Heat Acclimatization Guidelines by State
Exertional heat stroke (EHS) is on the rise and is currently among the top three reasons athletes die during sport. Having mandatory state guidelines for heat acclimatization provides a critical standard to protect athletes against exertional heat illnesses, and possibly save lives.
The majority of EHS cases occur during the initial summer workouts when athletes are neither prepared to cope with the environmental conditions nor the new physiological demands placed upon them during workout sessions. Heat acclimatization guidelines mandate that athletes be introduced slowly to environmental stressors during practice sessions, resulting in lowering the risk for EHS.
By not mandating heat acclimatization guidelines, states are failing to protect their athletes, and in fact, are placing them at greater risk for EHS and other heat-related illnesses. Coaches, school leadership, parents and legislators must push their states to establish guidelines or have inadequate guidelines revised. The Korey Stringer Institute staff is readily available to assist with this process and when reviewing states polices we utilize the guidelines set forth by the National Athletic Trainers' Association (NATA) in the consensus statement titled:
Preseason Heat-Acclimatization Guidelines for Secondary School Athletics
Casa DJ, Csillan D. Preseason heat-acclimatization guidelines for secondary school athletics. J Athl Train. 2009;44(3):332–333.
Policies between the NCAA and high schools are very similar. Review a Comparison of NCAA and High School Heat Acclimatization Policies.
The Korey Stringer Institute and the NATA suggest the following recommendations:
- Days 1–5 are the first formal practices. No more than 1 practice occurs per day.
- Total practice time should not exceed 3 hours in any 1 day.
- 1-hour maximum walk-through is permitted on days 1–5, however there must be a 3 hour minimum between practice and walk-through (or vice versa).
- During days 1–2 of first formal practices, a helmet should be the only protective equipment permitted (if applicable). During days 3–5, only helmets and shoulder pads should be worn. Beginning on day 6, all protective equipment may be worn and full contact may begin.
The History of Adopting Heat Acclimatization Guidelines
In 2003 the NCAA began implementing heat acclimatization guidelines. Since the NCAA started these guidelines there has only been 1 death in collegiate football during the pre-season period, when there had been an average of 1-2 every pre-season (saving an projected 15 lives). In 2009 the NATA released guidelines very similar to those of the NCAA. Since these have been released, KSI has been working with many state athletic associations (as well as others) to assist these states in the adoption of the guidelines for high schools as well as other sport levels. The table below reflects the timeline of those that have adopted these guidelines:
Date Guidelines Were Adopted
National Football League
|Deficient, but working with KSI to improve|
|Number of guidelines that match KSI recommendations|
|State||KSI approved guidelines||Deficient, but working with KSI||Has guidelines, but deficient||No guidelines|
|District of Columbia (DC)||✔|
|New Hampshire (NH)||✔|
|New Jersey (NJ)||✔|
|New Mexico (NM)||✔|
|New York (NY)||✔|
|North Carolina (NC)||✔|
|North Dakota (ND)||✔|
|Rhode Island (RI)||✔|
|South Carolina (SC)||✔|
|South Dakota (SD)||✔|
|West Virginia (WV)||✔|