HAVE RECENT RULE CHANGES IMPACTED LACROSSE'S CONCUSSION RATE?

FROM INSIDELACROSSE.COM

An ever increasing understanding of the negative effects of concussions and the types of hits that are most likely to cause them has led to a series of rule changes in men's lacrosse over the past several years, along with an increased emphasis by officials on penalizing those types of hits.

Data published in scholarly articles lags several years because of the lengthy writing and publishing process, and there does not appear to be a published study that specifically examines the impact of the rule changes on the concussion rate in men's and boys' lacrosse.

That makes the challenge of answering the question "Have Recent Rule Changes Impacted Lacrosse's Concussion Rate?" more difficult, but not insurmountable.

MORE AFTER THE BREAK

There are many potential sources of data on concussions in lacrosse, but for our purposes there are two important factors that we are looking for. The first is that the data should come from a consistent source, but be able to be split by year depending on whether or not it is before and after the rule changes. The second is that it should also include comparative numbers for other contact sports and team sports with significant concussion rates, such as football, ice hockey, soccer and basketball.

Over the past decade, there has been an incredible increase in awareness about concussions and the need to report and treat them properly. Comparing the concussion rate to other sports helps to provide a control for changes in knowledge and culture surrounding concussions in sports. Further, comparisons to football and ice hockey help to provide a control for improvements in the ability of helmets to prevent concussions. Therefore, we aren't looking for a decrease in the rate of concussions as much as we're looking for a greater decrease (or lesser increase) in the rate of concussions in lacrosse compared to other sports.

Since that data is going to include women's and girls' lacrosse, it is worth taking a look at their relative changes in concussion rates, as well.

NCAA Data

In terms of the men's lacrosse NCAA rules, the rule book added a prohibtion of players targeting the head and neck for the 2011 season, and both the 2009-10 and the 2011-12 rule cycles asked referees to more stringently penalize head and neck contact as a point of emphasis. There have been no additional rule changes or rules emphasis directly pertaining to concussions, body checks or hits the head. Therefore, the ideal year to split the data is either 2009-10 or 2011-12.

In NCAA women's lacrosse, it's more difficult to point to a singular rule change or emphasis aimed at reducing the number of concussions as causing a substantial change on its own. Rather, there has been a continual effort to improve player safety and protect players from stick-on-body contact that's primarily responsible for concussions in women's lacrosse dating back to at least the 2007 rules.

The best source that I could find for the NCAA was in a 2013 report by the NFL that provided data on concussion rates in NCAA sports split between the 2008-09 and 2009-10 seasons, the year that The Datalys Center for Sports Injury Research and Prevention assumed management of the NCAA Injury Surveillance System. That is very close to the ideal point to split the data for men's lacrosse and is good enough to provide at least a good indication of impact of the rule changes.

This table shows the average rate of concussions for 10 NCAA sports (baseball, softball and volleyball were left out). All numbers are in concussions per 10,000 athletic exposures (each time an individual player participates in a game or practice, it is considered an athletic exposure regardless of their playing time.) 

	2004-09	2009-13	Change
Football	6.0	6.3	5%
W Ice Hockey	7.0	5.0	-29%
M Ice Hockey	6.0	8.2	37%
W Lacrosse	6.2	5.5	-11%
M Lacrosse	6.0	3.1	-48%
W Soccer	6.7	6.5	-3%
M Soccer	4.2	3.1	-26%
Wrestling	4.9	12.4	153%
W Basketball	4.8	6.1	27%
M Basketball	3.4	3.5	3%

No sport had such a substantial reduction in the frequency of concussions between these two time periods as men's lacrosse. The 48% decrease is made slightly more substantial because it happened during a period in which the average change in concussion rate for the 10 sports was an increase of 11%. Women's lacrosse also saw both a decrease and a decrease relative to the average, but the decrease of 11% was only the fourth largest of the 10 sports and much closer to the average.

It is also particularly noteworthy that this reduction occurred during a time when there was an increase in the reported rate of concussions in football and men's ice hockey as that helps to rule out changes in helmet technology as the explanation because it can be presumed that each of the three sports' helmet technology improves at a relative rate.

In terms of the nominal rate, the concussion rate in men's lacrosse was tied with men's soccer for the second-lowest concussion rate out of all sports (not just the ones included in the table) behind only baseball (0.7) and even slightly lower than volleyball (3.3).

The concussion rate for women's lacrosse was the sixth-highest and behind three men's contact sports (football, ice hockey and wrestling) as well as two other women's sports (basketball and soccer).