6 minute read
Injury & Prevention
Lacrosse has a long history having originated with the native populations of North America, particularly a group of tribes called the Iriquois, now an area that encompasses parts of the northern US and Canada. Although first documented by a Jesuit missionary (thus the French name) some form of lacrosse is thought to have been around for thousands of years and still holds very deep cultural and spiritual significance for certain groups in these areas. Previously played between tribes, the more modern game as it is seen now can be traced back to the late 1800’s and remains strongest in both Canada and the US. New Zealand was one of a few countries that had an active lacrosse community in the late 19 th and early 20 th century. However, as with many other sports, World War 1 decimated the game and it was absent from the country until 2001 at which point the game was restarted in Auckland. With numbers growing steadily, the growth of the game in New Zealand has mirrored the progress of the sport internationally, evidenced by the number of countries competing at the World Championships growing from 8 in 2002 to nearly 50 in 2018.
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Lacrosse Today
With only 400 men’s players in NZ Lacrosse is still an obscure sport so an overview may be of value. The game is played over 4 x 20 minute quarters and involves 10 players on each team- 3 attackmen, 3 midfielders, 3 in defence and a goalie. Required gear includes gloves, arm pads, and a full helmet (similar to Ice Hockey) with few restrictions on how long or where to carry, pass and, or shoot the ball. Each restart begins with a contested faceoff, there are few stoppages and no restrictions on substitutions allowing for a rapid, fluid game with consistent changes of personnel throughout. Defence and attack have to stay in their respective half of the field, usually creating a 6v6 situation when attacking the goal except when players incur a penalty during which time the penalised player is sent from the field for up to a minute. Contact is allowed in 2 primary ways. The first is using your stick to check the ball carrier’s stick or gloves in an attempt to dislodge the ball, the second is using your body and hands in contact with the opposition player’s body (from the side or front) to impede their progress or knock them away from the ball when not in possession. The combination of speed and physical contact makes lacrosse an extremely taxing game when played well. It’s fast pace and end to end nature makes a balance of speed, agility, and size a necessity. However, it also leaves ample opportunity for injury.
The challenges as a developing sport are, I suspect, not unique to lacrosse. As the sport has grown domestically and internationally the level of physical capability and skill level has risen accordingly. Within the National team the expectation on players and support staff has increased significantly with the level of fitness, skill, game knowledge, and time commitment rising pointedly to simply keep pace with international competition. Finding a way to balance this while acknowledging that lacrosse is still an amateur sport can be difficult with the need to work around the other commitments for player’s and support staff alike including study, work, and family.
Lacrosse Injury and Prevention
During my time looking after the NZ lacrosse squad most significant injuries other than bruising and contusions have been largely unrelated to the contact nature of the sport. Most commonly seen are joint related injuries to the hip, knee and ankle along with muscle injuries to hamstrings and gastrocnemius and were sustained during the rotational loading and rapid changes of direction during play, particularly while passing or shooting on the run. Although shoulder issues and lower back tightness has been noted, it has been less frequent than anticipated. As a result of these observations, the 6-month conditioning program for the national team intially focussed around building strong foundational strength of key muscle groups including glute med, hamstrings, quads and the core along with generalised upper body work and was then
progressed into sports specific functional movement and interval training. Although difficult to quantify, this approach appears to have been effective at helping minimise game restricting injuries.
High quality, basic physiotherapy advice and intervention pre and post injury is vital in helping developing sports such as lacrosse continue to progress. As the sport grows, I’m hoping that you start to encounter more players looking for assistance in both injury prevention and rehabilitation to help keep performing at a top level and help to raise the quality and performance at all levels of the sport.
Andrew Muir (BHSc, PGDip), Physiotherapist, New Zealand Lacrosse
Past Sports/Orthopaedic Physiotherapy commitments/involvement?
Graduated from AUT in 2005 before moving to Taranaki where I worked with the Mountain Airs NBL team then Wanaka where I worked with a range of winter athletes, mostly on injury rehabilitation. In 2008 I moved back to Auckland to work and complete post graduate studies during which time I focused on coaching both hockey and lacrosse and playing in the national team.
Andrew Muir (BHSc, PGDip), Physiotherapist, New Zealand Lacrosse….
Please describe your current role and how you ended up there.
After completing my time playing lacrosse for NZ I subsequently transitioned into a support role as physiotherapist.
What are your specific areas of interest/research?
My clinical work has two aspects with sports and personal injury intervention along chronic pain assessment and treatment using the Biopsychosocial Model of care
What are the types of injuries you commonly see?
In the lacrosse setting its primarily contusions and injuries typically associated with fast, agility based running sports. Lower limb muscle and joint injuries are the main concern
What do you think are the key elements in successfully preventing injury? (Please provide any specific information regarding screening tools/injury prevention strategies that would be useful for our members and links to documents if possible).
Basic, fundamentally sound advice and intervention is often the most effective. Sports specific strengthening in particular during the conditioning phase along with accurate assessment and staged return to activity plans avoid ongoing complications.
Who else is involved in the “support” team that you communicate with and how do you integrate with them to optimise injury prevention and rehabilitation?
Communicating with coaches as well as athletes and their health providers located around the country and internationally is challenging, but important in ensuring complete, effective injury management
Are you involved in performance aspects for your clients?
I also set the conditioning programs which helps to ensure appropriate injury prevention elements are included.
What are the key attributes you feel are required to work with elite level athletes?
An understanding of the pressures the athletes feel, often self inflicted, to continue performing. The desire to return to sporting activity needs to be managed well to ensure squad members have the best possibility if performing when it matters
What do you see as the major challenges for Sports Physiotherapy?
Effectively understanding and addressing the pyschosocial contributors to ongoing injury. Fear of movement, anxiety around return to sporting activity, low mood, and frustration are often left to physiotherapists, particularly in developing sports where a sports psychologist is unavailable. This is nan area in which we have a great effect, often unknowingly, and a greater knowledge in these aspects may help us gain better, more consistent outcomes.
