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Study on Headgear Use in Girls' Lacrosse

By Paul Ohanian, US Lacrosse, 06/18/18, 12:00PM CDT

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“We’ll have to see whether the elevated risk remained when the girls began wearing the new protective headgear designed specifically for the women’s game in the spring 2018 season.” 

Findings from a recent research study on the effects of head protection on player safety in girls’ high school lacrosse indicate that there may be an elevated risk of injury with the use of certain styles of headgear. 

The researchers compared the rates of concussion and musculoskeletal (MSK) injuries among a small sample of Florida high school female lacrosse athletes before and after the 2015 implementation of a statewide protective headgear mandate. 

Significantly, girls’ headgear used from 2015-2017 did not meet the ASTM performance standard, F3137, developed specifically for women’s lacrosse. In most cases, athletes used soccer style headbands that are not considered legal for play per US Lacrosse rules.

Data extracted from an athletic trainer-driven electronic medical record system in Alachua County for the three years prior to and three years after the implementation of the Florida headgear requirement showed significantly greater frequency of concussions and MSK injuries. 

Similar data was extracted during the same time frame for boys’ lacrosse to help assess for changes in injury recording or reporting over this period of time and showed no significant differences.

While US Lacrosse and the NFHS mandated that optional headgear used after January 1, 2017 must meet the ASTM performance standard, the FHSAA (Florida High School Athletic Association) did not mandate the use of standard-compliant headgear until the 2018 season. Potentially, some headgear used in the study during the 2017 season may have met the standard.

The University of Florida’s Daniel C. Herman, MD, PhD, served as primary author of the study, with MedStar Sports Medicine’s Andrew Lincoln, ScD, serving as a supporting researcher.

“This is an intriguing analysis that suggests high school girls may play more aggressively when wearing headgear not designed for lacrosse,” Lincoln said. “We’ll have to see whether the elevated risk remained when the girls began wearing the new protective headgear designed specifically for the women’s game in the spring 2018 season.” 

Lincoln indicated that further research is needed to capture player attitudes about the use of headgear, as well as the reasons behind the elevated injury risk.

“We should investigate whether play is more aggressive and/or rules are not enforced to the same degree as they were prior to the introduction of headgear,” he said. “We are also studying players’ reaction to wearing the new headgear to better understand barriers to adoption of voluntary protective equipment such as this.” 

Per US Lacrosse/NFHS rules, girls’ headgear use remains voluntary in all states, other than Florida.

Herman presented a research abstract about the findings at the annual meeting of the American Medical Society for Sports Medicine (AMSSM) in Lake Buena Vista, Florida in April. Conclusions noted in the abstract indicate that further monitoring of injury rates using larger data sets is warranted.

“This information has not been published in a peer-reviewed journal, however, it correctly points to a need for further research since it only uses data from one county in Florida,” said Dr. Bruce Griffin, director of the Center for Sport Science at US Lacrosse. “The reason someone presents information like this at a conference is to raise the issue and show a demonstrated need for additional funding and research.”

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