It seems to happen somewhere every year — a fresh-faced teen practicing football in the sweltering heat collapses on the field and dies.
With high school football practice in Greenville County officially underway, games starting in a couple of weeks and daytime temperatures in the 90s with no end in sight, exertion in the heat, especially with helmets and pads, could be dangerous.
So on Monday morning, Don Frost, football coach at Christ Church Episcopal School in Greenville, called off practice when the heat index made it feel like it was 104 degrees outside.
“They were in T-shirts and shorts, but we decided to just send them on in,” he told The Greenville News. “That real feel is what’s against your skin so you’ve got to be very, very careful. You don’t want your kids to get sick or hurt or anything. We try to protect them as much as possible.”
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But every year, an average four or five high school or college football players die from heat stroke, said Yuri Hosokawa, director of communication and education for the Korey Stringer Institute, established at the University of Connecticut in memory of the Minnesota Vikings offensive lineman who died from heat stroke in 2001.
A variety of conditions can occur with heat exposure, according to the U.S. Centers for Disease Control and Prevention, including heat exhaustion and heat stroke.
Heat exhaustion, which results from excessive loss of water and salt, is marked by headache, nausea, dizziness, weakness, heavy sweating and elevated body temperature.
Heat stroke, which is the most serious condition, happens when the body temperature rises rapidly and can’t cool down, according to CDC.
Symptoms include hot, dry skin or profuse sweating, confusion, altered mental status, slurred speech, loss of consciousness and seizures, and can result in death or permanent disability without emergency treatment.
And that’s the last thing a coach wants to see on his field, or anyone else’s, said Hillcrest High School coach Greg Porter.
'Take care of my kids'
“In the back of your head, you always have that thought in your mind — if this was my kid, how would you want them treated,” he said. “So I make sure I take care of my kids.”
In Greenville County, Greenville Health System supplies certified athletic trainers to all public high schools and four private schools who have expertise in sports injuries, including heat-related illnesses, said David Webb, an athletic trainer at Eastside High School.
They are on the field at all practices and games, he said, adding physicians are on hand for the games.
And there are usually one or two cases of heat exhaustion a year in this area, he said. So lots of precautions are taken to keep players safe.
One of the most common is holding practices early in the morning so players are off the field during the worst of the heat so that the body isn’t at as great a risk for heat stress, Webb said. Another is frequent breaks and hydration.
Frost said his players practice from 8-10:15 a.m. and then break for an hour and go from 11:15 a.m. to noon. And they never practice more than 20 minutes at a time without a water break, he said.
Porter, who limits practices to three hours, also makes sure his players get plenty of water breaks.
“I try to teach my kids that rehydration for the next practice or next game begins when you step out of the locker room,” Webb said. “And I tell them to keep it clear, no bubbles and no caffeine. And for every pound lost during exercise, especially at this time of year, they need a maintenance dose of at least three quarts of water per day.”
Light-colored, breathable jerseys also help, Webb said, as does having any players not actively in a drill remove their helmets and shoulder pads when possible.
Following the guidelines
Getting acclimated to the heat is also important, said Porter.
Frost has the players practice three days in helmets and shorts, two days in shoulder pads and shorts, and then full pads and helmets to acclimate them.
And trainers, the coaches agree, have the final call.
“If they say it’s too hot, we stay inside and spend more time on film,” Porter said.
“If it’s too hot, there’s no argument. If he says pull the kids out, no argument,” adds Frost. “He has full control.”
Heat stroke statistics are increasing, said Hosokowa. Two decades ago there were an average two or three fatalities a year, she said.
But the reason for the rise is unclear. It could be from increased reporting, or a surge in competitiveness, or kids being put at high risk during the preseason when they’re not acclimated to the heat, she said.
However, she added, most fatalities occur when there isn’t a health care professional or athletic trainer on-site and the right protocols aren’t followed.
Hosokowa noted a person who is cooled down to 102 degrees — the best method is submersion in cool water — within 30 minutes of collapse is likely to survive without complications. And, she said, it’s best to cool the person down before transporting them to the ER.
Frost, who’s been a coach for 37 years, said that none of his players has ever succumbed to the heat, but a player on another team once had to have IV fluids during a game because of the heat.
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Webb said that by insisting that players are drinking plenty of water, practicing during the coolest part of the day, and continuing to sweat as the heat index increases, most problems can be avoided.
“In any sport, injuries will happen,” Webb said. “But following the (National Athletic Trainers Association) guidelines should reduce the risk of that occurring.”
To learn more about heat-related illnesses and how to deal with them, click here.
