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Keven Moore: The risks of high school football heat exhaustion — and what to do about it

As an old retired peewee football coach and 20-year fantasy football vet, it’s that time of year where many of us are just barely surviving on NASCAR races and MLB games, as we crave the start of the football season.

I believe that men are physically and biologically drawn to this war-like sport because of our tribal embedded territorial, hunter and warrior-like instincts. Rivalries are all about defending your schools or cities honor, in a territorial way by defending and keeping the enemy away from one’s “turf” where the winners successfully invade and conquer the territory of the other.

The game is filled with several military-like terminologies such as blitz, bomb, down in the trenches, aerial assault, formation, field general and quick-strike offenses. Even team names are even sound warlike such as Vikings, Raiders, Chargers, Cowboys or all the aggressive animals’ names. It’s also been said, that any living man in the US that doesn’t like football, just may have too much estrogen in their body.

Football is inherently dangerous and violent, because of the physicality and demands of the game mixed in with the law of physics, speed and head-on collisions on the field of play. It’s a game of pain, as my son once said to me after coming home from a middle school football practice, “Dad, I think I bruised my bruise.”

Max Gilpin

High school football teams state-wide have already begun their pre-season and are taking to the field for two-a-day practices. In Kentucky, August 1st marked the first-day high school teams can go full pads and parents and coaches need to put heat exhaustion at the top of their concerns during these dog days of summer.

A prior-dated CDC report found that football players suffer heat illnesses at a rate 10 times higher than the average rate for the eight other sports. In addition, most cases occur in August. The CDC analyzed data from the National High School Sports-Related Injury Surveillance Study from 2005 to 2009 and found there were 9,000 cases of heat illness.

Since Pleasure Ridge Park football player Max Gilpin’s death on August 23, 2008 death, Kentucky high school football has made a huge stride in heat safety. His death made national news after then-PRP head coach Jason Stinson became the first coach to be criminally charged in the heat-related death of a player. Stinson was found not guilty of all charges.

Gilpin’s death on Aug. 23, 2008, inspired the Kentucky High School Athletic Association into making changes to its heat-related policies, making them among the national leaders in heat safety.
The Korey Stringer Institute is named for the former Minnesota Vikings offensive lineman who died of exertional heatstroke in August of 2001.

According to an article in the Courier-Journal the Korey Stringer Institute, Kentucky ranks No. 6 in the nation on heat-safety measures, including the requirement of cooling tubs, heat-stress monitors and air-conditioned practice breaks and policies for easing players into summer workouts and for responding if they show signs of heat stress. In addition, all outside activity must stop if the heat index reaches 105, and schools are required to keep daily logs.

Gilpin’s death led to two changes here in Kentucky — the use of cooling tubs for heat-stricken athletes and a requirement of all coaches to complete a four-hour safety course every two years. The course is updated every two years to reflect new strategies concerning safety issues.

Even with all the changes, high school players are still dying due to heatstroke. For examples according to an article in the Tampa Bay Times in June of 2019, a 14-year-old incoming freshman collapsed during football drills after participating in a preseason football conditioning session for about 30 to 40 minutes when he collapsed around 4 p.m. EST. The session had included weightlifting, wind sprints, and one water break.

Heat illness symptoms include confusion, nausea, rapid pulse and headaches. As soon as these symptoms turn up, experts say it is vitally important to see medical help because they can be fatal.
Insurance carriers have been concerned about the risks of football for quite some time, and have been trying unsuccessfully to exclude all contact sports from general liability insurance policies. But football is simply too popular and too widespread to be excluded from general liability coverage though.

Underwriters today will thoroughly examine a school’s athletic trainers, first responders, as well as equipment and hydration practices. They also figure out how rigorous the practice schedule is, and more and more high schools and colleges are implementing policies to alter or even do away with two-a-day practices, especially in the heat of summer.

All school districts, administrator, coaches, league administrator, and even pee-wee football coaches should put a great deal of time in the planning process to reduce the instances and severity of heat illness where the temperature and humidity are above predetermined levels. 

As football season begins to heat up, parent of a football player you should worry less about playing time; and focus on questioning your coach if they: 

* Educate administrators, officials, and coaches on all aspects of heat illness.

* Monitor temperate and heat the index and plan accordingly to the recommended guidelines.

* Allow for acclimation periods in which athletes gradually increase intensity and duration in heat using the 10% increase rule per day.

* Schedule mandatory non-routine fluid breaks and allows proper rest breaks during activity, as well as 5-minute water breaks in some cool shaded area every 20 minutes of activity.

* Have your athletes pre-hydrate, as athletes reach dehydration levels more quickly if they begin their workout dehydrated.
* Postponed and rescheduled practices and games to avoid peak temperatures, practicing in early morning hours or during the cover of darkness under the lights.

* Shorten their duration, intensity, and equipment usage during practices.

* Modified the normal work/rest ratios during practices and games.

* Make water and/or sports drinks readily available.

* Minimize the amount of equipment and clothing worn by athletes on hot and humid days – particularly during an acclimatization period.

* Avoid wearing dark-colored clothing, as they increase the body’s absorption of solar radiation.

* Develop an emergency action plan for EMS access and to make available immersion tub to treat heatstroke.

* Consider providing outsourced medical services onsite such as a certified athletic trainer or an emergency medical technician.

* Promote sports drinks over water since the carbohydrates in sports drinks provide energy and electrolytes.

* Encourage athletes to rehydrate as soon as possible completely within two hours after practice or game.

* Keep an immersion kiddy pool on hand to fill with ice in the event of a heat-stroke, as studies of hundreds of heat-stroke victims on athletic teams and in the military show that all will survive if immediately immersed.

All heat-related football deaths are preventable if proper precautions are taken. We have come a long way as it relates to preventing heat exhaustion deaths. As a country, we have criminalized the senseless act of parents leaving their children in hot cars in the summer. We have even gone as far as criminalizing pet owners for leaving their pets in hot cars as well, and as a nation, we need to be prepared to place the same accountability on youth and high school coaches that still believe in the win at all cost at the expense of their players.  

Times have changed, and most coaches have as well, but as a parent, you need to trust but verify that they have.

Be Safe My Friends.

Keven Moore works in risk management services. He has a bachelor’s degree from the University of Kentucky, a master’s from Eastern Kentucky University and 25-plus years of experience in the safety and insurance profession. He is also an expert witness. He lives in Lexington with his family and works out of both Lexington and Northern Kentucky. Keven can be reached at kmoore@roeding.com.

From the CDC

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