From The Field: ‘Unprecedented Breakthrough’

US Lacrosse

March 31, 2021


Effective Jan. 1 of this year, all lacrosse goalies must wear chest protectors that meet the NOCSAE performance standard ND200. That goes for youth (US Lacrosse), high school (NFHS) and college (NCAA) and all disciplines of the game (men and women) played in the U.S. Come 2022, the mandate will extend to all field players in youth and high school boys’ and college men’s lacrosse.

US Lacrosse helped fund the research that led to the standard, which protects against commotio cordis, the rare but catastrophic phenomenon that occurs when a blunt blow to the chest wall directly over the heart happens during a precise moment in the heart’s cycle, disrupting the heart’s normal rhythm and causing cardiac arrest. NOCSAE approved the ND200 standard in January 2017.

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The Center for Sport Science at US Lacrosse serves as a national hub for the study and improvement of safety and performance in lacrosse. Since its inception in 1998, US Lacrosse has invested more than $1 million in lacrosse-specific safety research.

Among recent developments:

• A new study measuring the effects of headgear in high school girls’ lacrosse indicates that headgear reduces the magnitude but does not change the rate of impacts, how they occur or how penalties were administered. “Our findings suggest that anecdotal concerns about headgear causing a ‘gladiator effect’ may not translate to game play,” said Dr. Shane Caswell, who was on the research team along with fellow US Lacrosse Sports Science and Safety Committee member Dr. Andrew Lincoln.

• The NFHS has removed its high-moderate-low classification for sports related to COVID-19 transmission. Boys’ and girls’ lacrosse had initially been classified as high- and moderate-risk sports, respectively. US Lacrosse experts say that community infection rates are the strongest predictor for athletes contracting COVID-19 and that on-field transmission of the coronavirus is rare, particularly for sports played outdoors.


“It will make lacrosse safer.” — Dr. Mark Link, board-certified cardiac electrophysiologist and worldwide authority on commotio cordis

“This is an unprecedented breakthrough in sports protection. If they are wearing a protector that meets the standard, I have an extremely high level of confidence that the chances of that person sustaining a sudden cardiac death from impact is almost negligible.” — Mike Oliver, executive director of NOCSAE


Even with enhanced chest protection, USL strongly encourages an on-site AED for games and practices. The combination of immediate CPR and defibrillation with an AED can more than double a cardiac arrest victim’s chance of survival.



Survival rate in instances of commotio cordis.


Commotio cordis chest protectors receiving SEI certification (


Seconds to restart the heart in the event of commotio cordis before there is irreversible damage.


Manufacturers that have produced ND200-certified chest protection products as listed on the SEI website. Cascade Maverik, STX/Nike, True Temper and Warrior.


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