The Headgear Conundrum in Women's Lacrosse
|In response to concussions,
Bullis (Md.) School became the first girls' lacrosse team in the
nation to mandate its players wear headgear.
© John Strohsacker/LaxPhotos.com
Kathleen Lloyd is not trying to change girls' lacrosse.
"I've been coaching for 17 years. I played without goggles or boundaries. I'm old-school," she said. "I don't want to see the game change or see hard helmets."
But Lloyd, director of athletics and head coach at Bullis (Md.) School, did generate considerable dialogue in the girls' lacrosse community when she decided — after consulting school administrators, athletic trainers, parents and coaches — that all members of her varsity and JV teams would wear rugby helmets in the 2012 season. Officials at US Lacrosse believe the Bulldogs became the first girls' lacrosse program in the nation to mandate its players wear headgear.
A 2011 season that saw Bullis players sustain seven concussions during lacrosse activities.
Obviously a focus on one team skews the frequency of the injury in the girls' lacrosse, but in the moment of such an injury, statistical data may not be the first thought of parents and coaches.
"The intention was to protect the girls as best we could," Lloyd said. "We had several meetings about how we could protect players knowing that there's nothing else out there."
But as doctors and other professionals in the sports medicine field contend, helmets were not designed to prevent concussions. Lloyd acknowledged that fact as part of the decision-making process.
The scenario of a team resorting to a piece of equipment designed for another sport and lacking in proven efficacy against a given injury illustrates the crossroads at which girls' lacrosse finds itself. The rules allow for soft headgear, but they do not specify a measurable safety standard against which such a piece of headgear must be tested for effectiveness. That has led to a void of girls' lacrosse-specific headgear in the marketplace, likely leaving players who wish to wear headgear, whatever their reasons, in the unfair role of uneducated consumers.
But the head scratching has an end in sight. Since November 2010, US Lacrosse has vigorously pursued research and development of a unique standard for a girls' lacrosse-specific headgear. It's one of several initiatives the sport's national governing body has underway related to head injuries in girls' lacrosse, all with the goals of promoting player safety and preserving the integrity of the game.
Education and Rule Changes
In 2004, US Lacrosse debuted its Coaching Education Program (CEP) to give adults the knowledge and skills needed to teach lacrosse to the exploding base of youth and high school players. Since then, some 20,000 adults have completed either the online or in-person component of the CEP's Level 1, and many have gone on to become US Lacrosse-certified (which includes a criminal background check).
But Susan Ford believes in a more intangible approach to keeping players safe and the girls' game true to itself.
"Respect equals protect," said Ford, a member of the National Hall of Fame and a former president of the United States Women's Lacrosse Association (which merged with other lacrosse organizations to form US Lacrosse). "That's what happens. If you respect what you're doing, respect your opponent and respect the rules, you don't have to hit someone in the head. Any contact with the head is accidental. It's not practiced. It's not accepted. It's not part of game."
Before the 2012 season, US Lacrosse passed rule changes designed in part to reduce exposures of a player's head to a stick and to punish offenders who check at or near the head. At the scholastic level, US Lacrosse prohibited all checks toward the body and all attempts by a defensive player to reach into a 7-inch sphere around the ball carrier's head. This coincided with requiring teams to play man-down at both ends of the field for two minutes if a yellow card was issued.
As part of a comprehensive effort to develop age-appropriate rules for youth lacrosse, based in part on the physical and cognitive development stages of children, US Lacrosse outlawed stick checking in girls' lacrosse at the U9 and U11 age levels beginning in 2012. Modified checking is permissible at the U13 level, while full checking at the U15 level may take place if two US Lacrosse-trained umpires are calling the game.
Funding research projects that examine the mechanisms of injuries in lacrosse remains an annual program of US Lacrosse, thanks to the resources provided by members and donors.
Dr. Trey Crisco, a member of the US Lacrosse Sports Science and Safety Committee and the director of the bioengineering laboratory at the Brown University Medical School, is in the throws, perhaps literally, of a project entitled "Head Accelerations from Various Stick Checks in Girls' Lacrosse: A Surrogate Impact and Pilot Field Study."
The study, funded by NOCSAE and US Lacrosse, is in its lab phase. Dr. Crisco constructed surrogate models — "crash test dummies" — that were outfitted with sensors to measure the acceleration of the head following an impact with a lacrosse stick. On July 26, members of his daughter's lacrosse team came to the lab to take swings. Also tested and measured: various stick velocities, angles and locations of impact on the head, and using the shaft, throat and head of the stick to make contact.
|Bullis' headgear mandate helped
raise concussion awareness, the Bulldogs' coach says, and made
players hesitate before issuing wild checks.
© John Strohsacker/LaxPhotos.com
The field phase of Dr. Crisco's project is scheduled for the fall and will involve players wearing sensor-equipped headgear to measure the same variables.
"We want to get an understanding of the head accelerations associated with stick checks," Dr. Crisco said. "That should give us guidance on the severity and types of impacts we're seeing."
Head acceleration includes how fast the head moves and then stops after an impact. It's a measure associated with brain injuries, including concussions. Dr. Crisco's project will help define the relationship between stick velocity and head acceleration, while also factoring in player movement and the variables mentioned above.
"It's those values that would bracket the performance factor of a piece of headgear," Dr. Crisco said. "If the decision is made to pursue a standard, ASTM would use that data as guidance in the development of the standard."
Valley of the Sun
More directly related to Bullis' decision and to the discussion of headgear in girls' lacrosse is US Lacrosse's current work with the American Society for Testing and Materials (ASTM).
On May 2, US Lacrosse hosted a webinar outlining the current body of research. A week later, US Lacrosse CEO Steve Stenersen, Managing Director of Games Administration Ann Carpenetti and Women's Game Director Melissa Coyne joined approximately 65 stakeholders at the first meeting of the ASTM women's lacrosse headgear standard work group in Phoenix. The participants included leaders in the women's lacrosse community, coaches, umpires, administrators, doctors, sports medicine specialists, lacrosse equipment manufacturers, engineers, researchers and other testing officials.
"The people who know the most about the game should control conversation and be willing to be leaders," Ford said. "In Arizona, Ann, Melissa and Steve did a marvelous job of setting the conversation. They were so well-prepared."
Discussion included a presentation of the differences between girls' and boys' lacrosse and a preliminary report from Crisco as it compared to other studies of stick-to-head impacts.
"Many individuals spoke about US Lacrosse's position on head protection for girls' and women's lacrosse, and they did so passionately and rationally," Carpenetti said. "The ASTM members understood the need to maintain player safety and the integrity of the women's game when considering equipment interventions, and they appreciated our efforts to advocate for protection that is unique to the women's game."
The meeting proved so fruitful that ASTM agreed to form task groups for the stick and for the ball, in addition to previously established work groups for eyewear and headgear. Both the stick and ball can be factors in head injuries, and thus present the opportunity for adjustments to improve player safety.
For instance, a stick's flexibility varies from its head to the shaft. The stick's point of impact on a player's head may play a role in the severity of a head injury, so participants discussed the possibility of adding padding to the least flexible part of the stick: its throat.
Related to ball-to-head contact as a cause of concussions, the assembly in Phoenix discussed the possibility of engineering a lacrosse ball that retained its size properties, but was of less mass.
"Right now, lacrosse balls are performing in a wide spectrum, almost from billiard balls to tennis balls," said Mike Oliver, the executive director and general counsel for the National Operating Committee on Standards for Athletic Equipment (NOCSAE), which, like ASTM, responds to requests from sports governing bodies to research and develop equipment standards. NOCSAE representatives participated in the ASTM women's lacrosse meeting in Phoenix.
"The ball must perform the same," Oliver said. "That will be crucial if women's lacrosse moves to a unique ball, which seems to be one effective way to approach the problem. Require a ball that would have a certain amount of give to it, more than the current ball, so that if the ball strikes the head, there's the chance that the ball would absorb significantly more energy, not the head. We'd have to find that sweet spot where the ball does what we want it to do, but it doesn't change the game."
Women's lacrosse is on the agenda of the next ASTM meeting in November.
Bullish on Headgear
Of the seven concussions for the Bullis players in 2011, four were caused by stick-to-head contact. Lloyd reported three concussions suffered by Bullis varsity and JV players during the 2012 season — two as a result of stick-to-head contact.
"Did the rugby helmets prevent more concussions? We have no idea," Lloyd said. "But they generated awareness. Our girls were very aware of how they're playing, and our opponents were aware when seeing our helmets. We got fewer yellow cards this year. To me, it's more about the awareness. The rugby helmet makes you hesitate going for a crazy check."
Lloyd hasn't made a final decision about mandating the rugby helmets for the Bulldogs in 2013, in part because she has not yet met with school administrators about the topic.
"If US Lacrosse comes out with a headgear that's women's game-specific, that's what we would go with," Lloyd said.
A version of this article appears in the August issue of Lacrosse Magazine, the flagship publication of US Lacrosse. Don't get the mag? Join US Lacrosse and its 400,000-plus members today to start your subscription.