The findings from a three-year research study measuring the effect of protective headgear use by female high school lacrosse players were presented for the first time today at the American Academy of Pediatrics’ National Conference. The researchers reported that the use of headgear that meets the ASTM standard F3137 significantly reduces concussion rates.

The primary aim of the recently completed study, funded jointly by USA Lacrosse and NOCSAE, was to examine concussion rates in female high school players when wearing versus not wearing headgear specifically designed for women’s lacrosse.

Players were monitored across three seasons and included teams from Florida — which mandates the use of approved headgear for all high school girls’ players — as well as teams from across the country that comprised the non-headgear group. All head injuries were tracked in a customized database by athletic trainers.

This was one of the largest cohorts ever tracked and included nearly 300 school-seasons and over 350,000 athlete exposures (an exposure is defined as one athlete participating in one practice/game).

Overall, the researchers reported a 59 percent greater incidence of concussion in players not wearing headgear. This value increased to 74 percent when only considering concussion incidence during games but was lower (42 percent) when solely focused on practices.  

Of note, the most recent injury study from the NFHS shows that concussion rates in girls’ lacrosse have remained stable at a time when they are rising significantly in other sports.

The research team, led by Dr. Dan Herman, formerly at the University of Florida and now a member of the faculty at UC Davis, as well as Dr. Shane Caswell and Dr. Andrew Lincoln, both members of the USA Lacrosse Sports Science & Safety Committee, also noted that other factors (officiating, coaching, player skill development, body control, neck strength) could influence the relationship between wearing headgear and the incidence of concussion.

“We are thankful to Dr. Herman and his colleagues for this work as it provides important sport and gender specific data on head injuries and the efficacy of the headgear that meets F3137,” said Caitlin Kelley, women’s lacrosse director at USA Lacrosse. “It is great to see the effectiveness of the equipment and we look forward to working with various sport science and safety groups, rulemaking bodies, and other leaders in our game to best understand how this data should impact policy moving forward.”

The ASTM standard (F3137) for women’s lacrosse headgear was approved in 2015, and several smaller previous studies have provided some measure of the impact of headgear use. USA Lacrosse helped lead the development of the standard, but receives no financial benefit from the use of women’s headgear or any other protective equipment.

“The evidence from this novel study highlights the risk mitigation benefits of wearing headgear in girls’ high school lacrosse,” said Jason Vescovi, PhD, director of USA Lacrosse’s Center for Sports Science. “Future research will need to examine other levels of play along with influencing factors noted by the researchers to establish a comprehensive view of headgear use across the developmental spectrum for women’s lacrosse.”

USA Lacrosse has long advocated that protective equipment, including headgear for both men's and women's players, is just one component of a holistic approach to game safety and head injuries. Education, the use of age-appropriate rules, sport-specific training for coaches, and the use of certified game official are also critical factors.

Herman, Caswell, Lincoln and two other authors of the research results – Heather Vincent and Patricia Kelshaw – will provide a fuller explanation of their study and findings during the 2021 USA Lacrosse Sports Medicine Symposium on October 13.  Registration for that virtual event is open to all.

A preprint of the study is available via medRxiv. The researchers have also submitted a manuscript for publication to the British Journal of Sports Medicine.