Back in the good ol' days of high school football, say, around 2005, coaches hustled their players onto the practice field for August two-a-days and then ran them ragged in the hot sun and stifling humidity. It was all a part of "toughening up" the kiddoes for the big season ahead. If you could survive several weeks of several hours a day of rock-'em-sock-'em football with the heat index cranked up to 100 or higher, the "thinking" went, then you could survive anything.
Well, not anything. According to a 2005 white paper published by the American College of Sports Medicine (ACSM), between 1995 and 2001 twenty-one young football players reportedly died from heat stroke in the United States. Ten years later, the numbers aren't getting better. In August 2014 the Washington Post reported that the total number of such football deaths since 1995 had grown to 52 – to include 31 more dying from 2002-2014. Of those 52, forty-one were competing at the high school level.
Various states, high school districts and athletic associations have passed laws, policies and guidelines addressing what could, or should, be done to prevent heat-related injuries on the football field. Measures include mandated rest and hydration breaks, a required presence of more athletic trainers skilled in treating heat injuries and limitations on practice times. Often, though, those laws, rules and guidelines are ignored or unenforced; meanwhile, most U.S. high schools don't have a certified athletic trainer on staff.
Several years ago the state of Georgia enacted a law requiring schools to cancel practice when the heat index reached a certain mark. The kicker: schools themselves were allowed to set their own heat index limit. Some schools, not taking it seriously, established a limit of 150, higher than any recorded heat index in state history. Note that in 2011, two Georgia high school players died from heat injuries – on the same day, at different high schools.
Coaches roll the dice with their players' health every time they conduct a practice when unprepared to prevent or treat heat injuries. "It's staggering," said Douglas Casa, COO of the Korey Stringer Institute at the University of Connecticut, quoted by the Post. "I'm the one sitting across from the parents of the dead kids when I’m an expert witness. And I have to explain to them that with ice water and a tub, their kid would have lived."
One such kid who didn't live was Edwin "Dek" Oliver Miller, 16, a wide receiver at a D.C. area high school. About six years ago Miller collapsed while running wind sprints during a voluntary offseason workout in July. He was rushed to a hospital and treated for severe heat exhaustion, but he passed away four days later.
While other high school fall sports begin their preseasons during the sweltering days of August, scientificamerican.com reported that "football players are 11 times more likely to suffer heat-related illnesses than all other high school sports combined," according to a University of North Carolina study. Florida, Alabama, Arizona and Kentucky were singled out as the states with the highest incidence of football-related exertional heat illnesses.
So, what can young football players (and their parents) and the coaches do to reduce, and perhaps eliminate, heat injuries? Athletes can start acclimating to the heat by working out in moderation at least a month before the start of August practices, noting, as the ACSM points out, that most early-season football heat stroke deaths occur within the first four days of practice, especially the first and second days.
Along with that, coaches are advised to begin their August practices by taking it easy on the players. Helmets should be the only piece of equipment worn for the first few days with pads, etc. added gradually. Also start out with just one practice a day, to include as many walk-throughs as sprints, before alternating between two-a-days and one-a-days.
Hydrating often by drinking fluids such as water or Gatorade is a given: ACSM recommends weighing players before and after each practice – they should weigh as much at the end as they did at the beginning, with in-practice hydration compensating for weight lost through perspiration.
Early signs of dehydration, which is a step or two away from heat injury, include fatigue, thirst, dry lips and tongue, lack of energy and feeling overheated, says webmd.com.
“Almost all the time, changes have been reactive instead of proactive,” Casa told the Post. “The motivation level never seems to cross the key threshold until there’s a tragedy.”