Junior Researches Attitudes Toward Concussion Incidence and Headgear in Women’s Lacrosse

Shivani Iyer ’23 interviewed coaches, players, researchers and others to better understand the perspectives and experiences surrounding head injury and protection in the sport.

By: Meghan Kita  Tuesday, September 14, 2021 10:57 AM

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Shivani Iyer ’23. Photo by Joe Romano ’23

In April 2022, Shivani Iyer's research project, "A Helmet of Her Own," earned the Outstanding Public Health Research award at the Ohio State Research Fair.

News-watchers know Florida as a state where mandating certain public health protections (masks, vaccine passports) has been prohibited. But in 2015, in the world of women’s lacrosse, Florida became known as the only state to mandate protective headgear for high-school players. The Florida High School Athletic Association’s decision polarized athletes and coaches, says Shivani Iyer ’23. She has been conducting research on attitudes toward protective headgear and its influence on concussion prevention in women’s lacrosse—and, more broadly, on how gender norms and other social factors affect public health interventions—since this spring.

“I did not play a sport in high school. I’m the least athletic person. I had the mindset, ‘Why aren’t they wearing helmets?’ It feels so obvious,” she says. “After doing this research, I realized, even if I might feel like a helmet is a great form of protection, there's so much more nuance involved in this conversation.”

Iyer, a predental biology major and Dana Scholar, realized her interest in public health after taking a course with Assistant Professor of Public Health Kathleen Bachynski last fall. At the end of the semester, she asked Bachynski about research opportunities. Bachynski, who studies sports-related brain injuries from a public health perspective, mentioned wanting to explore the issue of protective headgear in women’s lacrosse, which, Iyer learned, has a different set of rules from men’s lacrosse. The men’s game allows full-body checking, she explains, while the women’s game allows only stick-to-stick contact.

However, the women’s game has evolved—the rules have changed to make it less stop-and-go and more enjoyable for players and viewers, which makes it more difficult for refs to catch and card illegal contact. The game’s increasingly fast-paced nature, as well as the dangers presented by sticks and balls, means head injuries can and do happen. 

Iyer spent the spring semester researching the context surrounding the protective headgear debate and its relation to the incidence of concussions in the sport via news articles and existing published research. She learned that, in the 1980s, Massachusetts required high school girls’ lacrosse players to wear hockey helmets, which, coaches and players claimed, led to a more dangerous style of play.

“It’s called the Gladiator Effect, this idea that if you put a helmet onto a player, the players are naturally going to play rougher, and because of this, there’s going to be increased risk,” Iyer says. “This isn’t a proven notion, but it’s very commonly argued in this sport.”

She continued her inquiry this summer by interviewing about 20 researchers, coaches, members of various governing bodies, headgear manufacturers and players she’d found during her spring literature review. The experience gave her a better understanding of the complexity of the discussion surrounding the headgear (a term that’s used because “helmet” implies a product similar to what men’s lacrosse players wear) specifically designed for women’s lacrosse players.

“I interviewed some really great people from Massachusetts, some former coaches who worked in the 1980s when the hockey helmets were implemented,” Iyer says. “A common argument as a reason not to implement the headgear is about maintaining the integrity of the girls’ game. They mentioned the fact that girls’ lacrosse was one of the first games to be purely a girls’ game. Their perspective is, even with the current rule changes, the game they coached in the ’80s isn’t the game played now. Putting headgear on top of it could completely change it.”

This fall, she and Bachynski will analyze the interviews to identify trends in the perspectives and attitudes shaping the debate. Iyer’s ultimate goal is to present her findings.

“A lot of the existing research is looking at the number of concussions and contacts or how effective the headgear is, not what conversations are being had,” she says. “If we don’t understand the different arguments and emotions associated with headgear, it’ll be really hard to implement headgear on a widespread level.”