This article appears in the November edition of US Lacrosse Magazine, available exclusively to US Lacrosse members. Join or renew today! Thank you for your support.

Josh Covelli was the first to reach the 16-year-old goalie who lay motionless on the field.

James Hendrik, then a sophomore at Fletcher High School in Neptune Beach, Fla., had collapsed after blocking a shot with his chest Feb. 27, 2008. Covelli, the part-time boys’ lacrosse coach and full-time firefighter with training as an emergency medical technician, sprang into action. He tried to keep Hendrik conscious and stable until paramedics arrived with an automatic external defibrillator to revive him.

“I remember being down and I remember Coach’s voice saying, ‘Squeeze my hand if you can hear me,’” Hendrik said afterward.

Hendrik briefly stopped breathing. The paramedics delivered a shock to his chest with the AED to restore his normal heartbeat and vital signs. A sigh of relief filled the air as James was then taken to a nearby hospital for further evaluation and rehabilitation.

“It’s definitely a lot more emotional when it’s somebody you know,” Covelli said. “There’s also this thought in the back of my head that this is a kid. He’s just started his life. There’s a little more riding on it.”

It was later determined that the shot to Hendrik’s chest had caused commotio cordis, a rare but serious cardiac event disproportionately affecting male athletes ages 10-18. It occurs when a low-impact trauma — like that caused by a projectile (lacrosse ball or baseball) or body part (elbow or head) — affects the area of an athlete’s chest or rib cage over the lower-left chamber of the heart mid-beat.

Since a teenager’s rib cage is more flexible than that of an adult, such blunt force can cause the rib cage to touch the heart, triggering ventricular fibrillation (an abnormal heartbeat), which causes blood to stop flowing to the brain.

Commotio cordis is the second-leading cause of sudden death in young athletes in the U.S. Only an estimated 20 percent of victims survive such an episode, an ominous statistic that is only modestly improved to 35 percent with prompt administration of CPR or defibrillation with an AED. Notably, 20-30 percent of documented commotio cordis victims collapsed while already wearing chest protection, highlighting a significant vulnerability in equipment that needed to be corrected.

As a result of these findings, the National Operating Committee on Standards for Athletic Equipment (NOCSAE) — the nonprofit organization that develops performance and test standards for athletic equipment — established the first performance standard for lacrosse chest protection against commotio cordis.

The ND200 standard describes the necessary laboratory equipment and basic requirements needed for testing chest protectors to determine if they sufficiently guard against commotio cordis.

The Safety Equipment Institute (SEI), the independent organization responsible for testing the safety of athletic equipment, uses this ND200 standard to test lacrosse chest protectors. Those that pass are believed to provide sufficient protection for reduced risk of commotio cordis and thus receive the SEI certification mark. 

Effective Jan. 1, 2021, the NFHS, NCAA and US Lacrosse will require all men’s and women’s lacrosse goalie chest protectors to bear the SEI certification mark to be deemed legal for play. On Jan. 1, 2022, this same rule will be extended to men’s field players’ shoulder pads.

Maverik has responded by pioneering a line of ND200-compliant and SEI-certified goalie chest protectors and field-player shoulder pads. The External Kardiac Guard (EKG) pads meet the standard for protecting against commotio cordis without sacrificing range of motion.

The chest protection standard was developed based on research and testing conducted by Dr. Mark Link, a board-certified cardiac electrophysiologist and worldwide authority on commotio cordis.

US Lacrosse helped fund Link’s research, worked with industry leaders and collaborated with the NFHS and NCAA on the development and adoption of the standard. “This is simply another step in US Lacrosse’s established history of being focused on player safety,” Link said. 

Some lacrosse programs wasted no time implementing this increased level of chest protection for players. Penn State men’s lacrosse coach Jeff Tambroni equipped all of his players with Maverik EKG pads since the start of the 2019 season. “This type of protection is long overdue,” he said. “It has not compromised flexibility and weight.”

Whether you’re a goalie, a long pole or a short-stick d-middie, wearing Maverik’s revolutionary EKG protective equipment will give you the confidence to perform at your highest level.

“The EKG was easily the best chest pad I’ve ever used,” said Sean Sconone, the two-time MLL Goalie of the Year for the Connecticut Hammerheads. “The mobility and lightweight technology was amazing. It helped keep me cool and allowed me to have maximum movement during the high temperatures. It is a fantastic feature to have the EKG pad that emphasizes for better protection around the heart. I think it is a huge step for protecting goalies of all ages.”

A list of ND200-compliant/SEI-certified equipment that contains the SEI certification mark can be found at seinet.org. Click “Certified Products,”  “NOCSAE” and “Lacrosse.”