Is concussion protection in Florida too much, too soon?

Today’s New York Times featured a long exploration of “Headgear Rule for Girls’ Lacrosse Ignites Outcry.” As a former lacrosse player and health policy researcher, I read the piece with interest.

Essentially what’s happened is that Florida has instituted a headgear rule ahead of the sport’s national governing body. Florida made this decision in advance of this season based on statistics that show that female lacrosse players experience the fifth-highest rate of concussions of any high school athlete. If you’ve ever held a lacrosse ball, this won’t surprise you.

Still, it is not immediately clear what the actual rate of concussions is in Florida. Identifying girls lacrosse as coming in 5th place doesn’t help the reader judge how pervasive the risk really is if we consider that there could be large gaps between the ordinal rankings. Florida officials have suggested that if even one injury is prevented by the introduction of headgear, the rule would be worth it. I’m not sure I’m so risk-averse.

The real issue here is that Florida seems to have made this decision with little evidence about what the recommended headgear does to prevent injury. All we get as far as a description of intervention effectiveness is a comical anecdote about someone seeing a girl get hit in the head and “the ball bounced off her head, and she was fine!”

Needless to say, the governing body (US Lacrosse) is not happy at having its power and authority usurped – by a state that is a relative newcomer to the game, no less. Those not in favor in introducing headgear abide by the familiar argument that headgear may make the game more dangerous because players will be less inhibited. And then there are some folks who are walking a middle ground, remaining open to the possibility of headgear but not wanting to rush to any policy before the science can be fully vetted.

(Note: There is a precedent for this kind of thing in girls’ lacrosse. Well before protective eyewear became the standard (which it now is in all states) – my home state, New York, was requiring my teammates and I to wear goggles. It’s tough to tell if the politics of goggles was quite as controversial, but looking back, New York looks ahead-of-the-curve.)

The comment section is chock full of people recounting their own injuries and suggesting that to do anything but put girls in helmets is absurd. Clearly, the NFL head injury scandal has taken roots in the larger cultural discourse about sport safety. There’s also an interesting feminist streak running through them – suggesting that women deserve the same protections as men.

For now, I hope the research community takes the opportunity that natural experiment being created by the Florida decision. When it comes to comparing the concussion rate in Florida with that of other states, we should just be sure to take the level of play and quality of officiating into consideration. Good coaches, skilled players and confident officials are other levers to make the game safer that we talk too little about.

 [This post reflects my own views only.  It does not necessarily represent the views of the Petrie-Flom Center or the Football Players Health Study at Harvard University.]

One thought to “Is concussion protection in Florida too much, too soon?”

  1. Great points Lauren, it just goes to show what those with power but not much knowledge of the game can have enforced, especially when we are below soccer in the concussion department!!!!!!
    I still find it hard to believe that they went above US Lacrosse and without an approved logistical piece of headgear to wear.
    Believe me, it is very aggravating for the Florida coaches when they were told told to institute this as a mandate, very infuriating when they know that more research needs to be done.

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