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Soccer Headgear: Does It Do Any Good? 
By JERE LONGMAN Published: November 27, 2004 Associated Press 
Kevin Rivoli for The New York Times 

Patrick Fisher, product manager for Full90, modeling the headgear that
the company sells to soccer players. The device weighs less than 2
ounces. Most soccer players on the Santa Clara University women's team
will enter the N.C.A.A. quarterfinals today wearing protective
equipment - headgear - that is as controversial as it is lightweight.
In the 15 months since FIFA, soccer's world governing body, began
permitting its use, headgear has been worn by thousands of American
players from youth leagues to high schools to colleges to the pros.
The headgear gained international visibility during the 2003 Women's
World Cup and the Athens Olympics this summer. This has triggered
skepticism within the United States Soccer Federation, which contends
that marketing to the fears of parents has trumped science regarding
the effectiveness of headgear in preventing concussions. This
resistance has not dissuaded some youth clubs from requiring the use
of headgear. "I remember when baseball players didn't wear batting
helmets," said Steve Ryan, commissioner of the Major Indoor Soccer
League, which approves of headgear. "You see some resistance in
soccer, which is natural. But I expect, over time, you will see it
broadly accepted." The founder of a San Diego-based company called
Full90 said he had sold 100,000 pieces of headgear. The headgear
resembles an enlarged headband, weighs less than 2 ounces, and covers
the forehead, temples and occipital bone in back of the head. The
device is made of shock-absorbing foam situated between an outer layer
of Lycra and an inner layer of sweat-absorbing polypropylene. Several
models are available for $24 to $39. Full90 does not claim that its
headgear prevents concussions. But the company does say the headgear
can reduce, by up to 50 percent, the peak impact forces that occur
during typical collisions when a player's head strikes another head,
the ground, an elbow or a goal post. The headgear debate is occurring
at a time when some studies indicate that concussions occur in soccer
at a rate similar to the rate in football. There also is disagreement
on whether heading the ball can cause concussions or long-term brain
impairment. Studies have presented contradictory results, and the
matter remains disputed as the soccer federation undertakes a
long-term examination of head injuries. The resolution of these
head-related issues could have far-reaching health and financial
impacts, given that nearly 18 million people play soccer in the United
States. On one side of the headgear argument is Jeff Skeen, founder of
Full90. He said he developed the protective device after his daughter
Lauren suffered two soccer-related concussions in high school, causing
her to quit the sport. At 46, Skeen possesses the righteousness of the
aggrieved parent. He believes his product can reduce head injuries
without giving an illicit advantage in heading the ball. The soccer
federation, which permits headgear but does not endorse it, fears that
its wide use would undermine the assertion that soccer is a safe
alternative to football, Skeen said. He likens the doubt of soccer
officials to familiar but failed arguments once made against the use
of bicycle helmets, automobile seat belts and soccer shin guards.
"They are trying to thwart the evolution of headgear in soccer because
they think it will scare soccer moms away from the sign-up table,"
Skeen said of soccer federation officials. "And because they think it
could be viewed as an admission that heading the ball itself is
dangerous." Calvin Williams, founder of the Kangaroo headgear company,
said he thought soccer officials resisted the equipment because they
felt "it is sissified." Soccer federation officials disagree, saying
their caution is based on scientific uncertainty. Insufficient
independent evidence exists to confirm that headgear can reduce the
risk of head injuries, they say. Doctors affiliated with the
federation also say that headgear is being marketed primarily to
children, who least need them because there is little incidence of
concussions in players under the age of 12. Players might develop a
false sense of security, relying on headgear instead of proper medical
evaluation after suffering a concussion, federation doctors say. Or,
they say, players might feel invincible in headgear and play with
reckless aggressiveness, displaying behavior known as the Superman
effect. Rather than headgear, federation officials advocate better
technique, stricter rules enforcement and improved officiating to
reduce the number of head injuries. Some also recommend mouth guards
and padded goal posts instead of padded headgear. "There is no
evidence headgear are going to help, and some theoretical stuff that
it could hurt," said Dr. Gary Green, a clinical professor at the
U.C.L.A. division of sports medicine who is on the soccer federation's
medical advisory committee. "Why take a chance until this gets
studied?" Because Full90 pays some pro players (the equivalent of $50
to $100 per game, it says) and some state soccer associations ($4,000
to $10,000) to endorse its product, the soccer federation says the
company's claims are suspect. "We're talking about marketing and fear
and manipulation," said Dr. Bert Mandelbaum, team physician for the
United States national teams. Not all medical soccer experts oppose
headgear. Dr. J. Scott Delaney of McGill University in Montreal said
laboratory data, not yet published, does indicate that headgear could
reduce impact forces by 10 to 30 percent. (The soccer federation says
this involves low-level forces that don't cause concussions.) Delaney
said an industry standard for headgear has been drafted and could be
instituted in May. In a study, published in the Clinical Journal of
Sports Medicine, Delaney queried 328 Canadian university football
players and 201 university soccer players as they reported to fall
training camp in 1999. He found that 70.4 percent of the football
players and 62.7 percent of the soccer players had experienced
symptoms of a concussion in the previous year. "We've shown
concussions are a problem, and in the lab these things work," Delaney
said of headgear. "What else do you need? Why wouldn't you start
protecting people?" Studies involving large numbers of players can
occur only after headgear is used widely, said Delaney, who is team
physician for the McGill soccer team and the Montreal Alouettes of the
Canadian Football League. The concern over concussions, and whether
headgear can protect against them, is a growing issue for youth soccer
associations. In September, the New York State West Youth Soccer
Association, which governs more than 200 clubs and 80,000 youths in
the Buffalo-Rochester area, voted to require headgear for all players
under 14. The association later retreated over concerns about
liability and protests from some coaches and officials. Several
coaches interviewed in Rochester wondered why headgear were proposed
for young children and not for older teenagers, who are more likely to
get concussions. Others said risk was inherent in any sport. "Where
are you going to draw the line? Make everyone wear knee braces?" said
Tom Maines, who coaches an under-10 boys team in Brockport, N.Y. Some
players resist headgear on aesthetic grounds. "It looks goofy," said
Brittany Myles, 13, of Syracuse. Ross Paule, a midfielder for the
Columbus Crew of Major League Soccer, wore Full90 headgear for a dozen
games in the recently completed season, seeking some security after
suffering three earlier concussions. "I'm on the fence," said Paule,
who was not paid to endorse the headgear. "I don't agree it should be
mandated. If something makes you comfortable, why not?" He added: "I
can't tell you if it was a huge help. When I got hit one time, maybe
it gave me a little extra cushion." Any club or association that makes
headgear compulsory risks losing its affiliation with the United
States Soccer Federation, Dr. S. Robert Contiguglia, its president,
said. But that threat is either unknown or ignored by the Temecula
Valley Soccer Association in Southern California, which for three
seasons has required headgear for players under 8. Peter Schilperoort,
president of the association, said headgear prevented bumps and cuts
previously suffered by his players, calling the equipment "the best
thing since sliced bread." The De Anza Force soccer club of Cupertino,
Calif., will require headgear for players under 17 beginning in March,
said Tom Pridham, a club official. Both the Temecula and De Anza clubs
are sponsored by Full90. Jerry Smith, coach of the Santa Clara women's
team, which received free headgear from Full90, said the equipment
made his players more confident in challenging balls in the air, and
more assertive, but not overly so. Anson Dorrance, who has coached the
women's team at North Carolina to 18 national championships, said
compulsory use of shin guards had not changed the nature of soccer, as
many feared. He predicted that headgear would not, either. "I'd
challenge any of these doctors who feel this has no value to run into
the goal post without a Full90 and with it, then tell me, if they were
forced to do it a third time, whether or not they would wear it," said
Dorrance, whose team is also sponsored by Full90.

Several players, including Joy Fawcett of the United States women's
national team, who endorses Full90, discounted the so-called the
Superman effect, saying the headgear did not make players dangerously
aggressive. "It's like a flag that reminds you not to go up for stupid
plays," said Jill Conaboy, a defender at Downingtown West High in
suburban Philadelphia, who wore headgear last weekend as her team won
the Pennsylvania Class AAA state championship. Kathy Conaboy, Jill's
mother, said she held no illusion that her daughter, who has suffered
two concussions, would never be hurt again while wearing headgear.
What she hopes, she said, is that a blow that might have caused a
third concussion will result in only a bruise. "A seat belt is not
going to save a life in a 90-mile-per-hour crash into a wall," Kathy
Conaboy said. "A 30-mile-per-hour crash, a fender bender, it helps.
I'm looking at this as a seat belt."