the athlete’s progress and wait until an ambulance arrives if deemed necessary.
If a first degree/mild and second degree/moderate concussion occurs the athlete must be removed from the activity. There actions must be observed and assessed every twenty minutes for delayed symptoms such as headache, dizziness and confusion. If signs and symptoms continue but do not worsen, the athlete must be taken to an emergency room for an evaluation within two hours. If conditions appear to be worse, the injury must be re-classified as a third-degree/severe concussion and treated as described earlier. Everyone involved in lacrosse must be familiar with the signs, symptoms and return to play criteria. The “Heads Up: Concussion in High School Sports” tool kit is provided free of charge from the Department of Health and Human Services Center for Disease Control and Prevention at www.sportssafety.org. Everyone should take advantage of this offer and arm themselves with education.
Return to Play Procedures:
As in all sports, injuries do unfortunately take place in lacrosse. When proper procedures are followed a quicker recovery and return to participation is the end result. USIL requires that any lacrosse player who has suffered a first degree/mild concussion should be removed from the activity. A head injury beyond this level of severity equals transportation to a hospital (if deemed necessary by an on-site medical professional) and a full evaluation. The athlete should not be allowed to return to play for a minimal period of three weeks. If any injury occurs, athletes should receive an evaluation and medical clearance from a health care professional in order to return to play.
Additional Resources:
US Indoor Lacrosse is working to form partnerships with non-profit organizations to provide cutting edge health and safety information. The Positive Coaching Alliance and the National Center for Sports Safety are among the list of recognized contributors who we recommend. Parents should encourage athletes to participate in safe activities such as lacrosse. We strongly encourage all administrators and coaches to view and use the tools included below to create a safer environment for all athletes.
