Lacrosse Helmets: Good Enough For Boys, Why Aren't Girls Wearing Them?

High school lacrosse players wear helmets — if they're boys. The girls don't. On its face, it's a clear example of female athletes not being treated as equal to their male counterparts. But, as Bill Pennington reported for the New York Times this week, the question is anything but straightforward in Florida, the first state to require that high school girls' playing lacrosse wear protective headgear.

Dawn Comstock of the Colorado School of Public Health explained the data behind the rule change to Bill Littlefield.

BL: The rules are different in boys' and girls' lacrosse. There's far less contact in the girls' game, and that leads some to say that helmets are not necessary. But your research suggests contact isn't the problem in the girls' game. Why not?

DC: Boys' lacrosse is a full-contact sport. Girls' lacrosse is not. So on the face, you would think girls' lacrosse is much safer. However, I run a national high school sports injury surveillance system, and when we look at multiple years of data, we see that approximately 25 percent of all injuries among boys' lacrosse players were to the head and face, while 26 percent of injuries to girls' lacrosse players were to the head and face. More specifically, among boys, 22 percent of their injuries were concussions and, among girls, 23 percent of their injuries were concussions.

BL: So girls' lacrosse does have a concussion problem. 

[sidebar title="Are Helmets The Answer?" width="630" align="right"]Dr. Michael O'Brien tells Bill Littlefield why he thinks protective headgear won't reduce injury in girls' lacrosse.[/sidebar]DC: Girls' lacrosse does have the fifth-highest rate of concussions out of all the 22 sports that I study in my surveillance system. When we look at, again, the data from my surveillance system, we can determine the mechanism of injury — how the injury occurred.

Seventy-five percent of the injuries among boys' players — 75 percent of their concussions — are from player-player contact. However, it's very different among girls. In girls' lacrosse players, 64 percent of their injuries are what we call "player-apparatus contact." That means they're literally being struck in the head by either the lacrosse ball or the cross — the stick — the players use when they play.

BL: Now, the rule in Florida requires headgear, not necessarily helmets. Most players and their parents are choosing 10-mm-thick headbands instead of helmets. To me, that would seem to leave an awful lot of the head unprotected.

[sidebar title="Safety Recommendations For High School Sports" align="right"]Between 20 and 30 high school athletes die while playing sports in the U.S. each year, estimates researcher Doug Casa. Casa outlines the steps the National Association of Athletic Trainers is taking to protect high school athletes from preventable deaths.[/sidebar]

DC: You're right. And it's an interesting question. Right now, US Lacrosse and the [American Society for Testing and Material] are actually working on a standard for a soft-shell helmet. The question is: will those soft-shell helmets actually attenuate enough force from being struck in the head by a ball or a cross to prevent injury? The answer right now is no one knows.

BL: Some studies have suggested that sports without helmets, such as rugby, Australian rules football and soccer, have lower rates of concussions — possibly because athletes don't feel invincible. Do you worry that adding helmets to girls' lacrosse will result in a so-called "gladiator effect?" 

DC: The "gladiator effect" is, in my opinion, a myth that simply will not die -- despite the fact that there's not a single piece of published research that I'm aware of that actually proves this idea that if you put a piece of protective equipment on an athlete they will simply, as a result of wearing that protective equipment, become these super-aggressive, high risk-taking players. Girls' lacrosse players can't play more aggressively unless the officials, the coaches, their parents, the policymakers allow them to do so.

BL: Why has this question caused so much controversy then? Just because the "gladiator effect" refuses to die?

[sidebar title="Complete Concussions Coverage" width="630" align="right"]OAG has tracked the latest news and research on concussions for decades.[/sidebar]DC: No, I think it's a broader question. Girls' and boys' lacrosse are two very distinct games. They are very different games. However, if you take a step back and look at all of the arguments put forward for why girls' lacrosse players should not be wearing helmets, you can address each one with scientific evidence now.

And, to those people that say, "We can't put a helmet on a girl yet because we don't have a helmet standard," if boys are wearing a helmet because we are concerned that they're at risk of head injury, and they have a helmet standard for hard-shell helmets that they say does in fact decrease their risk of head injury — if it's good enough for the boys, why isn't it good enough to protect the girls as well?