
Flickr/CC photo by Rob Helfman
With football and other fall sports practices in full swing, I want to make sure everybody is aware of the heat acclimatization guidelines, released by the National Athletic Trainers’ Association.
Each year, a handful of deaths occur from heat stroke. Yet, heat illness is totally preventable.
Today, I had the chance to talk with WAKR host Ray Horner about this topic. We discussed not only the importance of hydration, but also ways in which kids can slowly acclimate to the high heat of summer during practice.
Below is an audio file and transcript of our discussion.
Horner: Dr. Joe Congeni on board with us. Football practices are starting tomorrow. A lot of people are walking outside for the Bridgestone Invitational. Even though the next few days look comfortable, you have to worry about the high heat, especially for those youngsters, right Joe?
Dr. Congeni: Yeah, we do, Ray, and I really appreciate [that] you always [offer the opportunity to ensure] people are aware of some of the issues that are real important in health.
We know in sports medicine that heat illness, and especially those handful of deaths that occur every year from heat illness, is totally preventable. So, until that number is zero kids dying from heat, we’re gonna keep beating the drum on this deal and make sure everybody’s aware of it.
There still have been 58 deaths in the last 20 years; there are 2 or 3 or 4 kids every year that die of heat illness, and we’re just going to keep talking about this.
There are new guidelines I wanted everybody to know about that came out last year. They kinda slid under the radar screen maybe a little bit. They are called the heat acclimatization guidelines, and we’re right in the middle of them right now.
Part of the problem is, you know, so many kids go directly from spending the summer in air-conditioned homes and air conditioning and then they go outside and they start playing in the heat. The heat is gonna come in August here and we need to get kids acclimatized.
On recommendations from the National Athletic Trainers’ Association and the Korey Stringer Institute, there are some new guidelines:
- Days one through five of practice, you’re not allowed to have two-a-days. One practice only day one through five.
- Those practices are not to exceed more than three hours in length.
- Days one to two is helmet only.
- Days three through five is helmet and shoulder pads only, and then only after day six are they able to go into full equipment and go to double sessions.
- When they have double sessions, no more than three hours per session. No more than five hours total and in between, there has to be three hours in a cool environment.
Those are the new guidelines that the OHSAA (Ohio High School Athletic Association) and about half of the states have [recommended]. Another strong recommendation is that a trainer be available for those early practices. A lot of our schools have trainers, but some don’t, so we need to be aware of it on the acclimatization side.

Flickr/CC photo by Familymwr
On the hydration side, make sure that all the athletes are weighed before and after practice in shorts and a T-shirt. Kids will average in the heat losing a pound and a half to three or four pounds a day.
They have to drink, of course, before, during and after [practice]. You know, a water bottle is about 16 ounces, and the recommendation is to start drinking two hours before practice and then during practice every half hour and then for every pound that you lose, at least 16 ounces of fluid — water or Gatorade — is recommended.
Really, again, the trainers have to tell these kids no energy drinks, avoid the supplements, and kids that are on meds like stimulants are more at risk. … You know, any sign of vomiting or fever or nausea, that’s gonna put those kids through the roof at risk for heat illness. So again, the trainers do a real good job with that.
And then, in the very worst of cases, where somebody starts heading to heat stroke where they are having dizziness, lightheadedness, weakness, confusion, headaches, we need to rapidly cool those kids.
So, if you go to practice sessions, Ray, you’ll see that most of the high-school trainers have those inflatable pools out there with ice water in them. You want to throw the whole kid into the ice water pool, put towels over them. We have to get that body temperature down quickly to save those kids from heat stroke.
So, again, in summary, the Acclimatization Guidelines were new in 2012 and they are in full swing this year.
Think about hydration and if you’re getting a kid that is heading toward the symptoms of heat stroke, don’t mess around, don’t waste time, douse the kid, put the kid fully into a cold water bath or ice bath and get that temperature down in a hurry.
Horner: Alright. Sounds good, Joe. Great stuff as always, my friend. We’ll probably see you out there at Firestone this week.
Dr. Congeni: I hope to see you out there at Firestone. Thanks for giving us the opportunity and the forum to [help] prevent this problem.
Horner: Alright. Thanks, Joe.
Dr. Congeni: Thanks, Ray.
Horner: Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital, joining us this morning. You’re at 1590 WAKR.
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