Physical Therapy for Lacrosse Injuries
Lacrosse is a high-energy, full-body sport that combines quick sprints, agility, and coordination of the upper and lower extremities. Lacrosse injuries are more common in the lower extremities, particularly ankle sprains, ACL tears, shin splints, or hamstring or quadriceps muscle strains. Physical therapy can help lacrosse players not only address and recover from injuries during the lacrosse season, but also help prevent injury through a customized strength and conditioning program. For most lacrosse injuries, physical therapists incorporate a progressive therapeutic exercise and strengthening program coupled with manual therapy, core strengthening, balance and proprioception training, and functional sport-specific training to optimize the athlete’s recovery.
Common Lacrosse Injuries
Lacrosse is an increasingly popular sport throughout the United States. Lacrosse is a team sport with the goal of getting a rubber ball into a net or goal using a long stick with a net on the end (the lacrosse stick). Players can run, carry, catch, shoot, and pass the ball with the net of the stick. Lacrosse is a high-energy, full-body sport that combines quick sprints, agility, and coordination of both the upper and lower extremities. The biomechanics of lacrosse requires athletes to possess the speed and power of football and hockey players and the endurance, agility, and strategy of basketball and soccer.
While an intense fairly high-contact sport, especially for men’s lacrosse, injury rates for lacrosse are much lower than in other full-contact sports like hockey, football, or boxing. Injuries are more common in the lower extremities, particularly ankle sprains, ACL tears, shin splints, or leg or hip muscle strains. Men are more at risk of contact-related injuries than women, as women’s lacrosse prohibits intentional contact.
Common lacrosse injuries can include:
Ankle sprains: Ankle sprains are the most common lacrosse injury, accounting for 21% of female and 16% of male lacrosse injuries. Ankle sprains can occur when cutting or dodging which involve a quick change of direction, causing the ankle ligaments to extend beyond their normal range of movement and overstretch or tear. Most lacrosse ankle sprains are low lateral ligament ankle sprains and often have a high recurrence rate, meaning physical therapy is essential to prevent future sprains.
Knee injuries: ACL sprains or tears are the leading cause of lost practice and game time in lacrosse players. An ACL tear typically occurs due to a cut and plant action in which the athlete makes a quick change of direction or speed with the foot firmly planted.
Shoulder injuries: Shoulder injuries like a shoulder separation are more common among men as men’s lacrosse allows for increased contact. A shoulder separation typically occurs due to contact, causing the ligaments of the shoulder joint to strain or tear, resulting in a separation between the clavicle and acromion.
Hand, wrist, or arm fractures: These injuries are more common in men’s lacrosse due to being slashed by an opponent’s stick, causing a break in the bones of the hand, wrist, or arm.
Shin splints: Shin splints involve inflammation of the tibia and surrounding muscles, which strain where they connect to the tibia, developing microtears. Shin splints can occur due to increasing activity too soon with too much intensity such that the shin muscles cannot adapt, leading to pain.
Hamstring, quadriceps, or hip flexor strains: Muscle strains, particularly in the lower extremities like the hamstrings, quadriceps, or hip flexor muscles, can occur due to fatigue, dehydration, lack of conditioning or warm-up, or explosive movements that stress these muscles.
Concussions: A concussion is a mild traumatic brain injury caused by a blow, jolt, or bump to the head or a jarring motion to the body that can cause the skull and brain to move back and forth rapidly. While not as common, a concussion can occur in lacrosse due to player-to-player contact or player-to-ground contact.
Physical Therapy for Lacrosse Injuries
Physical therapy can help lacrosse players not only address and recover from injuries during the lacrosse season, but also help prevent injury through a customized strength and conditioning program. For most lacrosse injuries, physical therapists incorporate a progressive therapeutic exercise and strengthening program coupled with manual therapy, core strengthening, balance and proprioception training, and functional sport-specific training to optimize the athlete’s recovery.
Physical therapy treatment for common lacrosse injuries:
Ankle sprain treatment: Following an ankle sprain, it is essential to receive functional rehabilitation with a physical therapist focused on balance and proprioceptive training to prevent ankle instability and ankle sprain recurrence while ensuring a safe return to competition. Research has shown that early dynamic balance and proprioceptive training after an ankle sprain resulted in enhanced athletic performance, improved return to play, and less re-injury. Proprioception refers to the ability to control one’s balance involving the neural process in which the body takes in sensory input from the environment and integrates the information to guide the individual’s motor response.
ACL Tear rehabilitation: Proper rehabilitation with a physical therapist is essential after an ACL tear. Athletes normally work with a physical therapist for at least 9 months to help the athlete regain function and strength in the knee, progressing the athlete systematically through a return to sport protocol focused on knee and lower leg muscle strength, stability, agility, and coordination to ensure a safe return to sport
Hamstring or quadriceps muscle strain: Physical therapists play a critical role in preventing an acute hamstring or quadriceps muscle strain from becoming chronic through a structured therapeutic exercise program to restore muscle control, strength, range of motion, and balance in the lower leg muscles as well as strengthening the trunk, hip, and core to establish a strong foundation for movement.
Shin splint treatment: Shin splints can be quite painful. Physical therapists help manage pain through ice, compression, and manual therapy; implement calf stretching and targeted strengthening of the hip, core, leg, calf, ankle, and foot muscles to reduce pressure on the tibia; incorporate sport-specific agility and speed drills; use of orthotics; and establish a graded return to running to build up tolerance of running.
Shoulder separation treatment: The physical therapist uses range of motion exercises and manual therapy to increase shoulder mobility as well as targeted strengthening of the muscles of the shoulder, upper back, and chest to improve shoulder stability after a shoulder separation.
Concussion management: It is essential to receive effective, timely, and well-monitored treatment after a concussion. A physical therapist manages concussion recovery with evidence-based protocols, using vestibular rehabilitation, balance training, manual therapy, and a graded, progressive exercise program to help the athlete adapt to the increased physiological demands of activity over time with careful monitoring.
Before lacrosse season, a physical therapist can evaluate your movement and identify areas where you may need improvement in strength, agility, and coordination. The therapist then designs a customized strength and conditioning program to address any deficits or weaknesses and maximize your potential for the season while reducing the risk of injury. This might include aerobic exercise to increase your aerobic capacity, full-body resistance training, agility, balance, and coordination drills, plyometric training, neuromuscular training, and sport-and position-specific functional training.
