E:60 investigates if girls' lacrosse players should wear helmets

As the daughter of the longtime team doctor for the Pittsburgh Steelers, Callee Bradley grew up around the game of football, with its emphasis on speed and teamwork. The sport she fell in love with as an athlete, girls’ lacrosse, featured many of the same traits.

Head games

The Center for Injury Research and Policy, which tracks national high school injuries annually, began collecting data on girls' lacrosse two years ago. The game has the highest concussion rates among girls' sports, based on combined data from the 2008-09 and 2009-10 school years (estimates are based on concussions per 10,000 "exposures," with an exposure defined as one athlete participating in one practice or game):

Lacrosse 3.53
Soccer 3.36
Field hockey 2.25
Basketball 2.12
Softball 1.59
Gymnastics 0.68
Volleyball 0.64
Track 0.18
Swimming 0.17

Source: National High School Sports-Related Injury Surveillance Study.
What she didn’t expect to find was the hostility, and head injuries.

Last year, while playing for her middle school team, Callee, now 15, was rolling the crease with the ball in her basket when she came across a defender who was determined to stop her from shooting.

“She took her stick back like a baseball bat and smacked me in the side of the head,” Callee said. “It was a very deliberate hit.”

She suffered a concussion. Her brain took more than three months to recover. Callee’s father, Jim Bradley, said his daughter’s injury was worse than many NFL players who get concussed, based on her scores on a computer-based, neuro-cognitive test.

“It’s not a safe sport,” Callee said. “We need to be wearing helmets.”

In boys’ lacrosse, hard helmets are required. But in the girls’ game, they’re not even allowed, except on goalkeepers.

It’s an inconsistency that U.S. Lacrosse, whose rules are widely adopted by schools and clubs, defends as appropriate, while not ruling out the possibility that its stance could change.

As part of an E:60 investigation, ESPN RISE spoke with doctors, coaches, officials, players, parents, administrators and bio-mechanists about the pros and cons of introducing helmets to the girls’ game.

Here are the arguments on both sides of the issue.

FIVE REASONS NOT TO ALLOW HELMETS

1) The girls’ game could become more like the boys’ game
Highlighted on the wall of the Lacrosse Hall of Fame in Baltimore is a quote from lacrosse historian Milton R. Roberts, who said in 1978, “It’s clear that men’s and women’s lacrosse are two different games; both the same sport, yet each showcasing its own gender.” The last four words in that statement, whether you find them comforting or sexist, are key to understanding the resistance to helmets. The girls’ game is based more on finesse and stick skills than the boys’ game, in which full contact—and collisions—are allowed.

The fear among is that girls will deploy helmets as weapons, using their heads in the manner of the boys. Helmet advocates question that assumption, saying they’re not asking for a change in the rules against contact, just a change in uniform. But traditionalists are skeptical. “We want to try to preserve it as a version of lacrosse that’s uniquely for girls and women,” said Steve Stenersen, U.S. Lacrosse president.

2) No helmet is specifically tailored to the girls’ game
Given that girls are prohibited from slamming into each other, they probably don’t need the helmets with the full, football-style face mask that are used in the boys’ game. All that’s required is a shell to protect their skulls from reckless sticks, unintentional collisions and flying balls. But currently, nothing on the market is designed for girls’ lacrosse. U.S. Lacrosse would need to work with equipment manufacturers to come up with a model tailored to the game. Think of a modified ski helmet, with room for some form of the protective eye gear that is currently mandated by U.S. Lacrosse.

3) Better coaching and officiating can help address the problem
Girls’ lacrosse is the fastest-growing team game in the U.S., having gone from 90,000 participants to more than 220,000 in less than a decade. Girls are being coached by fathers who played as teens and, by instinct, teach the girls to play like boys. There’s also a dire shortage of qualified officials, especially in emerging areas like Pittsburgh. U.S. Lacrosse is trying to address those problems with a campaign to promote fair play, and by getting more coaches and officials trained in the rules of the game.

4) Skirts and helmets are fashion incompatible
Aesthetics matter to the teenage girls we spoke with. Hey, where does my ponytail go?

5) Helmets don’t eliminate the risk of concussions
Stenersen argues as much, noting that the standard concussion occurs when a brain gets rocked back and forth inside the skull. A head shaken violently could still be injured, even when covered with a hard plastic shell. The medical community agrees.

FIVE REASONS TO ALLOW HELMETS

1) They could eliminate some if not many concussions
Biomechanical studies have shown that helmets reduce the impact forces on the brain. And by far, the most common way girls’ lacrosse players get concussed is with sticks to the head, according to U.S. Lacrosse researcher Andy Lincoln. Those impacts tend to produce less force on the head than the collision-based concussions more common in the boys’ game. Cover the temple and the rest of the skull with helmet, and fewer girls are likely to end up in his clinic, said Pittsburgh doctor Mickey Collins, one of the world’s leading concussion experts. “I’m sure of it,” he said.

2) Refs will hear more fouls to the head
Right now, it’s hard for refs to know when a head gets struck, especially in games where there’s only one official (U.S. Lacrosse recommends two) and that person is 25 yards away from the point of contact. The sound of stick on skull is dull. With a plastic shell, argues Callee’s father, Jim Bradley, “you’ll hear the sound of stick hitting the helmet. When the referees hear that, then guess what? Then, all of a sudden, the (penalty) cards are coming out, and the girls will learn, ‘Hey, I can’t do that or I’m going to be sitting.’”

3) The sport will lose less future talent
Callee, fast and competitive, dreams of playing at the NCAA level. The coach on her elite club team expects she’ll get that chance. But Callee’s agreement with her parents is that with one more concussion, she’ll retire from the sport. And she just can’t imagine that the three years between now and when she goes to college will be concussion-free. “I’m gonna get hit in the head again, I know it,” she said. “I just have this gut feeling that if I don’t have a helmet, I’m never playing again.” The sport’s growth is dependent on parents’ perception of the risks involved, and they’re getting nervous.

4) The Aussie experiment worked fine
In the 1980s, concerned about the legal implications of denying women the ability to protect their heads, Australia’s lacrosse officials made helmets optional. For years, several players on the national team wore hockey helmets with a face mask. It didn’t make the game more dangerous, or lead to more injuries, former national team coach Peter Koshnitsky said in 2005. U.S. Lacrosse officials prefer to cite the experience in Massachusetts schools in the ‘80s, when hockey helmets were mandated, then disallowed a decade later when a parent threatened to sue after claiming that helmets hurt their daughter's chance at a college scholarship. At the time, some coaches contended that helmets made the game less safe, though no data has emerged to support that viewpoint. U.S. Lacrosse has declined to fund a study on the effects of allowing girls to wear helmets.

5) Girls deserve as much protection as boys
To parents who didn’t grow up with the game, the ban on helmets makes little sense. It makes less sense to doctors, who are aware of 2009 research suggesting that girls in general are at greater risk of concussion than boys. Girls also appear to suffer symptoms more deeply. “When you have girls that come through here who have to be held out of school three, four, five, six months, that have to be put onto medication, that have to be put into rehab, it does concern me,” Collins said.

Now, the question is whether such concerns will lead to a major change in the experience, or at least look, of the hottest game in girls’ sports.

Tom Farrey is an ESPN correspondent with E:60 and Outside the Lines. He can be reached at tom.farrey@espn.com.

For more information about this article, please visit http://rise.espn.go.com/lacrosse/articles/2010/08/e60-girls-concussion.aspx

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