The Effect of Head Impact Biomechanics on Short-and Long-term Neurological Status in Collegiate Men’s and Women’s Lacrosse and Soccer Players

Principle Investigator: Margot Putukian, MD, FACSM; Director of Athletic Medicine, Head Team Physician

Institution: Princeton University

Title: The effect of head impact biomechanics on short-and long-term neurological status in collegiate men’s and women’s lacrosse and soccer players

Abstract: The incidence of concussion has been best studied in football and ice hockey, where the mechanisms as well as the impact forces have been elucidated. For soccer and lacrosse, although data exists for the mechanism of injury, there is a paucity of information as it relates to the head impact forces that occur in each sport and across genders, the acute and long-term effects of sub-concussive impacts as well as the need for protective equipment.


  1. To study how baseline measures and recovery curves differ between athletes
  2. To study gender and sport (soccer and lacrosse) differences in the pre-injury baseline measures
  3. To quantify the gender and sport difference in biomechanical measures of head impact frequency and severity sustained
  4. To study the gender difference of the cumulative effect (dose response) of repeated sub-concussive head impacts on neurological function

Study Design:Prospective study including men’s and women’s soccer and lacrosse players. All athletes have a concussion baseline assessment including a standardized sideline assessment, and neurocognitive testing battery. Athletes will be prospectively followed with serial measurements of impact forces incurred during practice and games and subsequent repeat analyses.

Materials and Methods: Student-athletes (n=140) will be recruited to participate in a study consisting of men and

women’s soccer and lacrosse student-athletes at Princeton University and the University of North Carolina (UNC) at Chapel Hill. Participants will be asked to complete all clinical outcome measures prior to the start of year 1, with repeat assessments before and after their fall and spring seasons. Healthy control-comparison subjects will be recruited and asked to complete the same test battery. In addition, post-injury assessments after a diagnosis of concussion by the team physician and/or certified athletic trainer working under the supervision of a team physician will be performed.

Main Outcome Measures:

The raw head impact data sustained during practices, scrimmages, and games will be imported into Matlab. As each device is linked to a player enrolled in our study by unique identifiers, we will be able to associate impacts that belong to a particular player, and to categorize those impacts based on sport and gender information collected at the start of the season, in order to address our hypothesis-driven study aims.


There is minimal information regarding the impact forces incurred in the non-helmeted sports of men’s and women’s soccer as well as women’s lacrosse. There is also significant concern for sub-concussive blows in soccer and their potential relationship to cognitive deficits as well as other clinical measurements. There is controversy regarding the role of helmets in women’s lacrosse; research is required to determine whether helmets would prevent some concussive injury.