The Most Feared Injury In Lacrosse (Part I)

Lacrosse is a fast, physical, and extremely athletic game that presents an inherent risk for injury.

Common injuries for lacrosse athletes range from minor abrasions and bruises to far more serious injuries like concussions.

Yes, concussions are very serious injuries these days and they get a lot of attention.

But there is one injury, in particular, that is the most feared and potentially devastating injury that any lacrosse athlete will face.

It is the dreaded ACL injury.

The good news is that most athletes can fully recover from this injury, but it takes time and diligence with rehab.


The ACL (or anterior cruciate ligament) is one of the major knee stabilizers.

When this important ligament is torn, it’s “season-ending” for the athlete.

This is the most feared injury in lacrosse, not only for the athlete, but for parents and coaches too.

This is an injury that occurs all too frequently in field sports and can be absolutely devastating for the athlete because of the time required for post-op rehabilitation following surgery. 

Post-op rehab can take 6 to 9 months and sometimes longer until the athlete can return to their sport.

In my mind, this is the single biggest preventable injury for lacrosse athletes because there are many things that can be done to help reduce this devastating injury.

That’s good news that there are specific interventions that can done to help cut the risk for injury (which will be discussed in future articles in this series).

More good news is that most athletes do, indeed, return to sport after their injury.

I have treated countless athletes with ACL reconstructions and, while most do well, the time and work investment for recovery is quite extensive.

Not to mention the psychological aspect of returning to sport after this injury requires a high degree of mental toughness.


You might be surprised to know that the majority of ACL injuries are non-contact.

That means that there is no physical contact from another player (ex. player falls into another player causing direct contact or trauma to the knee joint).

It is reported that approximately 70-78% of ACL injuries are non-contact.

The foot plants, the leg moves in way it’s not supposed to and the ACL gets torn.

Most non-contact injuries occur when the athlete rapidly stops (decelerates) or changes direction (when running), cuts, or lands from a jump.

ACL injuries typically happen when:

  • the athlete rapidly stops
  • the athlete cuts or plants when changing direction during running
  • the athlete lands awkwardly from a jump (or hop)

What happens is the athlete makes an awkward, forceful movement that tears the ACL.

This happens in the blink of any eye and sometimes the athlete doesn’t even know what happened.

If you watch the NFL or college football, you’ve probably seen this many times when an athlete cuts or moves awkwardly, then falls to the ground grabbing their knee.

I’ve lost count how many times I’ve seen this on TV.

When see this though, I almost always suspect a season-ending ACL tear – then find out a few days later in the media that their ACL was, indeed, torn.

At that point, the athletes season is over and surgery is on the docket.


Unfortunately, the rate of non-contact ACL injuries is significantly greater for females as compared to males.

Females are reported to be anywhere from 2 to 9 times more at risk than males. 

Again, 2 to 9 times more risk with female athletes.

This is significant. 

There are proposed different reasons for this such as joint laxity, musculoskeletal differences, and varying levels of strength and conditioning between males and females.

There are things that are correctable and modifiable (such as muscle strength and imbalance).

And there are things that are not (body structure and bony anatomy).

What we know is that adequate muscular strength and appropriate muscle recruitment and timing are critical components for knee joint stability.

The hamstrings are of critical importance in the prevention of ACL injuries because they provide a key opposing force to anterior displacement. 

In other words, the hamstrings help to prevent the lower leg from moving forward (anteriorly) which could disrupt or tear the ACL.

So, hamstring strength is vital and we’ll talk more about that soon.

However, muscle strength is only one factor.

Remember what I just said here, many things are correctable to help prevent this injury from occurring.

Make sure to check out part II of this series where I cover more specifics on why these injuries occur and how to prevent them.

Coach Scott

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