Preventing heat stroke in high school athletes

By Denise Coffey - Staff Writer
Region - posted Tue., Aug. 28, 2012
Connecticut meets 3 of 7 recommendations set by KSI for heat acclimatization. Photo by D. Coffey
Connecticut meets 3 of 7 recommendations set by KSI for heat acclimatization. Photo by D. Coffey

Late August signals the end of summer, and for hundreds of high school football players, the beginning of preseason training. It can be a dangerous time, according to the Centers for Disease Control. A CDC study found that heat illness is the leading cause of death and disability among American high school athletes, sickening more than 9,000 annually, with football players at highest risk. Since 2006, at least 20 high school football players have died from exertional heat stroke, according to the University of North Carolina’s National Center for Catastrophic Sport Injury Research.

When Minnesota Vikings pro-bowler Korey Stringer died from exertional heat stroke in 2001, his wife Kelci founded the Korey Stringer Institute. KSI is based at the Neag School of Education at the University of Connecticut. The institute has published guidelines they want all high school football coaches to adopt for their training schedules. These guidelines are meant to gradually acclimate athletes to the heat in order to prevent exertional heat illnesses.

Football players are at higher risks than most because of the environment they practice in and the equipment they wear, according to KSI Vice President of Information Lesley Vandermark. For those reasons, KSI has suggested every state adopt a set of seven guidelines to help prevent heat exertional illnesses in high school athletes. Those guidelines include specific time frames for practicing and resting, conducting walk-throughs, wearing equipment, and when full contact practice should be allowed. They also recommend that an athletic trainer be on site before, during and after all practices.

“It's really about the work-to-rest ratios for athletes and limiting the length of time per practice,” said Vandermark. She said heat stroke tends to happen in football players after the two-hour mark. “They've been exercising, generally in a hot climate, and pushing hard to be part of a team,” she said.

The National Federation of State High School Associations released a position statement emphasizing progressive training, rest breaks, reducing the amount of equipment athletes wear, reducing practice intensity and duration as heat and humidity increase, and emergency response plans, including on-site rapid cooling. KSI works with states on this issue. The institute maintains a list of state policies and rates them against its recommendations, which include limiting two-a-day practices as the preseason begins.

The state of Connecticut currently meets only three of the seven recommendations set forth by KSI. The recommendations being met include: No more than one practice per day on days 1-5; total practice not to exceed three hours in any one day; During days 1–2, a helmet should be the only protective equipment permitted; During days 3–5, only helmets and shoulder pads should be worn; beginning on day 6, all protective equipment may be worn and full contact may begin: on days 3–5, contact with blocking sleds and tackling dummies may be initiated; 100-percent life contact drills should begin no earlier than day 6.

There are several symptoms associated with heat illnesses that are also indicative of other conditions. Without having an accurate core temperature measurement, it’s difficult to diagnose heat illness or differentiate it from other conditions, according to Vandermark. “Athletes should absolutely stay hydrated,” she said. “And coaches should allow their athletes water breaks, appropriate rest times and be mindful of their work-to-rest ratio. There should be at least three hours between practice sessions,” Vandermark said.

Connecticut doesn’t meet the KSI standards on limiting walk-throughs, double session days, or restricting practice times. Arizona, Arkansas, Florida, Georgia, New Jersey and North Carolina and Texas are the only states to meet all heat acclimatization recommendations set forth by KSI. 

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