Football teams across Georgia are practicing during one of the hottest summers on record. Two Georgia high school players died recently following summer practices, although the causes of death are still being determined.
With the grueling heat likely to continue through August and into September, The Atlanta Journal-Constitution caught up with Dr. Scott Gillogly, medical director of Atlanta Sports Medicine and last season’s head physician for the Atlanta Falcons. He talked about sweating it safely and keeping an eye out for warning signs, whether you’re doing tackling drills or just going out for an afternoon jog.
Q: As a physician and expert in this area, when you hear about football players collapsing and dying from the heat, what are your immediate thoughts?
A: Obviously, you find it hard to imagine that it still exists in the information age, when so much information is available about protection and pre-treatment, and having the resources to identify, detect and to treat early heat exhaustion. When I hear about this happening, it’s a real shame because it seems as though we should be smarter than that. And we are smarter than that.
Q: What are the first warning signs of heat exhaustion?
A: The earliest signs are muscle cramping. You can’t go to a football game in August or September without seeing, in the third or fourth quarter, a player jumping off the field because he has cramps, and he promptly lies down and gets whisked away, gets some water, rests, cools off and then goes back in the game 10 minutes later.
Q: What happens after the muscle cramps if the player doesn’t stop?
A: As the heat problems continue, you’ll see profuse sweating, vomiting, headaches and light-headedness, and you’ll still have the muscle cramps. As it gets more severe, you get into heat stroke and a person would become confused, and may have a seizure. The body temperature could be 106 or higher and ultimately the person will go into a coma.
Q: What is happening to a person’s body physiologically when someone is suffering from heat stroke?
A: The self-regulation of cooling system shuts down and the sweating stops. Once your body temperature goes above 106, your organs shut down. Even if you get treatment, you may not be able to reverse it. Early detection is far better than the most advanced treatments.
Q: How should football teams approach playing during this sweltering heat?
A: You can’t treat it like a normal fall day. You need to pre-treat with water and replace sweat while playing outside. Wear light clothes ... I think it’s incumbent on coaches and administrators and associated medical advisers and/or physicians to use good judgment. Exercise at 6 a.m. or 6:30 a.m. or at 6 at night. Have cooled fluids available — cooled fluids are easier to swallow. Make sure the number of water breaks and cool down breaks are doubled or triple during these hot days. You should have almost three an hour — you take five minutes in the shade and cool down. Misting machines and fans can help; at the higher level they have those. But for the 12-year-old, Pop Warner-type football player, parents may need to watch practices to make sure the volunteer coaches are doing it the right way. Parents need to talk to those in charge, to making sure they know about fluid management. And absolutely talk to your kids about the warning signs.
Parents need to make sure their kids drink plenty beforehand.
Q: How much should kids be drinking?
A: Two hours before the practice, drink 36 to 40 ounces. Just water is just fine, or you can have a sports drink like Gatorade, too. Water is still best, but you can do equal amounts of Gatorade and water, or all water. Also, make sure you have salt in your diet such as pretzels or low-fat potato chips to help electrolyte management.
Q: Where do you think folks get themselves in trouble?
A: Many folks think, “It’s not going to happen to me.” And they think, “I am stronger than this. I can handle this,” and before they know it, they are not thinking clearly and they are getting dazed. The other way people get into trouble is if the person who is in charge of the activity doesn’t have a good sense for when to stop. Failing to prepare is another way people get into trouble.
Q: Why do we hear more about football players collapsing than tennis players? Is it because of the equipment?
A: Equipment is part of it. Although tennis matches can last two or three hours, there’s the switching sides, and more rest built in, and the fluids are always right there. With football, by having your head covered, you are preventing that cooling mechanism. That’s why you [need to] consider taking helmets off during practices in the hottest months and just wear hats, and not have contact.
Q: What about runners?
A: Runners need to pre-treat with water, and however much water you usually take with you, you have to double that. Wear one of those belts with water. Decrease your mileage. And it’s best to go in the morning or at night.
Q: What do the Falcons do to prevent heat-related injuries?
A: They practice in the mornings and the evenings. They take frequent breaks, which includes sitting in the shade with misting fans to cool off. Water is available 100 percent of the time. Not every 30 minutes. Players can have water after every play if necessary. They sometimes take the helmets off and put on baseball caps to dissipate heat.
The Sunday conversation is edited for length and clarity.
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