A few years ago, a group of athletic training experts was pondering why there was no “peer-reviewed, evidenced-based” literature that made recommendations about what athletic training clinicians should do in the event of a catastrophic lacrosse injury, such as a spinal fracture.
Two consensus statements on best practices for spine-injured athletes — one broad, the other American football-specific — had been published, but nothing aimed specifically at spinal injuries in lacrosse.
“USA Lacrosse had a work group … that would review which helmets were on the market and provide suggestions to clinicians for what they should do in the event a catastrophic injury occurs,” said Dr. Tom Bowman, a member of the group and a professor of athletic training at the University of Lynchburg.
“We thought, ‘It’s great that we’re giving people recommendations, but we really need a peer-reviewed, evidence-based document — peer-reviewed is the key — with recommendations.’ We’d never done that before.”
This month, a consensus statement was released by what became known as the Spine Injury Sport Group, a group of U.S.-based researchers and health care workers with expertise in emergency care and lacrosse.
The statement, “Prehospital care of suspected spine-injured lacrosse athletes: a systematic search, evidence review, and consensus recommendations,” was published in the British Journal of Sports Medicine.
Bowman is its lead author. Co-authors include, among others, Caroline Wesley Siler ’07, the University’s athletic training director for student-athlete wellness. Funding for the project was provided by MedStar Health.
The consensus statement was described by Dr. Jason Vescovi, a coauthor and vice president of high performance for USA Lacrosse, as a “novel contribution to the scientific literature.” He added that the collaboration, which involved more than a dozen researchers, “uniquely contributes to the health and safety of lacrosse.”
According to the statement’s introduction, the SISG “aimed to review the existing peer-reviewed scientific and medical research literature, establish evidence-based practices for prehospital care of suspected spine-injured lacrosse athletes, and develop consensus-based recommendations for healthcare professions.”
It was a “systematic process,” Bowman said. “A librarian at West Virginia University, who has completed work like this in the past, created a search strategy. There were a bunch of databases with a bunch of different terms. Hundreds of articles.
“We had to sift through them and decide what works, based on the purpose of what we’re trying to do, and what doesn’t. We ended up with 20 papers. The next step was to take those 20 papers and look at every paper those 20 papers cited, and then all the papers that cited those 20 papers.
“We ended up with 27 papers that were the basis of the recommendations we came up with.”
Of the articles cited in the consensus statement, about a dozen were co-authored by Bowman. Some also were co-authored by Bowman’s athletic training colleagues at Lynchburg, Dr. Deb Bradney and Dr. Pat Aronson.
“Another cool piece to the puzzle is that a lot of the work I’ve done with students and colleagues over the last 15 years, beginning in about 2009, [was] part of shaping the recommendations that we made,” Bowman said, adding, “It takes a village.”
