When it comes to running, effective hydration requires a litany of decisions, like whether or not to use sports drinks and whether to follow your thirst versus setting a schedule. While there’s always a temptation to just do what feels right, “if you’re not hydrating well, you won’t be able to push your body as well,” says Stacy Sims, PhD, an environmental exercise physiologist and hydration expert.
Douglas Casa, PhD, has authored more than 200 publications related to heat and hydration issues for athletes. The necessity of proper hydration is something he understands from experience: “When I was 16, I suffered an exertional heat stroke during the New York state championships. I was on my final lap, and it was during the summer, and my body gave out.” In order to avoid both extreme situations like this or plain old fatigue, Sims and Casa shared their thoughts on how runners should best hydrate.
1. EVERY BODY (AND ENVIRONMENT) IS DIFFERENT
“Most people assume fluid loss is the same for everyone, but it’s different for each individual,” says Casa. “Everyone has a different sweat rate. The three things to consider are the intensity of your run, the environmental conditions and your body size.” Men and women also require different hydration strategies. “When we run, there are so many things that affect thirst sensation,” says Sims, which is why she doesn’t recommend the drink to thirst philosophy. “It changes across your menstrual cycle, for example.” Her advice? “Sip, sip, sip” water with a dash of salt as you go.
2. START YOUR RUN HYDRATED
Sims notes that starting out properly hydrated is perhaps the best thing that you can do to ensure a well-hydrated run. “That doesn’t mean slamming back water, though,” she clarifies. “It means eating a diet with plenty of watery fruits and vegetables and, unless a medical condition requires otherwise, you don’t have to be afraid of salt.”
3. FOLLOW THE 60-MINUTE RULE
While hydration is important, it’s not something you have to worry about if you’re out on a shorter run, anything around an hour or less, and started out hydrated. “Consider the sun and humidity, of course, and maybe back it up to 30 minutes or so, but for the most part you’re good as long as you rehydrate throughout the day,” says Sims.
4. DON’T OVERDO IT
“It’s important that people understand that they can drink too much,” cautions Casa. “If you drink so much that you dilute the sodium in your system, that can be dangerous too.” He also advises against launching a new hydration strategy in a race. Your stomach needs practice, too, when it comes to integrating a new hydration strategy.
5. TAKE REHYDRATION SERIOUSLY
“Rehydration can boost your immune system, get cortisol down and help your circulation — it’s important,” explains Sims. “The best way to go about it is by eating a lot of watery fruits and veggies and a protein-based drink like a yogurt smoothie. Hot soup is a great way to rehydrate after a cold run even if you don’t feel dehydrated.”
Want to implement these tips? Casa recommends backpack or water belts, which “are easy ways to carry water with you when you’re out for a run.” If you don’t want to carry water with you, Sims suggests routing your run to pass by water fountains or other water sources.
by CINNAMON JANZER
Source: MapMyRun Blog
INDIANAPOLIS – Emergencies are rarely predictable and that’s why having a detailed plan matters, especially when it comes to the health and safety of young athletes.
That was the underlying theme as health care experts released comprehensive emergency medical recommendations for youth sports leagues Tuesday at the 8th annual Youth Sports Safety Summit. The findings of a task force that originally convened in 2015 also were published in the Journal of Athletic Training on Tuesday. The task force was led by the National Athletic Trainers’ Association and the Korey Stringer Institute.
“Our kids deserved preparedness,” said Robert Huggins, the vice president of research, athlete performance and safety at the Korey Stringer Institute. “We need to be proactive. Sometimes our human nature is to be reactive and wait for something bad to happen …
“We’ve seen too many parents have to say goodbye to their child. They deserve that preparedness. They deserve to be able to go home at the end of the day with their family.”
The Sports and Fitness Industry Association says nearly 31 million children ages 6 to 14 participated at least once in sports or activities in 2015. Studies show 3.5 million children under 14 are treated annually for sports injuries.
The guidelines cover creating emergency action plans for sudden cardiac arrest, catastrophic brain and neck injuries, exertional heat stroke, potentially life threatening medical conditions, environmental issues such as lightning and access to medical services.
Beyond creating the plans, the task force called for youth organizations to develop training programs and education members on sports safety practices and create a reporting structure to monitor compliance.
Huggins called the task force’s document “probably the most important document ever released at the youth sports level.”
“There have been no safety documents to date at the youth sports level that have really focused on the emergency best practices,” Huggins said. “This is the first of its kind to comprehensively look at all of those together and identify policy change and procedures that we know will improve health and safety. It’s been shown at the NCAA level, the professional level and the high school levels are improving and getting better with their policies. … I think youth sports should follow suit. It’s a natural progression.”
There is no one organization that rules all of youth sports; each sport has its own national governing body. The task force got commitments from national governing bodies on what key policies they would implement in terms of the emergency assistance plans and changes to their organizational structure. The national governing bodies would then disseminate the information to regional and local leagues.
“Because the national governing bodies operate independently, implementing best practice safety policies remains a challenge,” said NATA president Scott Sailor. “This document is the first of its kind to serve as roadmap for policy and procedures. …
“We recognize some of this is aspirational. If there is not a policy in place or a policy that can immediately be implemented, we hope to move them in this direction. … Our document contains a lot of valuable information, but we will commit to following up and getting them information and disseminating it in format to get in the hands of policy makers and that might be the soccer mom. There is saying that nothing is more powerful than a soccer mom.”
Huggins pointed out that the document is structured in an easier to use way than many medical studies or journal articles might be.
“Every single bit of information in the text is also in checklist form — tear it out, take it with you, write stuff in it and use it,” he said. “And then say, do I have this, do I have this or this?
“No one is bigger than the checklist and that’s the head emergency room doctor or the person observing the surgery. The format is forward facing and marketable and easy to understand for parents. We’re really hoping the novel part of this is the check list that can be distributed to parents, coaches and medical personnel and everyone gets to see this document.”
Alexandra Flury from Safe Kids Worldwide noted that education is among the best means to improve safety at the grassroots level.
“We recognize it might be difficult to implement all of this, but the (document) can be a starting point,” she said. “This creates dialogue between parents, coaches and organizations and which items are appropriate.”
A key point was that parents need to know about safety and policies in place rather than assuming they exist or that coaches and league officials have the proper training.
“We have a very serious duty to make parents smarter consumers in youth sports,” said Jon Butler, the executive director of Pop Warner Little Scholars. “There’s become an elevated expectation of the volunteer youth sports coach.”
Huggins noted that parents need to know that in many cases, “the simplest prevention strategies are not being taken to keep them safe from a health and safety standpoint.”
Parents need to ask questions.
“The (document) has many things that parents won’t think to ask of their school, their program or coaches,” said Dr. John Jardine, an emergency room physician. “You go to a physician, you know the level of training. Are the coaches trained? Is there a certain level of expertise? There is a level of training we want to ensure across the board.”
Source: USA Today
A new study has revealed that there is a greater percentage of public secondary schools than private schools in the United States offering athletic training services.
The results of the study published in the Journal of Athletic Training state that while 37 percent of public secondary schools have a full-time athletic trainer to meet the healthcare needs of student-athletes, only 28 percent of private secondary schools do.
According to the research, only 58 percent of private secondary schools provide some amount of athletic training services, compared to 70 percent for public schools.
“Despite the documented benefits of having an AT on site for both practices and games, many schools, public and private, do not provide this critical medical service to their students,” writes lead author Alicia Pike, MS, ATC, the associate director of research at the Korey Stringer Institute at the University of Connecticut.
For the study, researchers from the Korey Stringer Institute in the Department of Kinesiology at UConn conducted the survey that was funded in part by the National Athletic Trainers’ Association. School athletic directors (or principals, if no athletic director was employed) from 8,509 public secondary schools and 2,044 private schools responded by phone or email. The data was collected from September 2011 to June 2014.
Despite the differences in athletic training services, though, both settings provided a similar number of student-athletes with access to medical care. Barriers to hiring trainers were seen as comparable between public and private secondary schools.
For more on the study, you can read the study from the scientific publication of the National Athletic Trainers’ Association scientific here.
Source: USA Today
A new study from researchers at Nationwide Children’s Hospital in Columbus, Ohio finds that the number of young soccer players who made a visit to the emergency room for injuries sustained on the field has more than doubled over recent decades, rising from just over 100 per 10,000 in 1990 to some 225 in 2014.
That trend was especially pronounced when it came to concussions and similar injuries, with the annual rate skyrocketing over 1,500 percent over the time period examined. And as the study notes, a growing awareness of the “potentially serious consequences of sports-related concussion” might simply mean that more incidents end up with a hospital visit.
“I wouldn’t necessarily say that the amount of injuries has actually increased, I’d say the amount of injuries reported has increased,” says Samantha Scarneo, a director of sport safety at the University of Connecticut’s Korey Stringer Institute who did not contribute to the study.
Where people used to think that “getting your bell rung” wasn’t significant, she tells The Christian Science Monitor, a flood of new initiatives by public-health organizations and state laws calling for parents, officials and athletes to receive education on the health impact of concussions on youths have instilled a greater scrupulousness among members of the public.
But some experts also say that as children and their parents take a less catholic attitude toward sports, focusing their ambitions on one sport and playing it year-round, they might be putting kids at a greater risk for injury.
“In the 1990s, kids played for one season and then they were done. Now kids can play year-round and in multiple leagues so they don’t have a lot of time to recover,” said Tracy Mehan manager of transnational research at the Center for Injury Research and Policy at Nationwide Children’s Hospital, in an interview with ABC. “If you play one other sport, it allows a break mentally and physically.”
“They’re not thinking about playing the sport for the fun of the sport and being active, they’re thinking, ‘where is this getting my kid in life?’” says Ms. Scarneo. “I’m hoping that that mindset starts to shift, because playing multiple sports might be more beneficial.”
Concussions and other closed head injuries, which saw the most concentrated leap in reports, still accounted for only 7 percent of all injuries. And the study’s authors add that the findings underscore “the need for increased injury prevention efforts” among parents, administrators and players.
Part of those efforts might consist of public education on what researchers call “physical literacy,” a term that stresses the development of proper mechanics for moves spanning a wide variety of athletic activities. By getting coaches and educators to implement certain warm-ups as a standard, experts say they could prevent injuries from developing down the road, especially among younger participants.
“At younger ages – the 7 to 12 age range, or 7 to 14 – those kids are not learning how to move properly,” says Scarneo. “If we can fix their biomechanics at a younger age, then we’d probably be able to see a reduction [in injuries to their extremities] when they get older.”
Source: Christian Science Monitor
By Ben Cates
Currently, the Virginia High School League operates under heat guidelines it installed in the last decade. Those guidelines and restrictions are important, especially given the science behind heat-related illnesses and the dangers facing teenagers throughout summer and into the fall season.
Those guidelines are also thorough. They provide facts about the threat of extreme heat and humidity, signs and symptoms of illnesses and how environmental factors play a role in the risks facing young athletes, especially football players.
The VHSL relies on heat index (the combined effects of temperature and air humidity) to recommend when athletes should and should not practice, when they need to go without equipment and when they should be carefully monitored for heat-related illnesses.
For instance, when the “humiture” is below 89 degrees, the VHSL recommends water breaks every 20 to 30 minutes. On days when it’s between 90 and 94 degrees, equipment should be removed as often as possible. At 95 to 104 degrees, the VHSL recommends practicing without equipment. And at 105 degrees or higher, all outside activities should be canceled.
There is, however, at least one problem with this measurement.
The heat index literally has it made in the shade. That is, it’s supposed to be measured out of direct sunlight.
The last time I checked, there isn’t too much shade around football fields. And while the majority of fields are grass, some are synthetic turf, which adds at least 10 degrees to air temperatures.
A more accurate measurement can be reached with a wet bulb globe, which takes into account not only ambient temperature and humidity, but wind speed, cloud cover and sun angle.
According to the Korey Stringer Institute at the University of Connecticut, the majority of deaths in a given football season occur in August in the eastern part of the U.S. According to the organization’s website, “over half of the reported deaths occurred during morning practices when humidity levels were high. These results show a direct correlation between increased temperature and humidity levels and the risk of mortality as a result of [Exertional Heat Illness],” or EHI.
We are well beyond two-a-days now. Players are practicing directly after school. They’re busy working during hottest part of the day, in a month of high humidity, in the midst of a year featuring record-breaking temperatures.
For 2016-2017, the VHSL has required all its member high schools to have emergency action plans in place. While those policies are by no means an end-all approach toward complete safety, they are a start.
Requiring that all member schools have athletic trainers on site would be another step in the right direction. Those athletic trainers, though, are often stretched to the max. It isn’t conceivable for them, in the midst of high school duties, to assist at middle schools, where a certified athletic trainer usually isn’t present.
The good news is that with proper education and implementation, heat illnesses are often avoidable. Cramping, dizziness and excessive sweating are all signs of a problem, but heat-related struggles can exist without those symptoms. That’s what makes practicing in the summer and early fall so dangerous and, sometimes, life threatening.
Hydration, proper nutrition and regular weigh-ins are, of course, vital to lowering the risk of heat-related injuries. Socio-economic conditions, though, often determine whether a student is getting the right kinds of fluids and nutritious meals in a timely manner.
And take a look around you: there are athletes everywhere growing up in poverty. They deserve a chance to play sports and let their talents shine; they also deserve a fair chance: proper education and the opportunity to implement that knowledge on a regular basis.
Athletic trainers constantly drill safety lessons into young athletes. They are also charged with figuring out when it’s too hot for pads, when athletes need regular water breaks and watching for heat distress among their other duties.
These employees adhere to their own governing body, the National Athletic Trainers’ Association, or NATA. Through that organization and a healthy, ever-advancing body of research, athletic trainers have at their disposal wide-ranging, practical knowledge.
Many of them, for instance, already use a wet bulb globe, exceeding outdated standards. Those who don’t may run the risk of seriously handicapping not only their programs but their athletes.
Here’s hoping the VHSL moves to a less-antiquated form of measuring heat and does so soon.
Later may be too late.
Source: Daily Progress
The death of 14-year-old Lewis Simpkins has once again raised questions about whether we are doing enough to prevent sudden deaths in sports.
The sophomore defensive tackle at River Bluff High School stumbled through the end of a 2-hour, 15-minute football practice before collapsing in the locker room on Aug. 10. Coaches gave him CPR and used a defibrillator. Paramedics took him to Lexington Medical Center, where he was pronounced dead.
Over a recent 20-year period, 243 deaths occurred during high school and college football practices and games. That’s about 12 per season. The most common causes were heart failure, brain injury and heat illness. The cause of Simpkins’ death has not yet been determined.
A recent article in The State newspaper pointed out that South Carolina high schools show poor compliance with guidelines to prevent sudden death. These guidelines come from the Korey Stringer Institute, a leader in research and education to improve safety and prevent sudden deaths for athletes and the military.
In the article, South Carolina High School League commissioner Jerome Singleton noted that he wasn’t familiar with the Institute or its guidelines. He did point out that coaches in this state must complete online courses regarding heat acclimatization and concussions. He also emphasized that the SCHSL reviews its medical policies annually.
Korey Stringer was an NFL offensive lineman for the Minnesota Vikings. He died from exertional heat stroke after an August practice in 2001. His wife Kelci partnered with heat stroke expert Dr. Douglas Casa at the University of Connecticut to create the Korey Stringer Institute. The NFL, Gatorade and other companies and organizations contribute to the Institute’s efforts.
One area of concern for football teams in the South is the heat, with 63 percent of deaths from heat stroke in football occurring in the South. Fortunately, these deaths are largely preventable. Unfortunately, South Carolina does a poor job complying with guidelines that can prevent these deaths.
While North Carolina and Georgia, as well as Alabama, Mississippi, Arkansas and Texas, meet the minimum best practice guidelines for heat acclimatization, South Carolina only meets one of the seven KSI guidelines. These guidelines include limits to the number and length of practices in the first weeks of summer football and recommendations for gradually adding protective equipment.
South Carolina schools also meet none of the guidelines regarding the use of Wet Bulb Globe Temperature (WBGT). The WBGT requires a special device to measure the outside environment for heat stress. It’s likely that the cost of the device plays a factor in our poor compliance, but Georgia meets all nine of the best practice guidelines for WBGT.
South Carolina does somewhat better with access to automated external defibrillators (AEDs) and training in CPR and AED use — meeting five to six of the Korey Stringer Institute’s eight best practice guidelines.
In terms of plans for emergencies like the tragedy at River Bluff, South Carolina again needs work. Of the 11 guidelines issued by KSI regarding emergency action plans — schools coordinating with local EMS, athletic trainers and physicians on-site to develop plans should a medical emergency occur — South Carolina meets none of them.
The South Carolina High School League needs to adopt these heat acclimatization and emergency action plan guidelines. It should work with its high schools and the state legislature to arrange funding for WBGT and certified athletic trainers for each school.
Schools, though, don’t have to wait for a statewide mandate to take action. Concerned parents of high school athletes can talk to the athletic directors and coaches to discuss plans to treat and prevent deaths from cardiac arrest, heat stroke and brain injury.
This isn’t about pointing blame at the SCHSL or the high school athletic directors and coaches around the state. My goal is to raise awareness and encourage change.
As tragic as the sudden death of a high school athlete is, it creates a perfect time to take steps to prevent another one.
Dr. David Geier is an orthopaedic surgeon in Charleston. For more information about football injuries and other sports medicine topics, go to drdavidgeier.com.
Source: The Post and Courier
When 18-year-old Ariel Newman set off for Israel in September 2014 for a nine-month gap year, he gave his dad a huge bear hug. Tragically, the farewell at JFK was the last time that Mark Newman and his wife, Ellen, would see their only child — eight days later, he collapsed from exertional heat stroke (EHS) while hiking in the desert.
The SUNY Binghamton-bound Ariel literally roasted to death 45 minutes from the end of a grueling 9.5-mile trek in temperatures in the mid- to upper 90s.
After Ariel Newman died due to exertional heat stroke, his parents, Ellen and Mark, created a guide to keep it from happening to others.
“His death was completely preventable if the right measures had been taken,” says interior designer Ellen, her voice cracking from the heartbreak. “Just some basic knowledge about hiking in heat could have saved him.”
Now, to show that Ariel’s passing was not in vain, the Great Neck, LI, parents joined forces with expert medics to produce a guide, Ariel’s Checklist, raising awareness of EHS and ways to avoid it.
While the condition is not always life-threatening, it can cause severe organ damage and lead to death if not recognized and treated properly. It is a particular danger to sports enthusiasts.
The Newmans have examined what went wrong on what Mark calls Ariel’s “death march.” Not only was Ariel a beginner, but, at 230 pounds, he was out of shape for the two-day challenge. His parents insist the organizers of the program should never have allowed him on such a tough hike in the first place.
Despite their grief, Ellen and Mark teamed with EHS experts including Dr. Robert Huggins of the Korey Stringer Institute, a research center at the University of Connecticut that aims to prevent deaths in sports. The resulting 10-point guide is aimed at hikers throughout the US — especially those in ultrahot environments — as well as abroad, including Israel.
“Bringing enough water and ensuring everyone wears a hat is not nearly enough,” says Mark, who works for the IRS in Manhattan. “Acclimatizing, getting a good night’s sleep ahead of the hike and wearing loose, moisture-wicking clothes are among other key factors.”
The Newmans hope the guide — which also recommends work-to-rest cycles and recognizing limits — will make a difference.
Says Ellen: “Ariel wasn’t an effusive character, but I think he’d be like, ‘Cool, Mom!’ and be quietly very proud of us.”
Source: The New York Post
It’s the heat, and the humidity, and when you throw in the hard work of getting ready for a game or the show, there is potential for tragedy if care is not taken to keep people hydrated.
The sunny skies, high temperatures and oppressive humidity of an Alabama summer take their toll on anyone doing anything outside. Young athletes and band members find themselves in the midst of it, as practices heat up before it’s time to take to the field.
Heat-related problems — heat stress, heat exhaustion and heat stroke — are real threats, and coaches need to know how to recognize, react and most importantly, to prevent those conditions.
The doctors of Northeast Orthopedics made dehydration a focus in their annual clinic for Etowah County coaches and band directors.
Athletic trainer Chris Russell said kids today don’t spend as much time outdoors in the heat as they did in earlier generations, and are not as accustomed to exertion in hot weather. “That’s one of the main reasons we see so much more heat illness now,” he said.
Young people often don’t eat and drink properly for daily life, Russell said, much less for the exertions of athletic practice.
It’s not enough to just give kids water breaks. “You’ve got to make them drink,” Russell said.
Heat-related illness can kill people. It’s important to know more about it, because it can be prevented.
According to information in Pernacity, a publication of the Korey Stringer Institute, 15 states, including Alabama, mandated practice schedules for football designed to acclimatize young people to the heat. There have been no heat-related football deaths in any of those states since then.
It was a no-cost fix; practice schedules were altered to limit time in the heat in early days, letting kids get accustomed to the heat before going full-on, in full gear.
Talk about heat issues in athletics, and Stringer’s name is sure to come up. The Minnesota Vikings’ Pro Bowler died from an exertional heat stroke in August 2001 during practice.
KSI is devoted to research, education and advocacy to maximize performance and prevent sudden death from heat-related issues and other causes for athletes, soldiers and laborers.
Since 1995, 54 football players have died from heat stroke — 42 high school players, nine college players, two professionals and one sandlot player, according to a 2014 survey of football injuries by the National Center for Catastrophic Sport Injury Research.
Russell said players need to drink 24 ounces of water or Gatorade or a similar drink before starting practice — and no caffeine. “Caffeine sucks the water out of you,” he said.
They then need to drink eight to 10 ounces every 15 minutes, whether they are thirsty or not. “If you are thirsty, it’s already too late,” Russell said.
It’s not uncommon for those exerting themselves in the heat to lose one to one-and-a-half liters of sweat, he said. Kids can lose seven or eight pounds, in water, during a day of practice.
Some body types are more likely to suffer heat-related issues — big kids (“your offensive linemen) and those that have low body fat, because they don’t have a lot of water in their systems.
There also are personality types that are more likely to have problems. “You’ve got kids who won’t tell you,” Russell said, that they don’t feel well. “The go-getters — they’ll try to push through it.”
Before they, their coach or band director know it, they can be in big trouble.
Russell said he dealt with a player like that last week. “This is the kid who never takes a knee, and he was taking a knee. Then he was bending over,” he said.
While these kids may think they are giving the team everything they’ve got, they aren’t.
“If a kid is dehydrated, it’s affecting his performance,” Russell said.
Heat stress is the first phase of heat-related illness, he said, marked by cramps because of low electrolytes, and possibly muscle spasms.
“That’s your muscle saying it’s out of something,” Russell said. “Get that kid to the sidelines. He needs something like Gatorade or electrolyte pills — what we used to call salt pills.”
Stretching and ice also help, he said, and the problem usually will resolve itself.
Heat exhaustion causes excessive thirst and lethargy, and comes when the core body temperature is 102 to 104 degrees. Russell said that kid needs to be gotten into air conditioning or at least shade, and have ice applied to the back of the neck, armpits and groin area. If a cold whirlpool is available, the kid should be placed into it.
“This kid is on the verge of something bad happening,” Russell said. “It’s nothing to play around with. I know we all have kids who are ‘high drama,’ but you need to take it seriously.”
Russell said he’s seen players with heat stroke twice — one in college and one in high school. “Heat stroke is when kids can die,” he said.
Symptoms include headache, vomiting and diarrhea. “That’s the body telling you something’s very wrong,” Russell said.
At this point, the body’s core temperature can be 104 degrees. “Call 911,” Russell said. “Get the kid in air-conditioning or shade,” and get clothing off and apply ice.
Coaches and trainers need to emphasize to players — or band members, cheerleaders or anyone else working out in the heat — the importance of good nutrition and proper hydration. It’s not a worry limited to athletic fields.
“Anyone outside in the heat, working in their yard or garden, needs to be properly hydrated,” Russell said.
It’s not unusual for older people to end up in the emergency room after getting dehydrated while working in a garden.
Knowing about proper hydration is the key, Russell said, and information from TSI supports that.
Heat stroke deaths averaged 2.6 per year from 2010 to 2014, down from the previous five-year period. However, in one year that recorded two dehydration deaths, there also were two deaths from over-hydration.
Source: The Gadsden Times