Q: I thought that it was known that helmets don’t prevent concussions?

A: Your understanding that “helmets do not prevent concussions” is a common point of view that US Lacrosse and others have repeated for a long time. What this new research shows is that this statement is both true and untrue.

The reason that this is true, “helmets do not prevent concussions,” is that historical information is based on comparing helmet use in contact sports such as football and boys lacrosse. In these sports, the majority of concussions are caused by body to body contact. This type of contact causes a “rotational force” in the brain resulting in a concussion. A helmet is ineffective at preventing this kind of rotational event.

However, this new research has two primary findings: first, the majority of concussions in girls lacrosse (72%) are caused by impact with a linear force stick or a ball to the head, not body to body, rotational force. Impact with a stick or ball to the head is known as a “linear force.”  A helmet is very good at preventing concussions of this type of linear impact. Dr. Comstock’s 9-year study concludes that 48% of these “Linear” types of concussions could be prevented and 35% of concussions overall could be prevented in the girls game if they wore helmets.  The ASTM approved headgear is specifically designed to withstand the velocities of these kinds of impacts in the girls game, e.g., 60 mph cannon test. So it can be deduced that headgear would have the same benefit.

Q: I just want to see some empirical data about the benefits of headgear

A: Until recently there was only anecdotal data. However, this year Dr. Dawn Comstock, released the results of her research that showed that would prevent 35% of the concussions currently experienced in the girls game. https://www.brainsafetyalliance.com/science-information/

In addition, in July 2019 NYU released the results of their two year study of a New York School district that mandate headgear. Their results were definitive and showed that headgear prevented concussions and also reduced other injury types. https://www.sciencedaily.com/releases/2019/07/190714103129.htm

Q: Will headgear lead to the “Gladiator Effect”? More dangerous play…

A: This is a common concern. It is curious because there is not a single scientific study that supports this fear. This is not dissimilar to some of the concerns raised prior to the introduction of goggles. Of course, we now see that those concerns turned out to be unwarranted. In fact, the only science around the notion that headgear will cause more aggressive athletic behavior shows the opposite effect. In both cycling and skiing, there were arguments stating that helmet mandates would cause more aggressive play. The research has shown that this has not occurred the impact towards concussion prevention has been significantly positive. Studies are on this site.

Q: Why has US Lacrosse not mandated headgear?

A: This is a good question for US Lacrosse. Based on comments we have read, we believe that US Lacrosse holds the belief that headgear may cause players to engage in dangerous play. Based upon feedback we have received from both coaches of players wearing headgear, as well as the new research we have seen, this has not been the case.

Q: What have coaches who have mandated headgear experienced?

A: According to several coaches in Florida, California, Connecticut and the state champs in Pennsylvania, they saw no more aggressive play and to a coach saw a reduction in concussions.

Q: US Lacrosse is planning to study this over the next season. Why not just wait for their results?

A: For any parent or player who has experienced the devastation of a severe brain injury, the answer is obvious. Between now and the 2021 season when US Lacrosse expects to have their data –not necessarily make any changes– severe, life-long brain injuries will occur across the country that ARE PREVENTABLE. The scientific and anecdotal data we have today supports this mandate. Every concussion matters and this is just extending this problem.

Q: ASTM approved Headgear has been mandated in Florida for over two years now. Why has US Lacrosse or others not already studied the outcomes.

A: The administrators in Florida have indicated to us that once the mandate was in effect, people on Florida stopped worrying about it as it just became a normal part of the equipment so they didn’t feel a need to do more research. As to why US Lacrosse has not studied this already, we have the same question.

Q: Some have said that we need to address this problem with officiating, rules, etc. What’s wrong with that?

A: Nothing is wrong with that. We support those efforts. However, those efforts have been underway for years and the problem persists. In just our small circle we know many girls whose lives have been permanently damaged. However, another important point about this is that, the option to use officiating and rules remains an option after a mandate. So, if the scenario were to occur where play changed due to headgear, the option to add rules, as with football, remains available.

Q: I don’t hear about this in my community. Could this just be a problem with your program or area? Perhaps you have more inexperienced officials?

A: We have learned about serious concussions caused by linear impacts on the East coast, the South and West coast. This has occurred at the youth, high school and collegiate levels. Note that there was a recent lawsuit brought against the NCAA (collegiate level) by players in the top lacrosse conference in the world regarding the absence of support for wearing headgear.

Q: Don’t you think that this effort will lead to hard helmets and other equipment as in the boys game?

A: This is a great point. If headgear is not introduced so this problem is addressed, there is an argument some would make for this direction. This is another reason we support headgear. Based on the science and anecdotal evidence, we believe ASTM approved headgear will have a meaningful impact which will alleviate any perception that more steps are needed.

Q: Won’t headgear change the game?

A: Perhaps. But few coaches, players or observers of this game will pretend the game has not changed dramatically in just the past ten years. If we go back further, it is almost unrecognizable. Shots are much harder, it is a very physical game today and the stakes are far higher. Yet the protective equipment has not changed.

Q: Who are you, why are you doing this and who is paying?

A: We are people who, until very recently, did not know each other. For the most part the tragedy of seeing girls get hurt playing lacrosse, and the desire to make a difference is something we have in common and has brought us together to try to organize and make change. Our efforts are 100% voluntary. Because Hummingbird Sports manufactures a girls lacrosse headgear, we asked them to help with our website and they have generously agreed to assist in that way. If you would like to get involved or have other suggestions, we would love to hear from you. Please add your name in the <join now> section on the website.

Q: I have seen reference to “helmets” and “headgear”. What is the distinction?

A: This is an important point. In lacrosse, “helmets” are what are worn in the boys game. They have a hard shell and full face mask. The ASTM approved headgear is what is worn in the girls game. This is specifically designed to withstand linear impacts known to occur in the girls game but has a soft outer shell so as not to harm other players in the event of a collision. Headgear can come with built in eyewear or can be worn with a player’s own eyewear.

Q: What are the approved options for headgear?

A: Today there are only two companies that sell an ASTM approved headgear for girls lacrosse: Cascade and Hummingbird Sports.

Q: Lacrosse is no more dangerous, or less dangerous, than other sports such as soccer. Why should we add headgear?

A: This is a common, but fallacious, argument made to prevent the change that may occur by adding headgear to the game. There is no correlation between sports when it comes to assessing safety measures that can be taken. Every concussion matters. From our perspective, as long as one concussion can be prevented in lacrosse, then the change is necessary.  Of course, we would feel the same about seizing any opportunity to make every sport more safe. There was a time where people could not understand, and argued vehemently, against helmets in skiing and cycling. Today, it is uncommon to see participants in those activities without helmets.

Q: As a parent I watch the game and cannot understand why the coach doesn’t support or tell the kids to wear headgear.

A: This is a very common question when we speak to parents on the sidelines of games and practices. While there is a danger of overgeneralizing here as different coaches hold different views, we can share some of the reasons we have heard or of which we are aware

  • Most youth and many high school programs nation-wide take their guidance from US Lacrosse regarding equipment, rules and policies if this sort. Having been involved with US Lacrosse, trainings, etc for many years the position that “helmets don’t prevent concussions and will lead to dangerous play,” has been taught and repeated to coaches, officials and administrators.  Of course, today there is new empirical data available to challenge these past assumptions made without data.
  • Coaches are generally a part of a club or school program. A policy change such as this would typically come from above the coach and most coaches are reticent to challenge the organization. We now know that there are a lot of coaches who have been uncomfortable that girls are playing without headgear as the protective benefits seem rather obvious. Many now seem buoyed to know that this discomfort was reasonable and proved appropriate.
  • There often seems to be a resistance from women who played women’s lacrosse at a high level to this type of change as there is a possibility that it will change the nature of the game they played and love. This is a totally reasonable sentiment. However, the game has changed dramatically and will continue to change dramatically since its beginnings. There was strong opposition to eyewear at one point. Fields had no boundaries, sticks were made of wood, shots were half as hard as they are today. Games are highly physical, athletes are faster, stronger and more aggressive.

Q: I am a coach and I would like my players to wear headgear but I am not sure how this wil go over. Any suggestions?

A: First, know that there are a surprising number of coaches now doing this on their own in spite of the resistance. And we have heard many comments from them about the success they have seen in terms of reducing concussions. We have also found that the vast majority of parents want their daughters to wear headgear but are unwilling to force the issue as their daughters are unwilling as they don’t want to be, “the only one on the team with headgear.” So your initiative will likely be more popular than you think.  Here are some tips we have heard from others:

  • Communicate: In many cases parents and players assume the coach is not supportive of wearing headgear. Let them know you are. Talk about your concerns at your team kickoff event, cite the empirical data. Send them to our website to read the “my concussion” stories. Not a single parent would hesitate to support headgear if they had the hindsight of dealing with their child’s serious brain injury. Especially if they know that there is at least a 30% chance it can be prevented with headgear.
  • Talk about the feedback you have heard from other programs. For example, the state champions in Pennsylvania this season mandated headgear due to too many in prior seasons. Obviously this did not harm their play and they had 0 concussions.
  • One team we know held a vote by the parents in preseason. The vote was 95% in favor so the coach mandated headgear.
  • One club we know has made it “strongly recommended” among their teams under 12. Nearly every parent simply bought the headgear and for these girls it is never a question about wearing it. As they grow up, they will not sense the stigma felt in some places.

Share your feelings with other coaches and the governing bodies of your team, club and US Lacrosse. You will likely be surprised at how many others quietly share your concerns yet are hesitant to make any changes that may ruffle feathers.

“I have coached for 12 years. We had a lot of concussions for random things such as getting hit with a ball….since we have had headgear (mandated) for 3 years we have had zero concussions.”

George Dick, Head Coach, 2019 High School State Champions, Harriton High School, Bryn Mawr, PA (https://www.fox29.com/video/573729)

“I have coached the girls game for 10 years from youth to competitive club to high school.  During this time I have seen the game transform and I have become alarmed by the tragedy that major concussions have had on several girls I have coached and cared about. As a result, I strongly encourage my players (and their parents) to wear helmets. Our high school team is known to wear more helmets than any other in the region. Concussions will not go away,  but I now know first hand that helmets do NOT change the way girls play.”

Avi Orenstein, Head Coach, Las Lomas High School, US Lacrosse Level 3 Coach