Men’s Lacrosse Helmets in Girl’s Lacrosse:
Concerns About Player Safety and Game Integrity
Presentation to NYSPHSAA Section VIII
Men’s Lacrosse Helmets in Girl’s Lacrosse:
Concerns About Player Safety and Game Integrity
US Lacrosse Presentation to
NYSPHSAA Section VIII
November 16, 2010
Steve Stenersen, President and CEO
Ann Kitt Carpenetti, Managing Director of Game Administration
Overview of US Lacrosse
• National governing body of men’s and women’s lacrosse
• Staff of 65 headquartered in Baltimore
• Representative board, committee and subcommittee leadership
structure
• 320,000 members, 62 regional chapters across 40 states
• Provides comprehensive leadership, programs and educational
resources focused on the responsible growth of lacrosse
US Lacrosse Sports Science & Safety Subcommittee
Established as an advisory group to US Lacrosse
Serves as a source of lacrosse-specific safety education
Chaired by Dr. Margot Putukian, Dir. of Athletic Medicine at Princeton
Comprised of more than a dozen researchers and doctors representing
various medical specialties
• Represents US Lacrosse at various medical conferences
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Subcommittee goal: to utilize the existing sports medicine literature, and
grow the body of lacrosse safety knowledge, in order to objectively advise
US Lacrosse on factors that may enhance the safety and quality of
experience in men’s and women’s lacrosse.
SS&S Subcommittee Focus
• Injury Data Collection
– Fairfax County (VA) Public Schools
– Maryland Youth Lacrosse Association
– MedStar Sports Health
– NFHS
– NCAA
• Commotio Cordis
– Acompora Foundation (education)
– Cardiac Science (AED education and grants)
– NOCSAE (development of a chest protector standard)
SS&S Subcommittee Focus
• Collaboration
– NATA (Youth Sports Safety Alliance)
– AOSSM (Sports Trauma & Overuse Prevention)
– USADA – Supplement Safety Now
– USOC – Working Group for Safe Training Environments
– Sport-Related Traumatic Brain Injury Research Institute (pending)
• Measuring head impact force using helmet accelerometers
SS&S Subcommittee Focus
• Concussion
– American College of Sports Medicine (education)
– Centers for Disease Control & Prevention (education)
• Online toolkit, training & poster
• http://www.cdc.gov/concussion/HeadsUp/online_training.html
• http://www.cdc.gov/traumaticbraininjury/
– DVD Production (education)
– Neurocognitive Baseline Testing (ImPACT and others)
– NOCSAE (women’s headgear standard)
– NCAA & NFHS (rules)
• How to Hit Video
Overview of Men’s and Women’s Lacrosse Injuries
• Overall, lacrosse is a moderate risk sport; the vast majority of
injuries are minor strains, sprains and bruises.
• Non-contact ankle and knee ligament sprains, sustained while
cutting and dodging, are most common: girls (21%); boys’(16%)
• Knee injuries, including ACL tears, are the leading cause of lost game
and practice time in both games
• Head and face injury, including concussion, are less frequent but an
important issue for both games
– Body-to-body or body-to-ground contact in the boys’ game
– Inadvertent stick- or ball-to-head contact in the girls’ game
– More frequent in game than practice
What does Current Concussion Research Tell Us?
• NFHS, High School Sports Related Injury Surveillance Study
• NCAA Injury Surveillance System, DATALYS
• National Center for Catastrophic Sports Injuries
• US Lacrosse
– Trends in Sports-Related Concussion Incidence at the High School
Level, 1997-2008
Related US Lacrosse Initiatives
• US Lacrosse Medical Conference - Baltimore
– Friday, March 11 (prior to Face-off Classic)
• Sport-specific Coach & Official Education/Certification
– Essential to a safe lacrosse experience
• Parent Education
– Best-practices for youth lacrosse experience
• Standardized Youth Rules
– Based on physical & cognitive development stages
– Safe play standards for tournaments
2011 US Lacrosse Research Priorities
• Interventions/pilot studies related to concussion
– Education (officials, coaches, parents, players), rules, equipment
– Head acceleration in boy’s and girl’s lacrosse
– Focal impact of stick-to-head contact in girl’s lacrosse
• US Lacrosse coaching education curricula effectiveness
• Effect of regional variability in level of play on game safety
• Developmentally appropriate practice/game frequency by age
– incidence of overuse injuries, acute injuries, and burnout
• Concussion/head injury/facial injury summary across both games
and all levels of play
US Lacrosse Concerns
About the Use of
Men’s Lacrosse Helmets
in Girl’s Lacrosse
Women Lacrosse and Men’s Lacrosse are
Two Distinct Versions of the Sport
GIRL’S RULES
BOY’S RULES
CONTACT
Aggressive stick checking
and body contact are illegal
Aggressive stick checking &
body contact are legal
EQUIPMENT
Shallow pocket rule allows
for easier ball dislodgement
Deeper pocket rule requires
more aggressive checking
Protective eyewear and
mouth guards are required
Mouth guards are required
Soft head gear and nose
guards are optional
NOCCSAE-approves men’s
helmets are required
Close-fitted gloves are
optional
Arm pads, shoulder pads and
heavy gloves are required
Current NOCSAE Lacrosse Helmet Standards Were
Developed Specifically for Men’s Lacrosse
• Designed for a collision sport
• Based on football helmet standard
and testing (drop test)
• Designed to prevent catastrophic
head injury (skull fracture)
• Only three recorded catastrophic
head injuries in women’s lacrosse
over 27 years
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Two eye (pre-eyewear mandate)
One c-spine
Helmets Do Not Eliminate the Risk of Concussion
Q&A with Dr. William Meehan
Director of the Sports Concussion Clinic at Children’s Hospital Boston
Boston CBSlocal.com
October 26, 2010
“Helmets will not decrease the risk of concussion (in girl’s lacrosse). In fact, they’ll
probably increase it a little bit,” says Dr. William Meehan. “It’s due to a rapid spinning or
rotational acceleration to the brain. So if you put a helmet on and somebody hits you in the jaw
of the face mask, your head is going to spin, and the helmet is going to spin with it, but you’re
not going to reduce the risk of that rotation.”
Q: Even if helmets don’t prevent concussions, they do protect against catastrophic head injuries.
So why not require the girls to wear helmets for that reason?
A: “In the medical literature I didn’t see one case of catastrophic brain injury to a
woman,” says Dr. Meehan.
In addition, some people are concerned that if girls wear helmets, the level of aggressiveness will
go up actually leading to more concussions. That’s why Dr. Meehan doesn’t advocate helmets for
the girls. “Personally I think the price of the increased number of concussions would
be too much to pay,” he says.
Women’s Lacrosse Rules
Have Long Allowed Soft Headgear
US Lacrosse 2010-11 Rule Changes:
Increased Penalties for Dangerous Play
Rules continue to evolve and focus on player safety. Major changes in
the women’s game were recently made to Rule 7, Misconduct and
Suspensions:
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The head coach is now responsible for the behavior of her/his team, including
assistant coaches, and will receive any cards related to bench decorum.
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Anyone receiving two yellow cards in a single game is required to sit out of the
team’s next game.
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High school players who receive a red card must sit out of the team’s next two
games. Youth players who receive a red card as a result of a check to the head
are required to sit out team’s next game.
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Once a team receives three red cards in any game, it will play shorthanded for
the remainder of the game…and will lose an additional player each time another
card is received.
Case Study
Massachusetts Interscholastic Athletic Association
1986-1996
• The MIAA mandated ice hockey helmets for girl’s public high school
play starting in 1986
• After ten years, the MIAA overturned its decision for two primary
reasons:
– Concern over increased injuries caused by a more aggressive style of
play
– The threat of litigation from parents whose daughters were not being
recruited by colleges as a result of the helmet mandate
Headgear Designed Specifically for Women’s Lacrosse
US Lacrosse is now working with NOCSAE and the lacrosse equipment
industry to create a headgear standard specifically for the rules and
culture of women’s lacrosse.
Men’s Lacrosse Helmets
Were Not Designed for Women’s Lacrosse
It would be irresponsible and potentially dangerous to require girls’
lacrosse players to wear a helmet designed specifically for the
rules, style of play, culture and mechanism of injury of a completely
different game. Men’s lacrosse helmets were designed to prevent
catastrophic head injuries in a collision sport, but there has been no
evidence of catastrophic head injury in women’s lacrosse since 1982.
Such a decision would also ignore the potential of unintended
consequences to player safety and game integrity.
Equipment intervention decisions should be based more on empirical
data analysis than emotion.
Recommendations
Collaborate with US Lacrosse ongoing
Consult with women’s lacrosse and concussion experts ongoing
Encourage Section VIII schools to participate in NFHS/RIO research
Educate coaches, players and parents about concussion and returnto-play guidelines following injury. When in doubt, sit it out!
• Require all coaches to be US Lacrosse-certified to assure that they
have received proper game-specific training
• Require all officials to be US Lacrosse-certified to assure that they
have received proper game-specific training
• Do not mandate men’s lacrosse helmets for girl’s lacrosse –
wait until a NOCSAE standard for women’s lacrosse is
established.
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Questions?
Thank you!