Impact Of Crosse Hold And Lower Body Running Mechanics On Musculoskeletal Pain And Injury In Lacrosse Athletes

PURPOSE: To determine if: 1) lower body biomechanics in lacrosse players differ when holding a lacrosse stick with one or two hands during running compared to running hands-free, 2) what common combination of biomechanical variables in each condition predict occurrence of any lower extremity pain or injury over 6 months. METHODS: Lacrosse players (N = 87; 34.4% female; 15.6 ± 0.8 yr) reported any lower body musculoskeletal injuries or pain at baseline and months 2, 4 and 6. Sport history and volume were recorded. Three running conditions were performed at near maximal speed: (hands-free, one-handed crosse hold, and two-handed crosse hold). A 3D motion tracking system captured peak angles and excursions about the ankle, knee, hip, pelvis and trunk. Repeated-measures ANCOVAs and logistic regression models determined the motion differences among the three conditions, and to found biomechanical features that best predicted lower extremity pain or injury in each condition. RESULTS: Individual biomechanical variables were not different across conditions. Over 6 months, 26 players developed injury or pain (30.7% females). Atraumatic pain was reported in the ankle (4), knee (4) knee (4), shin (2) quadricep or calf muscle strain (4), foot (6) or hip (5), with one ankle sprain. After testing of several models, the following combination of variables produced the best injury prediction model in all hold conditions: frontal plane knee and hip joint excursions, peak ankle eversion angles, peak trunk lateral lean; transverse plane knee and trunk excursions. Number of seasons of play was entered last. The models for hands-free and one-handed hold conditions predicted pain/injury in 18.8%-25.0% of injured players. The two-handed hold model was significant (χ2 = 17.45; p = .042), and correctly classified 38% of pain or injury cases (Nagelkerke R2). CONCLUSIONS: Crosse use (irrespective of hold type) did not significantly impact individual biomechanical variables. However, players who visibly use trunk rotation and side-to-side trunk lean while running with a two-handed hold may produce knee twisting and valgus, ankle drop and would more likely develop injury than players without these combined features. Neuromotor exercises coupled with two-handed crosse holds may improve motion control while running on the lacrosse field.