John Carroll midfielder Katie Hormes isn’t difficult to spot on the lacrosse field, and not just because of her Division I talent.
The senior is one of a scant few players in the Baltimore area, and the only one on her team, to wear headgear, a lightweight helmet with integrated goggles she’s been using for the past two years after suffering multiple concussions in both lacrosse and soccer. Though she initially tried the equipment at the insistence of her parents, the extra protection now gives her peace of mind, as well as the confidence to charge past defenders near the goal.
"It's relieving wearing the helmet because I definitely feel safer in it and I'm not afraid to dodge through people," Hormes said. "I feel like if I'd have worn it from the start I probably wouldn't have had as many problems with my head."
Hormes is part of a small but growing contingent of players, coaches and parents around the country who think that making the currently optional helmets mandatory would reduce the number of head injuries in an increasingly fast and aggressive sport.
Many others, though, think such a move would be counterproductive, giving players license to act more reckless on the field while slowly transforming the finesse-oriented girls game into more of its hard-hitting boys counterpart.
"I worry about it becoming a more dangerous and less safe game if everyone has helmets," Glenelg Country School co-coach Brian Reese said. "People might think they're safer and have a false sense of security."
"I believe coaching your players correctly is the best way to prevent injuries," said Pallotti coach Mark Mozier, former president of US Lacrosse's Chesapeake chapter. "The women's lacrosse game has been a game of finesse and skill and I worry that helmets lead to pads, pads lead to contact and then [the] grace of the game disappears."
It's a subject that stirs deep emotions on both sides. While all agree the goal is to make players safer, there's so far no clear consensus on the best way to do just that.
While players, particularly those suffering from concussions, had voluntarily worn various types of headgear for years, the issue came to the forefront in 2017. That's when US Lacrosse, the Sparks-based governing body for men's and women's lacrosse in the U.S., adopted a new performance standard mandating that any headgear worn had to meet specific criteria for safety, limiting players to one of two approved models.
The goal was to mitigate the impact of sticks or balls to the head, the primary causes of head injuries, which multiple studies have shown disproportionately affect women. Since then, however, only one state, Florida, has made the use of headgear mandatory, meaning the vast majority of players are required only to wear eye protection and mouth guards.
Brad Kofoed wants to change that. Kofoed, a coach in the San Francisco Bay Area, is co-founder of the Brain Safety Alliance, an organization formed last year to push US Lacrosse to make headgear mandatory for all female players.
He knows first-hand just how dangerous the sport can be, despite its abundance of rules designed to protect athletes. Three years ago, he watched his daughter, Sophia, then a freshman in high school, suffer a life-altering brain injury during a game.
"She sustained essentially two strikes to the head with a stick within seconds of each other, which led to a blackout," Kofoed recalled. "She fell down and struck her head on the ground a third time. I witnessed everything that happened."
Initially diagnosed on the sideline with a mild concussion, Sophia soon began to spiral, unable to deal with her emotions or handle basic sensory stimulation such as light.
"Each day things got worse and worse, and it got to where she had to drop out of school and couldn't understand some of the most basic concepts," Kofoed said. "She lost her multiplication tables. She went into these dark depressions, then into these crazy, silly periods where it was just like this great, straight `A' kid was suddenly somebody we couldn't even recognize."
As she spent her summer in a dark room avoiding stimulation, her parents sought every possible type of medical help, including energy healers, craniosacral therapy and chiropractors. Now, as a senior, she still has daily headaches.
"If I can prevent one kid from living through what Sophia has lived through, it's worth it," Kofoed said. "I've seen my other daughter get hit in the head when she's wearing headgear, blows that I think would probably have been significant but ended up being non-issues."
US Lacrosse said it's waiting to see conclusive data.
For the past 18 months, the organization has supported a study out of the University of Florida to look at how players in that state have fared, compared with out-of-state players not using the headgear. That study recently was extended in an effort to deepen the data pool, with preliminary results due out as early as the end of this year.
"It would be a mistake to just make an emotional decision about something as important as player safety without the evidence to back it up," said Ann Kitt Carpenetti, the vice president of lacrosse operations at US Lacrosse. "I certainly know there are folks who have been around the game for decades and recall a time when women's lacrosse was played with nothing but a mouthguard. There always have been concerns expressed about the game changing fundamentally, but our position has been that the game doesn't have to change."
Carpenetti said that stricter enforcement of rules by referees and better teaching by coaches could eliminate most head injuries, regardless of headgear. What’s more, US Lacrosse says the current crop of helmets were never designed to prevent concussions — something even the most expensive and advanced football helmets can’t do.
Still, the idea of extra protection was enough to convince one local team.
Loch Raven last year became the first Baltimore-area school to require its players to wear them, a proactive move for a small program that couldn't afford to lose girls to injuries.
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“We’re just trying to make sure that we don’t lose any girls to concussions, because with the way the concussion protocol is, you could lose a girl for three-four or even six weeks,” Loch Raven coach Rob Persing said. “I believe it helps. I’ve seen girls get hit in the head last year with the stick and not think anything about it. They went right to the goal.”
Persing, whose team advanced to the Class 1A state title game last season, said some of his players complained about the look and feel of the helmets at first, but eventually grew comfortable with them.
The story was just the opposite for Bullis School in Potomac. The girls lacrosse team there had been wearing softer rugby helmets for several seasons out of concern about concussions, but in 2017 was forced to switch to the newly mandated models — with less than ideal results.
In short, not all of the helmets fit the players, particularly those with thick heads of hair.
“Some of the kids could not use them, so we just decided to make it optional,” said Kathleen Lloyd, the athletic director and coach at Bullis. “If they all fit, we might still be wearing them today.”
Lloyd said she still believes in the extra protection of helmets, and won't rule out using future models.
“When you’re riding a bike, if you fall down and you have a helmet on, you might still get a concussion but you’re definitely going to decrease the severity of the hit,” Lloyd said. “It just makes common sense to me.”