Athletes participating in fall sports inevitably face the dual challenges of heat and humidity.
And even though heat-related illness among young athletes is relatively uncommon, one study found that it is the leading cause of death among high school athletes in the United States.
The issue arose this week when an Omaha South High School football player died after collapsing at practice.
Sixteen-year-old Drake Geiger, a 6-foot-3½, 389-pound lineman, had taken a water break after about 10 minutes of practicing Tuesday afternoon. He was walking back to practice and fell over. He later died at the hospital.
Sports governing bodies, including the Nebraska School Activities Association, began issuing recommendations to address heat-related illness more than a decade ago.
Dr. Natalie Ronshaugen, a sports medicine physician with Children’s Hospital & Medical Center, said one study from the early 2000s tallied 4½ heat-related illnesses per 100,000 athlete exposures. An athlete exposure is one athlete participating in one practice or contest.
Heat-related illness occurs when a person’s internal temperature rises, she said. Heat and high humidity can combine to change the way people sweat and impede their ability to cool off.
Drake Geiger’s father, Scott Hoffman, said his son’s body temperature was “extremely elevated” Tuesday. He said the staff at the Nebraska Medical Center, where his son was taken, couldn’t get the teen’s temperature down.
Other factors that make sports more risky include equipment, Ronshaugen said. That’s why most football teams begin practicing without pads and other gear in order to acclimate athletes to the conditions.
In 2009, the NSAA issued a number of recommendations for high schools aimed at preventing heat-related illnesses during hot summer workouts.
Those included scheduling no more than three two-a-day practices during the same week when preseason drills begin in August.
At the time, the National Athletic Trainers Association also called for high schools to adopt a 14-day heat acclimatization period of limited on-field activity.
Since the 1995-96 school year, the National Center for Catastrophic Injury Research at the University of North Carolina has counted 51 heat stroke deaths in high school football. Officials received notice about two more deaths this week that may be related to heat stroke, which woudl bring the number to 53.
Ronshaugen said athletic trainers locally routinely monitor the “wet bulb temperatures” before practices to make sure conditions are safe for kids to practice. The National Weather Service defines the wet bulb temperature as a measure of the heat stress in direct sunlight that takes into account temperature, humidity, wind speed, sun angle and cloud cover.
For the casual athlete, monitoring the real-feel temperature can provide a similar measure of conditions.
Practices may be shortened or switched to cooler times in the evening or early morning.
One way for athletes to make sure their internal temperature doesn’t rise too high, Ronshaugen said, is to make sure they drink enough fluids.
The rule of thumb is to drink enough that you’re not thirsty. When it’s very hot, that means stopping to get a drink every 15 to 20 minutes. Most importantly, athletes should make sure they’re properly hydrated before practices or games. One easy sign: Their urine should be light yellow before they start.
In general during the summer months, athletes of all stripes should avoid exercising in the hottest times of the day. If they feel like they’re struggling, Ronshaugen said, they should back off. And those who are used to working out in a climate-controlled gym shouldn’t suddenly try a rigorous outdoor workout.
Most importantly, she said, heat illness should be treated as an emergency. Milder symptoms can include cramping, nausea, dizziness or fainting. More severe symptoms include confusion, inability to remember or speak, loss of balance and stopping sweating.