New Research Provides Data on Women's Headgear Use

Findings from a new research study measuring the effects of headgear in high school girls lacrosse indicate that headgear is associated with a reduction in the magnitude of overall impacts but not a change in the rate of impacts, how they occur, or how penalties were administered for impacts sustained during competition.

The findings were recently published in an article in The Orthopaedic Journal of Sports Medicine. 

The research team included two members of the USA Lacrosse Sports Science & Safety Committee, Dr. Shane Caswell of George Mason University, and Dr. Andrew Lincoln of MedStar Health Research Institute. The researchers monitored 49 high school players over the course of two seasons; one season with no headgear used and the second with headgear that meets ASTM standard F3137. 

All the players were from one high school in Virginia’s Prince William County, and no concussions were diagnosed in either season. Wearable sensors synchronized with video verification were used to collect data. 

“Collectively, these findings provide preliminary evidence that wearing lacrosse headgear meeting the ASTM F3137 performance standard does not appreciably change game-play behaviors, while it does reduce the magnitude of head accelerations associated with body impacts sustained during high school girls’ lacrosse,” Caswell said.

In their published article, Caswell and his cohorts noted, “The use of lacrosse headgear was associated with a significant reduction in the magnitude of overall impacts sustained during game play. However, the clinical significance of this reduction remains unknown, as it was largely driven by body impacts, and we observed no such reduction in magnitude when examining only verified impacts directly striking the head.” 

The researchers also expressed the need for further research with larger study populations to validate their findings. 

With significant leadership from USA Lacrosse, the ASTM headgear standard was developed to help reduce impact forces associated with stick and ball contact in women’s lacrosse. Approved in 2015, it was the first-ever performance standard for women’s lacrosse headgear.

While the optional use of headgear had always been allowed in the rules, USA Lacrosse updated its playing rules in 2017 by requiring that any headgear used must meet the new ASTM standard. Girls’ headgear use remains voluntary for players at all levels of play. Only Florida currently requires headgear use for state sanctioned high school play, and that headgear must meet the ASTM standard. 

The recent study acknowledged that opinions vary regarding the effectiveness of women’s lacrosse headgear and the possible associated changes in game play that may increase the risk of injury. Advocates believe that headgear use will decrease the severity of impacts and reduce the risk of head injuries, including concussions. Opponents maintain that headgear use will change the tenor of the women’s game, resulting in risk compensation and increased aggressive game-play behaviors.

“Our findings suggest that anecdotal concerns about headgear causing a ‘gladiator effect’ may not translate to game play,” Caswell said.

The researchers noted that, as a whole, their observations revealed that headgear use among high school girls’ varsity lacrosse players did not result in increased impacts or changes in game-play behaviors. Furthermore, the addition of headgear resulted in no changes in the frequency of penalties administered for illegal game play by officials.

“Our goal with this research was to help address the debate within the lacrosse community regarding the intended benefits and potential adverse consequences of women’s lacrosse headgear,” Lincoln said. “Our understanding of sports concussion and best practices for players' health and well-being is continually evolving.”

“This research, and continued studies and collaboration with the sports science community, are essential to our policies and positions to enhance safety in the game,” said Caitlin Kelley, women’s lacrosse director at USA Lacrosse. “We look to the experts and the data to inform our decisions on rules and equipment for play. We are so appreciative of the research that helps us best understand the specific needs of the women’s game and how best to protect players.”

USA Lacrosse is among the funding entities for another research study, now in progress, measuring the effectiveness of women’s headgear in minimizing the risk of injury among high school girls players. That study, launched in 2019 but suspended in 2020 due to the COVID-19 pandemic, hopes to resume data collection this spring with results announced later in 2021.