Lacrosse, Too Dangerous To Play?

Some of you may have followed the recent story of John Mack, the 17 year old player who fell unconscious shortly after he was checked with a lacrosse stick during a game earlier this month, he died two days later.  His father was at the game and said the hit he took was no different from others he had taken in games before. 

This isn't the first lacrosse death to have been seen in the news. In March 2004, Cornell lacrosse player George Boiardi, 22, died after he was struck in the chest by a ball during a game against Binghamton. It stopped his heart.

So what went wrong, what could have been done to save these players and could the lacrosse manufacturers do more to keep players safe?  As a mother of two children, I want to make sure my children are safe without making rules about what games they can and cannot play. 

No autopsy was performed  on John Mack but it's believed the most likely cause was commotio cordis -- where a blunt impact stops the heart as it cycles through its beat. Commotio cordis is so rare that only 20 to 30 cases occur across the nation annually with no all being fatal.

A new study released this week says children who play hockey, football, lacrosse or baseball risk sudden death from a hard blow to the chest even if they are clad in protective gear.

Commercially available equipment may not adequately protect young athletes if the chest is hit in a manner that triggers an irregular heartbeat called ventricular fibrillation, according to a study presented at the annual American Heart Association meeting in Chicago.

"If the blow occurs directly over the heart at a particular time in the heart's cycle, the results can be catastrophic," said the report's lead author, Dr Barry Maron, director of the Hypertrophic Cardiomyopathy Centre at the Minneapolis Heart Institute Foundation.

The heart's electrical activity becomes disordered and its lower chambers contract in a rapid, unsynchronised way, allowing little or no blood to be pumped. Collapse and sudden death can follow unless immediate medical help is provided.

Such a rare but tragic blow can come from a ball, bat, hockey stick, puck or hard contact with another person, according to the study.

Of the 182 cases of ventricular fibrillation tracked by Maron since 1995, 47% occurred during practice or competition in organised sports. Thirty-nine percent of the children suffered fatal chest blows despite the presence of protective equipment. Their average age was 15 years.

Athletes wore standard chest protectors  

The remaining 53% percent occurred during recreational sports or normal activities around the home.

Among the athletes were 14 hockey players, 10 football players, six lacrosse players and three baseball catchers. In 23 of the deaths, padding did not cover the chest at the time of the blows, and 10 deaths occurred when projectiles directly struck the chest protector.

The athletes wore standard, commercially available chest barriers made of polymer foam covered by fabric or a hard shell.

Further research conducted at the New England Medical Centre and Tufts University School of Medicine in Boston found ventricular fibrillation could by caused by a baseball moving 30mp/h (48km/h), but only if impact occurred directly over the heart during a 20-millisecond window when the lower heart chambers are relaxed.

The findings indicate a need for better chest protection to make the athletic field safer for young participants, Maron said.

Those involved with youth sports also must be taught to recognise when a child has suffered the potentially deadly heart rhythm - known as commotio cordis - so that prompt resuscitation and defibrillation can occur, he said.

"Hopefully, this data will represent a stimulus for developing a truly effective chest barrier that will be absolutely protective against the risk of these commotio cordis catastrophes," he said.

So as a parent I look at this information and it seems to be no more dangerous than other contact sports played at school.  Saying that I believe there is a community responsibility to continue to ensure efforts move in the right direction.  Coaches, players and refs have a responsibility to keep the games clean and fair.  Manufacturers have a responsibility to continue the development of safer protective gear with the end result being no further deaths from commotio cordis.  And finally, as parents we have a responsibility to continue supporting our children as they play the sport they love.