| Argument against helmets | Evidence and/or arguments against rationale |
|---|---|
| “We don’t know the risk of concussions in women’s lacrosse” | – Extensive evidence collected from emergency rooms, the High School Rio™ database [6], the Concussion Prevention Initiative [1] and other sports surveillance systems (e.g., 2) show marked risks of concussion in women’s lacrosse – Traumatic brain injury and repeated mild traumatic brain injury have been linked to permanent impairments and neurodegenerative disease, including chronic traumatic encephalopathy ([7,8] and many others) |
| “Helmets do not prevent concussions” Or, similarly: “They wear helmets in men’s lacrosse and they still have a high concussion rate” |
– The main sources of concussion in women’s lacrosse are head or stick strikes [2]. With ASTM standard F3137, the new women’s lacrosse headgear was designed and tested specifically to reduce impact to the head by ball and stick, thus reducing biomechanical forces that lead to the most common mechanism of concussion in this particular sport – Goalies are most commonly struck in the head by the ball, yet goalies, protected with superior helmets have the lowest concussion rate of all positions [1] – Helmets will NOT prevent ALL concussions (especially those caused by collisions, which is the main cause of concussion in men’s lacrosse), but they may reduce symptom duration or severity of brain trauma |
| “The best way to prevent concussions is through rules and education” | – Precautions and preventive measures need not be mutually exclusive or singular – Accidental hits to the head by a lacrosse ball can cause significant head injury. Education and proper game technique are important to emphasize, but the inherent risks of a game that involves swinging sticks and launching projectiles necessitates protective gear to prevent unintentional cranial impacts |
| “The game will become rougher (‘gladiator effect’)” | – The women’s helmet will not make players feel invincible because the nose, mouth, jaw, ear and large portions of the temporal and occipital bones remain fully exposed – The risk of increased aggression should be mitigated by consistent enforcement of rules by referees, plus education for officials, coaches and players – Concussion rates are increasing over time due to improved reporting, awareness and diagnosis; this rising trend can lead to the appearance that adding protective equipment increases concussion rate. Such factors must be controlled when evaluating impact of helmets on concussion risk [9] |
| “The game is about finesse and precision, not physical contact” | – Despite being a noncontact sport, the head injuries have high incidence, even higher than the rate of knee injuries [6]. Rather than player–player contact, the major mechanism of head injury in women’s lacrosse is direct impact from a stick or ball. Used correctly and consistently, helmets protect from incidental head impacts that are an inherent risk in the game regardless of physical contact |
| “Women’s lacrosse has not used helmets in the past. We want to honor the tradition of the sport” | – Athletes keep improving (i.e., starting at younger ages, premier leagues, better conditioning) and advanced stick design enables swifter ball tosses; despite their best intentions to play safe, accidents happen. The improving level of athleticism brings with it increased risk of serious head trauma and other injuries |
| “Players will lose their peers’ respect” | – This claim lacks evidence. Social stigmas and peer pressure impose on discussions of helmet policy, especially when dealing with developmentally vulnerable groups (e.g., middle and high school age girls). All preadult athletes lack adequate frontal lobe development to make proper risk judgments (e.g., to understand the long-term consequences of serious brain injuries) |
Note. Table 1 from Acabchuk, R. L., & Johnson, B. T. (2017). Helmets in women’s lacrosse: what the evidence shows. Concussion. 2,2. [Link to article here.]