Heat Stress And Injury Among Young Athletes Can Be Prevented

Coaches also should allow enough recovery between practices and gradually introduce parts of the uniform, experts say.

Mosthigh school and younger players are already fighting a losing battlewhen they show up to practice, says Dr. Michael F. Bergeron, panelco-chair and assistant professor of physical therapy at the MedicalCollege of Georgia. The panel’s full statement and recommendations arepublished in the August issue of Medicine & Science in Sports &Exercise.

“What we’ve found is that most players typically beginpractice dehydrated – pretty significantly dehydrated,” Dr. Bergeronsays. “Young players generally just don’t drink enough, especiallyfollowing extensive exercise or training in the heat.”

Surprisingly,though, hydration isn’t the most important aspect of preventingheat-related injuries. Players are often simply not acclimated to theenvironment, the intensity of practice and the uniform, he says.

“Whatcoaches and staff need to recognize and appreciate is that the athletesare not coming into the preseason as well-conditioned as they mighthope,” Dr. Bergeron says. “High school kids are going to be less fitand not only are they not accustomed to the physical exertion thatworkouts require, they’re not really acclimatized to the heat andworking out in that environment, especially while wearing a uniform andprotective gear.”

To help protect ill-prepared players, coachesshould introduce a training schedule that progresses slowly – waitinguntil week two to introduce twice-daily conditioning and trainingsessions, experts say. They also should realize that adding a heavyuniform adds to the heat and strain players are already experiencingwhen weather conditions are unbearable. That can significantly add tothe risk of heat injury.

“Most heat-related injuries and deathsoccur within the first four days of practice, particularly on days oneand two,” Dr. Bergeron says. “The primary factors for driving bodytemperature during practice and clinical risk related to overheatingare the environment and the intensity/duration of the workouts and theuniform.”

During the first week of practice, protective equipmentshould be introduced in stages, starting with the helmet, progressingto shoulder pads and helmet and, finally, to the full uniform, theauthors write.

Other suggestions include requiring a preseasonexam to determine what medications and dietary supplements athletes areusing and to rule out undiagnosed heart problems and other genetic riskfactors. Also, twice-daily practice sessions, once introduced, shouldbe staggered throughout the week to allow for at least a one-day breakbetween multiple-session days.

And even if the temperature outside hasn’t reached the boiling point, players and coaches should still take precautions.

“Whatwe are beginning to appreciate more and more is that it doesn’t have tobe unbearably hot to have problems,” Dr. Bergeron says. “The focus ofthis is prevention.”