Alexandra Fehmel remembers the dizziness. Then came the nausea, blurred vision and a dull pain on either side of her head.
During a sideline evaluation by a trainer for the Shoreham-Wading River girls lacrosse team more than two years ago, Fehmel, then 14 and in eighth grade, couldn’t remember her middle name, Michelle. Asked what it was, she replied, “Andra.”
“I guess my mind at the time was splitting my first name into two,” Fehmel said.
Fehmel, now 16, had collided with an opponent and was hit in the head with a lacrosse stick. Those were the symptoms of her second concussion.
Girls lacrosse, among the most popular and growing school sports on Long Island, is at the center of a national debate about the use of equipment in preventing injuries in general and concussions in young players in particular.
Nationwide, researchers are studying the causes, ramifications and prevention of concussions in athletics. Professional sports are studying the long-term impact of concussions. The National Football League has instituted stiffer penalties intended to cut down on helmet-to-helmet contact, and Major League Baseball has created a seven-day disabled list for concussion victims, while introducing new, thicker helmets in the minor leagues.
Long Island has 105 high school varsity girls lacrosse teams with about 2,700 players. The number of players increases when junior varsity squads and youth programs are included. Thousands of female athletes are playing a sport that is, by its definition, noncontact, but in reality is anything but. The ground is hard, as are the sticks used to throw the ball and the ball itself. Hard collisions with other players are not uncommon.
Rules for boys, girls differ
The rules of the boys and girls games are fundamentally different. Boys wear mandatory hard-shell headgear and face masks — along with padded gloves, elbow and shoulder pads — while most girls play with only goggles to protect their eyes and a mouthpiece to protect their teeth. In the boys game, stick to body contact is part of the game; no intentional contact is allowed to the head or body in the girls game. In speaking of their game, many female players and coaches talk about finesse and skill over force and strength.
In the boys game, pockets at the end of the stick are allowed, while in the girls game they are banned. Boys may shoot at the goal at any time; in the girls game, shooting is permitted only when the path to the goal is clear.
Many players, their parents and coaches are passionate defenders of the sport as unique from the boys game. They want to keep it that way. They say adding helmets will alter the girls game beyond recognition. Others who are also strong supporters of the girls game say making helmets mandatory would make the game safer for the players.
“I hate it, I don’t want them,” said Shannon Gilroy, a senior midfielder at Northport High School, of helmets in the girls game. “It would make girls lacrosse like guys lacrosse. Girls lacrosse should be girls lacrosse.”
Shaun Harney, the father of Bay Shore High School freshman midfielder Kyra Harney, and Taylor Harney, who plays lacrosse at SUNY Cortland, said he is opposed to making helmets mandatory. “I think with helmets it would just be human nature for them to get even more aggressive,” he said. “Would helmets decrease concussions? I don’t know if you can say that.”
Some experts also are not sure if helmets would decrease concussions.
“The jury is still out because there haven’t been extensive studies done on the effect of helmets in the sport,” said Dr. Tony Strickland, a neuropsychologist and director of the Sports Concussion Institute in Los Angeles. His two daughters, 11 and 8, play lacrosse. “I think the possibility is there that it could create a false sense of invulnerability and the players may take greater risks.”
Fehmel said most players on her Long Island Express travel squad, which is separate from her high school team, “have had at least one” concussion. One of Fehmel’s school teammates, Clare Blomberg, suffered three concussions in a year when she was 15 and said she couldn’t remember her parents’ phone number after the third injury, when she had been hit in the head by an opponent’s stick.
Fehmel and Blomberg now wear soft helmets made by Fehmel’s father and a family friend that are allowed under the female lacrosse rules. They say other players and their parents have inquired to see if these helmets could offer better protection. Last fall a proposal to equip girls with hard-shell helmets failed in a vote by representatives of the 11 sections of the New York State Public High School Athletic Association, said Shoreham-Wading River girls lacrosse coach Mary Bergmann.
Kerstin Kimel, Duke University women’s lacrosse coach, said the coaches she knows oppose hard-shell helmets for female players. “I’d like to think we as a coaching body . . . can do a better job of coaching kids to play safer with their sticks and I also think our officials can do a better job or enforcing some of the rules that are already in place,” she said.
Higher rate of head injuries
A 2008-09 school year study by the Columbus, Ohio-based Center for Injury Research and Policy, which used data from the National High School Sports-Related Injury Surveillance System, showed that 37.1 percent of girls lacrosse injuries were facial or concussions; in boys lacrosse it was 19.2 percent. In the 2009-10 school year study by the same group, 7.8 percent of all in-game high school baseball injuries reported were facial injuries or concussions, while 16.5 percent of all girls’ softball injuries were facial injuries or concussions. In both boys baseball and girls softball batters must wear helmets.
“Especially in sports that have identical rules — soccer and basketball being the best examples where you have the same exact rules for both genders — there seems to be an increased incidence of concussions in women,” said Margot Putukian, Princeton University’s director of athletic medicine.
There are several theories about why girls suffer more concussions than boys in some sports, including that females may be more likely to recognize and report their injuries, as well as differences in the skull.
Dr. Robert Cantu, a clinical professor of neurosurgery at Boston University School of Medicine and co-director of the Neurological Sports Injury Center at Brigham and Women’s Hospital, said whatever the scientific reason for female players being more susceptible to concussions, they should be required to wear hard helmets. “As a neurosurgeon, I think it’s crazy because I see people who get whacked with the sticks,” he said.
US Lacrosse, the governing body for the men’s and women’s game at all levels, has long held that putting boys’ helmets on girls would distort the sport.
“Men’s and women’s lacrosse are significantly different games, and as the game has grown many people have lost that recognition,” said Dr. Richard Hinton, a member of US Lacrosse’s Sports Safety and Science Committee and the head team physician for the U.S. women’s national lacrosse team.
“The lay public has a sense that if you just put the girls in men’s helmets, then that will take care of the problem,” he said. “The reality is this: The men’s game has a fair number of concussions and they’re already wearing helmets. So it’s not answered the problem.”
“I don’t see any conclusive studies in the literature or in my experience that says if you put a helmet on a women’s lacrosse player with the rules that are presently enforced, that they’re going to begin playing the game like men,” said Detroit-based orthopedist and girls lacrosse helmet proponent Dr. Jack Ryan.
“The referees are still going to call the penalties,” he said. “The coaches are still going to teach appropriately. All we’re taking away is the incidental stuff. If we just reduce that, then we would reduce a significant amount of the injuries.”
Ryan points to the forces that can incur just by a female player tripping and hitting the ground.
He also said, “If this person shoots the ball and it inadvertently deflects off to another player, and that player has nothing on their head, they’re going to be in trouble. . . . It’s a different game , but the similarities are this: There’s a ball that is very hard and there’s a stick that is very rigid.”
Girls play with the same hard rubber ball as boys. It is slightly smaller than a baseball and weighs 5 to 5.25 ounces. Hurled by a strong female player, the ball can reach speeds up to 60 mph.
“Women are more susceptible and in the situation we have right now they’re not protected from the stick or the ball,” Ryan said.
Work on helmet under way
Developing a sports-specific helmet for female lacrosse players has gained traction at the highest levels of the sport. Last fall, US Lacrosse began working with the National Organizing Committee on Standards for Athletic Equipment, a group that includes manufacturers among others, to create headgear. Although it’s unclear if such equipment will eventually become mandatory, as safety goggles did beginning in 2004, the rule-makers say they are willing to give the idea a shot.
“The best helmet might end up being one that’s not soft, but hard,” said Putukian, who is also the chair of the US Lacrosse Sports Science & Safety Committee. “But there’s no data to say that any helmet prevents concussions, so if that’s what we’re trying to prevent, then a helmet isn’t the way to go.”
Shoreham-Wading River school friends now playfully call Fehmel and Blomberg the “helmet heads.” They sport soft-shell headgear made by Fehmel’s father, Chris, and Gary Hanson, a family friend and physical therapist who used to design goalie masks for the National Hockey League.
Although Blomberg suffered a concussion in a preseason scrimmage in March, the two made it through the 2011 season without any further concussions once they began wearing the headgear and helped Shoreham-Wading River advance to the Suffolk championship game. The team Thursday lost to Hauppauge, 8-5. Fehmel scored a goal.
Both girls say they grateful for the helmets. Fehmel’s mother, Lori, is glad her daughter wore the protection this season, even if there are no scientific studies that show it helps.
Lori Fehmel said she believes helmets don’t prevent concussions, “but they can minimize stick-to-head injuries, and that’s what we’re looking for.”
“(Alexandra) has been hit in the head I can’t tell you how many times since she’s been wearing it, and luckily has walked away without an injury,” she said. “That’s all the proof I need.”