Lacrosse is fast, physical, and full of split-second moments. That is part of what makes the sport great. But as the game has gotten faster and the athletes have gotten stronger, protective equipment has had to evolve too.
One of the most important advances in recent years has been the requirement for lacrosse chest protection that meets the NOCSAE ND200 standard for commotio cordis risk reduction. This was a major step forward for player safety. Today, boys’ field players, goalies, and many levels of organized lacrosse are required to wear certified chest protection designed to reduce the risk of commotio cordis — the rare but often life-threatening cardiac event that can occur when a blunt impact strikes the chest at exactly the wrong moment in the heart’s rhythm.
Certification matters. It should be the starting point for every player, parent, coach, and equipment manager.
But certification is not the only question worth asking.
The next question is just as important:
Where is the heart-protection pad actually located?
The Peter Laake Story: A Reminder That Impact Location Matters
One of the most powerful examples in lacrosse is the story of Peter Laake, a Loyola Blakefield lacrosse player who suffered commotio cordis after being struck in the chest by a shot during a game in April 2021.
In the American Heart Association video telling Peter’s story, he clearly points to the location of the strike: a lower left chest impact.
That detail matters.
Peter’s survival was the result of a textbook emergency response. Athletic trainers, medical professionals, CPR, and an AED helped save his life. His story is an important reminder that every team should have an emergency action plan, trained responders, and immediate AED access.
But Peter’s story also raises a prevention question for the entire lacrosse community:
If a dangerous impact can occur low and left of center, should chest protection focus only on the center of the chest — or should it also consider the vulnerable left-side area where the cardiac silhouette may extend?
Current Lacrosse Chest Protection Has Improved — But Designs Are Not All the Same
The NOCSAE ND200 standard changed lacrosse protection for the better. It created a performance standard for chest protection intended to reduce the risk of commotio cordis. That standard pushed the industry forward and helped make certified protection part of the game.
However, when parents compare products across the lacrosse market, they may notice something important: the intended heart-protection pad is not always shaped, sized, or positioned the same way from brand to brand.
Many shoulder pad designs place their primary commotio cordis protection in the center chest area. That approach may help address impacts to the sternum and central chest. But cardiologists have long emphasized that the heart is not simply a small target in the middle of the chest. The cardiac silhouette can extend leftward, toward the left nipple line.
That means pad placement matters.
A protective pad that appears centered may still leave portions of the left ventricle area less covered, depending on the size of the player, the design of the pads, how the pads fit, and where the impact occurs.
What Cardiologists Have Said About Heart Coverage
Unequal’s design philosophy was shaped with input from cardiologists who emphasized that commotio cordis protection must account for the real anatomical location of the heart.
Dr. Jeffrey Mandak, M.D., FACC, a board-certified cardiologist, explained:
“Developing chest protection effective against commotio cordis is very complex. A traumatic blow to essentially any site on the left ventricle can produce the fatal arrhythmia associated with commotio cordis. So protective devices must be positioned in the correct location. The silhouette of the left ventricle can extend from the sternum to at least the left nipple line chest protectors that do not properly cover this entire area may be ineffective in preventing injury to these exposed regions. Be aware of devices that are in use, but have portions of the left ventricle unshielded. This deficiency can render the chest protector inadequate with regard to commotio cordis protection and expose athletes to unnecessary danger.”
Dr. Bryan Donohue, M.D., FACC, of the Heart and Vascular Institute at UPMC, added:
“The size, shape and position of the heart can vary The heart is positioned centrally within the chest cavity that can extend to the left nipple, known as the cardiac silhouette. To properly protect the heart from commotio cordis an effective chest protector will safeguard the player from the sternum to the left nipple, with proven certified protection.”
Their point is simple but important: when evaluating lacrosse chest protection, do not just ask whether a product has a heart pad. Ask where that pad sits and what area it is intended to cover.
The Unequal CC Lacrosse Difference
Unequal’s CC Lacrosse line was designed around a broader understanding of vulnerable impact zones.
Our products pass SEI certification and meet the NOCSAE standard, but the design goal does not stop at center-chest compliance. Unequal’s CC Lacrosse protection was built to help protect against direct impacts to the chest as well as the left-side area where athletes can be vulnerable.
That is why Unequal’s CC Lacrosse shoulder pads include protection positioned not only across the central chest, but also with thoughtful left-side coverage. At the time of the gear’s design, there was not a specific mandate requiring a left rib pad for lacrosse chest protection. Unequal included that added coverage because the medical guidance we received pointed to the importance of protecting the cardiac silhouette from the sternum toward the left nipple line.
In other words, Unequal did not design only for the minimum visible target.
Unequal designed for the way impacts can actually happen.
Why Left-Side Coverage Deserves More Attention
The Peter Laake story helps illustrate why this discussion matters. In the video, Peter identifies the impact as occurring in the lower left chest area. That location is important because it shows how a real-world lacrosse shot may not strike perfectly in the center of a chest protector.
Lacrosse balls do not always hit where equipment diagrams suggest. A shot can rise, skip, glance, or catch a player at an angle. A defender can be rotating, reaching, sliding, or turning at the moment of impact. A player’s shoulder pads can shift slightly during play. And athletes come in different shapes and sizes.
That is why pad location, pad coverage, and fit all matter.
A product can be certified and still look very different from another certified product. Parents and coaches should understand those differences and choose the design that gives them the most confidence for their athlete.
Questions Parents and Coaches Should Ask
When selecting lacrosse chest protection, consider asking:
1. Does the product meet the current NOCSAE ND200 standard and carry SEI certification?
2. Where is the intended heart-protection pad located?
3. Does the protective coverage extend from the sternum toward the left nipple line?
4. Does the product offer meaningful left-side or rib-area coverage?
5. Does it fit the athlete properly without shifting during play?
6. Will the athlete actually wear it comfortably and consistently?
The best protection is the protection that is certified, properly fitted, thoughtfully designed, and worn every time.
Certification Is the Floor. Thoughtful Coverage Is the Conversation.
The lacrosse community should be proud of the progress made in commotio cordis awareness. NOCSAE standards, SEI certification, CPR training, AED access, and emergency action planning have all helped move the sport in a safer direction.
But product design still matters.
Parents and coaches should not assume that all certified chest protectors provide the same shape, same coverage, or same positioning. They should look closely at how each product is built and where the protective padding is placed.
At Unequal, we believe prevention begins before the whistle blows. CPR and AEDs are essential after an emergency occurs. But the first line of defense is reducing risk before impact becomes a medical crisis.
That means certified equipment. Proper fit. Smart coaching. Player awareness. And chest protection designed with real-world impact locations in mind.
Protect the Heart. Protect the Player. Protect the Game.
Lacrosse will always be a fast, physical sport. That is part of its appeal. But the game can continue to grow while also becoming smarter about safety.
The Peter Laake story is not just a story about survival. It is a story about preparation, awareness, and the importance of asking better questions.
For families choosing lacrosse chest protection, the question should not be only:
“Is it certified?”
The better question may be:
“Where does it protect?”
Unequal’s CC Lacrosse line was designed to answer that question with broader, thoughtful coverage — including the center chest and the left-side area where athletes can be vulnerable.
Because when it comes to protecting the heart, location matters.
