Sometimes called the fastest game on two feet, lacrosse is also one of the fastest-growing sports in the U.S.

Between 2008 and 2012, kids' participation in lacrosse climbed 158 percent to a little more than three-quarters of a million, according to a survey conducted by the Sports & Fitness Industry Association/Physical Activity Council. At the same time participation in baseball, basketball, football and soccer has either stagnated or declined.

Kids who play lacrosse will tell you there's lots of action. Now, there's an analysis of injuries sustained by high school lacrosse players that quantifies the risks. Researchers analyzed a database of reports compiled by athletic trainers at high schools across the country.

Overall, there are about 2 injuries for every 1,000 exposures to the game, according to researchers from the Colorado School of Public Health and the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. An exposure was defined as one athlete taking part in a school-sanctioned game or practice.

The most common injuries were strains and sprains, accounting for about 38 percent of those recorded. Concussions were second, at about 22 percent of injuries. Injuries were three times more likely to occur in games than practice. Boys were 1.5 times more likely to be injured than girls.

Boys, in particular, were more likely to sustain concussions than girls — 0.5 concussions per 1,000 exposures for boys compared with 0.35 per 1,000 for girls. The rate of concussions for boys in games was seven times their rate in practice.

How the male and female athletes sustained concussions also differed. "Among boys nearly 75 percent of concussions were the direct result of contact with another player," said Dawn Comstock, associate professor of epidemiology at the Colorado School of Public Health and senior author of the paper. "In girls, over 60 percent of the concussions occurred when they were struck by the ball or stick."

In boys lacrosse, full-body contact is allowed and helmets are mandatory. In girls lacrosse, full-body contract is forbidden and helmets aren't typically worn. There's been talk about making helmets part of the girls' game. "The data does seem to support the call to put helmets on girl lacrosse players," Comstock said.

Boys lacrosse has injury rates very similar to football and hockey, Comstock said, while injuries in girls lacrosse are in line with those for soccer, basketball and field hockey.

The results were published online Tuesday by the American Journal of Sports Medicine.

While there are risks from playing lacrosse, there are also benefits. "We don't want any parent who hears about this study to be afraid to allow their child to begin playing lacrosse or to continue playing lacrosse," Comstock said. The side effects of an inactive lifestyle are more of a concern, she said, than the very small risk that any young athlete will sustain a serious injury playing lacrosse.

In late 2013, NPR and Truven Health Analytics surveyed Americans about the risk of sport-related concussions for kids, though we didn't ask about lacrosse. Almost all respondents were fine with idea of kids playing basketball or soccer. Three-quarters were OK with football and about two-thirds approved of hockey.

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