While the excitement for football and other fall sports is palpable now that the calendar has reached August, it can often overshadow the dangers local student-athletes face these first few weeks of organized practice.
August has long been the worst month for heat-related illnesses. According to a 2012 study by the American Journal of Preventive Medicine, 60.3% of exertional heat illnesses between the 2005-06 and 2011-12 school years occurred during the month, and climate conditions have continued to grow worse in the decade since.
An April 2021 editorial by the Journal of Athletic Training estimated that the likelihood of heat-related illnesses is 10 times greater during the preseason than it is during the regular season. And while the intensity of competition might be at its nadir during these first few weeks of practice, things can turn deadly in a hurry.
According to data from the National Center for Catastrophic Sport Injury Research, 50 high school football players have died of heat-related illnesses since 1996, and the numbers are trending up. From 2017-2021, there were an average of 2.4 deaths per year among high school football players, compared to 1.4 in the five years previous from 2011-2016.
In Chatham County, where official team practices began last Monday, local high schools are using every technique and technology at their disposal to protect student athletes from the elements. At several schools, including Northwood, a Wet Bulb Globe Temperature Thermometer (WBGTT) is used to determine whether conditions are safe enough to practice.
“It’s more accurate than heat index and has more factors involved like clouds, wind and the angle of the sun,” Northwood High head athletic trainer Jackie Harpham told the News + Record. “It gives us a really good measure of what kind of heat stress our athletes will face on different surfaces. We have different modifications and changes we have to make to our practices based on the reading. That might be more frequent water breaks, less equipment worn. It might be that if it’s hot enough on the reading, we might not be able to be outdoors at all.”
Teams without a WBGTT on hand are not at a disadvantage, though; the University of North Carolina has a tool that allows anyone to find the current and projected wet bulb globe temperature for their specific location, down to the latitude and longitude. Coaches and parents can enter their location and quickly get an overview of the conditions for the upcoming days, as well as the recommended NCHSAA guidelines based on the WBGT Index reading. The tool can be accessed at convergence.unc.edu/tools/wbgt.
Modifications to practice start to come in once the index reaches the high or “Red Flag” category, which encompasses WBGT readings between 88 and 90 degrees Fahrenheit. Under these conditions, all athletes must be under constant observation and supervision and remove any pads or equipment they might normally wear. There must also be at least one five-minute rest/water break for every 15 minutes of practice. Any reading above 90, and practice has to be suspended.
Bear Creek — home to Chatham Central — has had a wet bulb globe temperature in the “Red Flag” category several times this past week. Conditions regularly reached that zone by noon and lasted until 5 p.m.
“It’s been brutal, man,” Chatham Central football head coach Sherman Howze said. “This weather has been brutal, but (our players) have toughed it out. We gave them Friday and Saturday off because of the work they did last week. We did what we had to do. And they were fresh (Monday morning). It was our first hitting day. It was real hype in practice.”
At Seaforth High, head trainer Carley Brown combats the elements by setting up a cooling station during practices that features a tent with shade and a drinking station with 60 gallons of ice water. But for on-field remedies to be effective, athletes need to be able to recognize the symptoms of heat-related illness before things become dire.
According to the Centers for Disease Control, common signs of heat exhaustion are cold, pale skin, a fast, weak pulse, nausea and vomiting, dizziness, weakness and muscle cramps. Heat stroke, on the other hand, is signaled by a body temperature of 103 degrees Fahrenheit or higher, as well as headache, dizziness, confusion and possible loss of consciousness.
“It’s just like how a car will give you a signal and give you a light on the dashboard that say something is wrong,” Brown said. “That’s your body’s way of communicating to you that, ‘Hey, we need to slow down. We need ice. We need water.’ These kids have a good understanding of that, and they know to come over even if it’s for the smallest thing. If someone is feeling light-headed and needs to take a break for a few minutes, the coach is very understanding of that and doesn’t want to deal with any unfortunate circumstances of heat illness, even if it was something minor.”
The National Athletic Trainers Association has recommended four steps to prevent exertional heat illnesses:
• Conduct thorough preparticipation medical screening to identify athletes with risk factors for heat illness or a history of heat illness.
• Individuals should be acclimatized to the heat gradually over 7-14 days. Progressively increasing intensity and duration of physical activity and phasing in of protective equipment.
• Athletes currently sick with a viral infection or other illness or have a fever or serious skin rash should not participate until the condition is resolved.
• Individuals should maintain euhydration and replace fluids lost through sweat.
If a situation ever becomes dire enough, Brown said she is always prepared to perform a full-body submersion in ice water on an affected athlete. Her technique is effective, even if a bit unconventional.
“I know it sounds kind of morbid, but I keep a body bag on my sideline, because it’s 10 times easier to fill that with ice water than those really big troughs that most schools have,” Brown said. “We have one of those, too, but in the past I’ve just found the body bag works a lot better.”
While they receive most of the spotlight, football players are not the only athletes who are affected by the heat. One of the sports that sees the most heat-related illnesses is cross country, where student-athletes run a 5,000-meter (3.1-mile) race at a standard meet.
The Journal of Athletic Training said in 2021 that female cross country runners are twice as likely to experience a heat-related illness as athletes in other high school sports. In a sport where speed is the key, Harpham is trying to find ways to modify practice to adjust accordingly.
“(Cross country runners) might not be able to take as frequent breaks for hydration,” Harpham said. “So we’re working that into the practice plan and working with the coach on days where it feels like the temperatures might be higher and encouraging workouts that will allow for more breaks and more hydration. We also want to monitor athletes who might be more at-risk, newer athletes and younger athletes who might be new to the sport. We want to keep an eye on them to make sure that they’re doing OK.”
At Woods Charter, cross country head coach Karen Hawkins has her team practice in the early morning, when conditions are at their most bearable. She also makes sure the routes her team takes on practice runs are through shady areas.
“As a former cross country runner myself, I know what it’s like when you’re out there and not fully hydrated …” Hawkins said. “We’re talking to (the team) about proper hydration and sending their parents information to make sure it’s hitting home, because it not only makes the running more miserable, but it can be very dangerous.”
County coaches and trainers are being proactive in helping prevent heat-related illnesses, but they also know they can only do so much in the time they have with student athletes. Both Harpham and Brown encouraged parents to talk with their children about the importance of proper hydration, maintaining a nutritious diet and getting adequate rest.
Without a solid nutritional base, it can be hard for an athlete’s body to adjust to adverse conditions, including extreme heat. It is also necessary to drink plenty of water throughout the day to make up for any fluids lost through sweat while working out.
Brown said she emphasizes hydration and nutrition with parents throughout the year, especially at the beginning of the school year. While it technically is the “fall” sports season, summer heat and the chaos it brings will be here until possibly October.
“It’s hard telling any teenager what to do, but you really just need to pound that education into them about how important it is to have proper hydration and nutrition,” Brown said. “Just because you’re bringing a big 32-ounce water bottle to practice and drinking it at practice, if you’re not drinking water before then and you’re not eating good healthy foods before then, that one bottle of water isn’t going to save you.”
Jeremy Vernon can be reached at email@example.com or @jbo_vernon.
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