It’s important for players, parents, and coaches to understand commotio cordis and how to guard against it.

What is commotio cordis?
Commotio cordis is a life-threatening injury. It can happen when an athlete is struck in the chest, sending the player into a sudden cardiac crisis. Commotio cordis can affect athletes of any age but is more common in young players. Looking across all sports, 15-25 athletes die every year from commotio cordis.

Since the mid-1700s, there have been accounts in medical literature describing seemingly minor, unintentional blows to the chest that were lethal. Even farther back, there are ancient Chinese accounts of the martial art of Dim Mak (or touch of death), in which blows to the left of the sternum caused sudden death in opponents. It was through NOCSAE’s investigation of the injury that the cause of commotio cordis, and how to protect against it, first became known.

What has been NOCSAE’s role?
NOCSAE directed and funded the research that discovered the biomechanical cause of commotio cordis. This discovery ultimately made it possible to develop NOCSAE’s standard for protectors that could be worn by athletes. Companies that make and sell baseball and lacrosse commotio cordis protectors design their products for compliance with the NOCSAE standard and apply to the Safety Equipment Institute (SEI) for certification of this compliance. Read the full standard developed by NOCSAE.

NOCSAE also funded a national commotio cordis registry to track commotio cordis injuries. From registry data we now know how many players per year suffer the injury, their ages, gender, and how often it occurs by sport.

How to guard against it
Players, parents, and coaches can make sure their baseball and lacrosse gear meet the ND200 NOCSAE Performance Standard to Protect Against Commotio Cordis. Here’s a list of gear certified to our standard on the Safety Equipment Institute website. Also read about AEDs (automated external defibrillators). AEDs are the second line of defense against commotio cordis.