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Hut … Hut … Drink! Football Coaches Make the Call: Fight Heat With Water

  • Stevens High’s Matt Garrison cools off during a 2010 practice at Monadnock Park. (Valley News - Tris Wykes)
  • Sharon Academy players Ben Hanslett, left, and Jeremy Littlehales quench their thirst during an Aug. 26 scrimmage with visiting Windsor. (Valley News - Tris Wykes)

It’s August and a late afternoon sun drops a heavy curtain of heat over the football practice field.

Under the watchful eye of the head coach, the backfield works on its latest offensive sets. Out of the huddle, a young player gets the coach’s attention with a question on his assignment. Clutching something in his hands, the player has trouble diagramming his pass route in the air. He’s not holding his helmet, nor is he carrying a football. What is it that is so important that he won’t even put it down to talk with his coach?

It’s a water bottle.

Welcome to a new era of football enlightenment.

In the old days, a distraction during practice might cause a profane eruption from the coaching staff — followed by calisthenics, sprints or a mile run in full pads. Water? Water was a sign of weakness.

In years past, if players were allowed water — a big if — it was in a pail guarded by a manager at the far end of the field. Thirsty players were barely able to slurp a ladle full before the coach’s whistle quickly ended the break.

“Water? There was no water back in the day,” laughed Hanover coach Mike Ivanoski. “You just gobbled up handfuls of salt tablets … like they thought that would really help you. It made no sense. If you were tired and dehydrated you couldn’t perform.

“Today, we have water stations all over the field.”

Northern New England is spared the searing heat and suffocating humidity that smothers other parts of the country during the dog days of August. But that doesn’t mean athletes in this area are immune to heat issues or the risks that come from overexertion in hot weather.

And football is the biggest concern — because of the size of the players and the heavy equipment they wear — the helmets, pads and uniforms.

“We don’t see heat problems in this area as much as they do in places like Texas,” said Kristine A. Karlson, a sports medicine doctor at Dartmouth-Hitchcock Medical Center in Lebanon. “But the standard recommendation is still the same: hydration.”

In recent years, the study of concussions and the understanding of their dangers and attending treatment has dominated the discussion on athlete safety. As Karlson pointed out, there are far more reports of concussions and head injuries in this area than heat stroke. But, she said, heat issues shouldn’t be overlooked.

“If they look unfit, then you have to wonder is he or she in trouble,” she said, noting the obvious warning signs: a player looks slow or is leaning or holding on to someone or something.

In college programs, where the practices are much more regimented, there are scales for players to weigh themselves — a critical measuring point for hydration issues.

“If, for instance, a player finds his weight down significantly after practice, you need to return that weight in water,” said Karlson, who serves as team doctor for Hartford High School sports programs.

At Dartmouth, during preseason football practice, the players are weighed before and after each practice session.

“Everyone understands the dangers,” said head athletic trainer Jeff Frechette. “Even though it’s not as hot here as other areas in the country, you still can get in trouble.

“If a player loses 2 to 3 percent of his body weight in fluid, it could begin to restrict his coordination and stress the cardiovascular system. Then your body has to work harder to cool the blood down.”

A loss of salt is also a problem in hot, humid conditions where a large amount of sweat is lost, which can disturb sodium and water balance. To replace the lost salt, Karlson has a simple solution: “Sports drinks. They all have salt in them. Or else eat some pretzels and wash it down with water. That will do it, too.

“It’s all about the salt.”

Which brings up one of the great folktales of sporting health education — cramps — which were thought to be the result of a lack of potassium. So coaches used to tell athletes to eat bananas to replace the lost element and help ward off cramping.

Don’t believe it.

“It’s a myth,” said Karlson. “You hardly lose any potassium when you sweat. You get cramps because you’ve lost salt.”

The old days of denying water to athletes are long gone. Today, coaches push water on the players, and water breaks a regular part of the practice schedule. “We have maybe one or two cases (of dehydration) each preseason, but we can recognize the fact pretty quickly,” said Frechette. “Then you just use common sense — take a break, cool down and hydrate.”

But some groups want to see more regulation and education when it comes to heat acclimatization.

Korey Stringer was a 6-foot-4, 335-pound All-Pro offensive tackle for the Minnesota Vikings. During the team’s 2001 summer training camp, Stringer suffered heat stroke and died about 15 hours after collapsing.

Out of the ensuing lawsuit settlement, Stringer’s widow, Kelci, teamed up with the Neag School of Education at the University of Connecticut to house the Korey Stringer Institute. The mission of the institute, according to its website, is to provide information, resources, assistance and advocacy to help prevent sudden death in sports through health and safety initiatives.

In partnership with the National Athletic Trainers Association, the Stringer Institute wrote a seven-point position statement on heat-related issues, including length of practice, equipment restrictions and type of drills.

To date, only 10 states have Stringer Institute-approved guidelines — including football hotbeds like Florida, Texas, Georgia and Arizona. A total of 15 states are recognized as deficient, but working with the institute, while 24 more — including Vermont and New Hampshire — have guidelines, but are judged as deficient by the institute. Two, West Virginia and the District of Columbia, have no guidelines on the books.

In addition to general recommendations about hydration and cooling, the heat acclimatization tips from the Stringer Institute include a number of suggestions for handling practice sessions in the preseason:

■ Do not participate in more than one practice a day in the first five days of practice.

■ Do not practice more than three hours in one day.

■ Do not wear full gear until day six of practice.

■ For full-contact sports, live full-contact drills should not be used until day six of practice.

■ Double-practice days must be followed by a single-practice day or day of rest.

■ On double-practice days, practices should not exceed three hours, including stretching, warm-up, cool-down and lifting.

“I know that some high school state associations in the South have mandated some of the guidelines, but basically it’s common sense for most of us (up here),” said Frechette. “Everybody is more aware about heat issues than they used to be, and making sure players have plenty of water.”

The Pennsylvania Interscholastic Athletic Association took those suggestions a step further this year, mandating, among other things, that teams must go through three consecutive days of heat acclimatization practices before they can start full contact workouts.

Players are permitted to wear only helmets, shoulder pads and shorts the first two days of heat acclimatization. Practices are noncontact and limited to five hours daily, and no practice can be more than three hours, with a minimum two-hour recovery in between.

According to a story last month in the Pittsburgh Post-Gazette, Pennsylvania Interscholastic Athletic Association officials said they instituted the rule because of an increase in deaths of high school football players from heat-related problems around the country. According to the National Center for Catastrophic Sport Injury Research at the University of North Carolina, 52 football players — 41 in high school — have died since 1995 because of heat-related causes.

Most of the deaths occurred during two-a-day or three-a-day preseason practices, and mostly in the South.

“I would say I know change is something difficult,” Bob Lombardi, the association’s executive director, said in the story. “But this change is directly a result of health and safety concerns for football players.”

Both New Hampshire and Vermont have written guidelines for schools and coaches to follow, but they are suggestions, not mandates.

The Vermont Principals’ Association “Hot Weather” document includes a description of warning signs and remedies for heat-associated problems. It also gives coaches a “best practices for modification of participation” guide to help avoid problems on the field during hot weather sessions, along with recommended preventive strategies.

“We take the (Korey Stringer Institute) recommendations very seriously,” said Bob Johnson, associate executive director of the Vermont Principals’ Association. Common sense dictates no practices during the high heat of the afternoon, constant hydration and periodic down time between sessions.

“When there are situations where athletes may be suffering from dehydration, that’s where the athletic trainer steps in. If the trainer tells the coach to take a player out or cut short the practice, then that’s it. It’s just common sense.”

The guidelines, Johnson is quick to point out, are not mandatory. But it is made clear to member schools that failure to get in step with the program is not an option. Safety is the priority.

“The problem in Vermont is that our kids are not used to the heat,” Johnson said. “We just don’t get that kind of heat they have in Texas. But when it does get hot, and the kids are in full pads and uniforms, you could easily have a problem.”

Mike Stone is in his 27th year as head coach at Hartford High School. As he released his team from a preseason end-of-practice huddle, he reminded them in a sharp voice: “We’ve got a scrimmage in two days. Make sure you keep hydrating. You’ve got to keep drinking water.”

The word is out all over the Upper Valley. At Oxbow, fullback/defensive tackle Randy Snelling knows the drill.

“Water breaks are huge,” he said. “It’s something we always look forward to, especially in the heat. And it’s good to have real water, not just Gatorade.”

Two-way lineman Dylan Hatin has taken the message to heart — for very real reasons.

“I learned the hard way how important water is,” said Hatin. “When training camp and two-a-days started, I was drinking two to three gallons of water every night before practice the next morning. One night I only drank one gallon and I had huge cramps all day the next day.”

Back at Hartford, the Canes are unique in Upper Valley grid circles in that they work triple sessions in their first week of practice. But the time is mainly used for teaching — not hitting. “We hit once last week, on Thursday, and that was for about 15 minutes,” said Stone. “Sometimes we’re just in helmets, other times in pads, but we’re only doing drills — not full-speed hitting. And we take breaks. … We take a lot of breaks. I’d say we take a break every 10 minutes or so to make sure they are getting their water.

“The reality is that if you push them too hard to get something out of them today, you will end up losing them (for practice) for the next two or three days.”

Stone could recall only one incident — years ago — when he had a player who was really overheated.

“It was more about the fact that he had eaten at McDonald’s right before practice. And that was making him ill,” said Stone. “But we just took the fire hose to him and cooled him down.”

New Hampshire has an interactive 20-minute online course dealing with acclimatization and heat illness prevention presented by the National Federation of State High School Associations.

“Nationally, we have seen an increase in the number of heat-related issues the last few years,” said the association’s executive director, Pat Corbin. “We have some requirements we expect our schools and teams to follow. Basically, we are telling people to use common sense. There’s no excuse for heat-related stress, illness and fatality. It’s truly preventable.”

The association has included a number of guidelines on heat stress and athletic participation in its latest handbook. The 2 1/2 pages are a list of obvious — but necessary — steps to take to avoid heat problems. The handbook hits the key point in summary: “Never restrict the amount of water an athlete drinks.”

Corbin said most heat-induced illnesses and injuries occur in the first few days of practice. Players who may not be ready for heavy physical exertion are the most prone to problems.

“We have a rule that there can not be a scrimmage until a team has had three days of practicing,” Corbin said. “We also have rules that the minimum length of time between practice sessions is three hours. And water must always be available. No water is a prescription for fatality.”

Corbin and others pointed out that the new turf fields around the Twin States have their own unique heat issues.

“It can sometimes be 10-15 degrees hotter down on those fields,” said Corbin. “You have to take special care during those especially hot days. “The heat that radiates off those fields is really brutal.”

At Hanover, Ivanoski carefully monitors his players during practice for time and exertion.

“We never go more than five hours on the field in one day total,” said the Marauders’ coach, now entering his 19th year. “Most of that time is conditioning and repetition drills. And we are constantly taking water breaks.

“We try to teach the kids how to feel and to be smart. It’s important to know your body.”

In the old days, a coach’s chalk talk was all about the X’s and O’s, blocking assignments and check-off reads. Hitting was a way of life. Taking a break was the last thing a player who wanted to make the team would want to do.

All that has changed. Today, safety is the most important play. Coaches are now taking courses in concussion training and spending as much time reading about proper hydration and signs of heat problems as they are with the playbook.

“It’s not talked about as much,” said Dartmouth’s Frechette, “but you never want to forget. … If it happens, it can be really bad. And you always want to be conscious of that.”

Donald Mahler can be reached at dmahler@vnews.com or 603-727-3225.