Prevention:
Athletes should be educated on the importance of maintaining proper hydration as well as methods available to monitor hydration status. Research demonstrates this will help maintain optimal performance and reduce the risk of heat related illnesses. The primary goal is protecting the athlete’s health and safety.
Athletes are encouraged to consume 17-20 ounces of water or sports drink 2-3 hours prior to activity. An additional 7-10 ounces should be consumed within 10-20 minutes prior to practice. As a prevention measure, it is suggested that athletes engage in a summer conditioning program to acclimate their bodies along with gradual increases in fluid consumption prior to the official start of practice. This can help avoid unexpected nausea that may occur with increased fluid consumption.
Practice sessions should be guided by a written practice plan developed by the coach. This plan should clearly document 10-minute rest / fluid breaks every 15 – 25 minutes of practice. Athletes should be provided enough time to individually drink 7-10 oz. of water during each break. Breaks should be scheduled more frequently as the temperature, humidity, or heat index indicates or increases. Helmet removal is encouraged.
Athletes should be provided constant, unrestricted access to cold water or a cold sports drink circulated through the practice session (between scheduled breaks) by a designated staff assistant. Assistant’s should offer and encourage consumption of fluids.
On hot, humid days, an “Oasis” area should be preselected prior to each session. This area should consist of a shaded area, a hydration station (table), several slush buckets containing towels / sponges and at least one large size tub (kiddie pool) filled with cold water for submersion, if needed. There should be an ice supply nearby to access, if needed.
Weight Charts – During the acclimatization period, it is strongly recommended that athletes record their body weight (under supervision) before and after each exercise session.
Athletes will be designated into “zones” according to the amount of weight lost during the session. (See Example below) Consumption of fluids within the first two hours post-exercise is important for rapid tissue absorption. It is recommended that athletes consume 20 oz. per pound of weight loss.
Green Zone: Athletes with less than 1% weight loss versus pre-practice weight
Procedure: Encourage fluid consumption prior to next practice session
Yellow Zone: Athletes with 1 – 3% weight loss versus pre-practice weight.
Procedure: Athlete should consume 20 oz of fluid per pound lost and report to the next session within 1% of previous pre-practice weight.
Red Zone: Athletes with greater than 4% weight loss versus pre-practice weight.
Procedure: Should be evaluated for heat related illness and considered significantly dehydrated. They should not be allowed to resume practice or competition until they can re-hydrate to their previous hydration level or within 1% of their pre-practice weight. They should be monitored and considered at-risk upon their subsequent return to play.
Athletes should be encouraged to consume water or a sports drink during any meeting or film session to provide a maximum opportunity for pre & rehydration.
“Energy” Drinks or beverages containing caffeine, alcohol or carbonation should be discouraged.
Urine color charts and other educational material should be posted in the restroom and other common areas.
Athletes need to be encouraged to “look out for each other” if signs and symptoms arise during workouts.
Athletes returning from illness or injury should be monitored for response to heat and exercise as well as be given a graduated increase in activity. In addition, athletes taking prescription or OTC medications for the treatment of allergies, colds, flu, sinus infections or other medical conditions should be encouraged to consume higher amounts of fluids due to the increased dehydration that may occur.
Gradual Acclimatization – this is perhaps the single most effective method of preventing heat related injuries. Acclimatization should allow students-athletes to gradually adapt and cope to exercising in hot and humid conditions. Coaches have the responsibility of designing practice schedules to allow student-athletes to gradually acclimate to hot and/or humid conditions over a 10-14 day period. Each exposure should involve a gradual increase in the amount, intensity, and duration of exercise until it is comparable to competitive situations. The Florida High School Athletic Association (FHSAA) policy 41 specifically addresses the minimal acclimatization requirements for all sports sanctioned under this organization.
Identifying Susceptible Individuals – it is important to identify individuals who are prone to heat related injuries so they can be more closely monitored during activity. An accurate medical history can help the Athletic Trainer and coaches to better identify susceptible individuals. Coaches should realize some student-athletes may be more susceptible to heat illness than are others. The Athletic Trainer and coach ideally will review the past medical history of heat illness for student-athletes on a particular team roster.
Chain of Command
The responsibility of monitoring the environment for potentially dangerous conditions lies with the head coach of each particular sport. Furthermore, it is within this responsibility the head coach must have a plan for practice modification should environmental conditions warrant, as well as a plan for removing players from participation if they begin exhibiting signs or symptoms related to heat illness or other environmental concerns.
In the event the head coach is not present, an assistant coach designated by the head coach will assume responsibility.
When available, a licensed athletic trainer may advise the head coach and athletic director of warnings, concerns or reports of dangerous environmental conditions and can assist the coach in the monitoring of these conditions; however, the responsibility for modification remains with the coach.
The Athletic Director and Principal may implement other measures of restriction at any time for the safety of the student-athlete.
The Athletic trainer and Athletic Director should be notified in the case of any proactive steps a head coach takes to modify practice or competition for the safeguard of student-athletes as well as any environmental injury that occurs within the course of participation in athletics by any student-athlete. They will forward this information onto the school Principal.
No practice should ever exceed 3 continuous hours. Please refer to FHSAA policy 41.4.4 for information on practice interruptions.