The debate over whether helmets should be mandated in girl's lacrosse, which has been raging for several years, reached a new level of ferocity this past week with the publication of a blistering piece in the New York Times reporting on the backlash generated by the controversial decision by the Florida High School Athletic Association (FHSAA) to mandate a soft form of headgear for everyone in a girls' lacrosse game beginning this spring season.
Having written about the debate in the recent past, I don't see much point in rehashing the controversy in detail. Suffice it to say, the new mandate hasn't made anybody happy and has garnered plenty of vocal detractors (and rightly so), from US Lacrosse, the sport's national governing body (which, among other things, called the mandate "irresponsible" and premature), to coaches (who don't see the flimsy headband approved by FHSAA -- what one longtime game official told The Times looked "more like a thick bandana" -- as serving any purpose and no more than a "costly distraction to parents and the players"), to game officials (one told The Times that the only effect the headgear was having on the game was to cause delays because the headbands were prone to falling off) to the athletes themselves, who say all it does is get in the way of their goggles.
But what I and many others continue to find perhaps most disturbing about the mandate is that it was a policy change made by FHSAA in complete disregard of the unanimous recommendation of its own Operations Committee, US Lacrosse staff, nationally renowned sport medicine doctors and the Florida lacrosse community that it hold off until performance standards for helmets were established.
A lot of us in the youth sports safety community are simply scratching our heads, asking ourselves, "Why the rush?" As best as I or any of us can tell, it was because, as FHSAA's Executive Director, Dr. Roger Dearing, told The Times, "The board felt it had to do something." In other words, it was a policy decision which a slim majority of the board decided to take not in recognition of but despite the science. (A familiar occurrence these days in national politics, as well)
As a former college lacrosse and high school field hockey player, and a member of ASTM International's subcommittee on standards for headgear and helmets, which is working with US Lacrosse on developing a new standard for headgear in women's lacrosse, I have reservations about whether requiring female lacrosse players to wear helmets will make the sports safer, or, as a result of the phenomenon called risk compensation (also called the "gladiator effect"), will actually result in more, rather than fewer, head injuries.
There is some evidence to suggest that such fears may be unfounded. A study on the use of protective goggles, albeit in girl's field hockey and involving different protective equipment, for instance, found that their use did not increase concussion rates, despite fears that they would lead to more aggressive play and hence more concussions.
But the only way we will know is to, one, make sure that whatever helmets female lacrosse players wear meet standards that are based on science, and have been developed after a deliberative and collaborative process by an independent organization, like ASTM, which is not funded by helmet manufacturers and which does not just invite, but requires input from equipment manufacturers, product testing laboratories, researchers and governing bodies, in this case US Lacrosse; and, second, to hold off on mandating helmets in the girl's game until there is actual data to show that they help reduce concussions on which to base a policy decision. The only way to do that is by conducting pilot programs comparing injury rates for teams in which girls wear helmets meeting the new, soon-to-be-approved ASTM standard, to rates where they don't.
As The Korey Stringer Institute and University of Connecticut's Doug Casa argued during his presentation at MomsTEAM Institute of Youth Sports Safety's Smart Teams Play Safe summit last year, youth sports safety policies should be developed and implemented by sports medicine professionals.
The appropriate process for developing sports safety policy was summed up nicely in an email I got this week from Ann Carpenetti, vice president of lacrosse operations at US Lacrosse and co-chair of the women's lacrosse headgear task group at ASTM:
US Lacrosse is committed to making evidence based decisions, and we rely heavily on expertise provided by researchers, sports medicine practitioners, educators, athletic trainers, administrators, coaches, officials, parents, [and] players to help us establish a holistic and best practices approach to keeping the sport fun and safe for all.
The girl's lacrosse helmet fiasco in Florida amply demonstrates just how horribly things can and will go off track when that process isn't followed and when politics trumps science.