Month: August 2015

2015 New Balance Falmouth Road Race

Falmouth Group Picture

By Yuri Hosokawa, Director of Communication and Education

Korey Stringer Institute had another successful year working with the Falmouth Road Race, which took place on Sunday August 16th. KSI and the Falmouth Road Race expanded their collaboration together even further this year. On August 13th, William Adams, Director of Sports Safety Policies, Yuri Hosokawa, Director of Communication and Education, and Rachel Katch, Assistant Director of Research, presented at the 1st Annual New Balance Falmouth Road Race Sports Medicine Symposium, with Dr. John Jardine, Chief Medical Advisor of KSI. This was the first time that Falmouth Road Race hosted a medical symposium for local medical professionals and volunteers who have traveled across the country to work at the medical tent on race day. At the symposium, Adams presented on evidence based prevention, treatment, and care of exertional heat stroke, Hosokawa presented on emerging topics on sudden cardiac arrest in runners, and Katch presented on exertional hyponatremia and best practices for hydration. On August 15th, Dr. Robert Huggins, Vice President of Research and Elite Athlete Health and Performance, spoke at the EXPO on maximizing athletic performance in the heat.


Huggins and Meb

Also during race weekend, we had the opportunity to invite professional videographers to film interviews with Richard Dodakian, one of the exertional heat stroke survivors from the Falmouth Road Race, and Huggins. As they recalled the same event from 2013’s race, it was incredible to hear their stories from different perspectives—exertional heat stroke victim/survivor and the rescuer. The interview is currently under production. Please follow our social media and webpage for the video release. Their words will change the way you view medical care provided at the road race for thousands of runners. Remember, exertional heat stroke is 100% survivable with prompt recognition and appropriate care: cool first, transport second.

Richard Interview

This year’s race was very warm and humid, setting a perfect storm for exertional heat illness risk. To counter that, the road race organizers came prepared with rows of cold water immersion tubs and stations, with close to 200 medical professionals volunteering on the race day. KSI primarily assisted in the care of exertional heat stroke patients, educating the medical volunteers who are unfamiliar with the condition at the pre-race medical meeting and serving as leaders at each cooling station.


We were also fortunate to have representatives from our corporate partners, Kestrel and MissionAthlete Care, to join us at the race as volunteer. It was their first time to experience the intensity of a road race medical tent and see the treatment of exertional heat stroke cases.



Lastly, Hosokawa and Katch conducted the third field research study at the Falmouth Road Race, looking into the inflammatory response observed in runners completing the race. The study started 4 weeks before race, where the participants were asked to log their training. In addition, researchers invited the participants to the University of Connecticut campus to complete VO2max and lactate threshold testing to examine their fitness level prior to the race. Hosokawa is also working in collaboration with the EC Lee Lab, lead by Dr. Elaine Lee, at the University of Connecticut, to investigate potential genetic markers that may explain the variations of heat tolerance observed in runners. Our hope is to provide evidence-based recommendations for runners who are participating in the summer races and assist the Falmouth Road Race to become one of the safest summer road races in the world.



Falmouth Road Race weekend is by far the busied but most exciting weekend for KSI. We hope that our collaboration with the race will continue to grow in future years and hopefully inspire other races to have similar partnerships with KSI.

Keeping Runners Safe in Summer Heat (UConn Today)

The New Balance Falmouth Road Race is one of the premier running events of the summer season, drawing an estimated 75,000 spectators, who strain to catch a glimpse of Olympic-caliber runners as they tear through a scenic seven-mile seaside course in the sweltering summer heat.

The race from Woods Hole, Mass. through the flats along Martha’s Vineyard Sound to Falmouth Heights Beach can also be dangerous.

A volatile mix of heat and humidity, the race’s short distance, and the tendency for high-intensity competitive athletes to push themselves to the extreme invites trouble, if the runners aren’t careful.

The Falmouth runners aren’t alone. Thousands of competitive runners face similar challenges in summer races across the country each year.

UConn kinesiology professor Douglas Casa, chief operating officer for the University’s Korey Stringer Institute (KSI), has been working the Falmouth race for the past 14 years and will be there again on Aug. 16, when more than 12,500 runners gather at the starting line.

The Korey Stringer Institute is dedicated to the prevention of sudden death in sport, and is considered a national leader in research on exertional heat stroke. The institute has been conducting research at the Falmouth race since 2013.

Casa says Falmouth race officials are exemplary in their attention to athlete safety and their ongoing support of research that is advancing understanding and treatment of exertional heat stroke.

“We have such an amazing opportunity at Falmouth,” says Casa, who suffered an exertional heat stroke as a teenage competitive runner in 1985. “These race officials deserve a lot of credit. This race is single-handedly advancing medicine so much faster than we would ever be able to do working solely in the lab.”

The Falmouth studies produced by KSI researchers represent some of the largest and most comprehensive in the field in terms of the number of actual cases of heat stroke reviewed.

At least one runner in every 1,000 entrants in the Falmouth race suffers a potentially deadly exertional heat stroke, according to KSI researchers – an incident rate 10 times higher than that reported at cooler races in the spring and fall. Since 1984, more than 270 cases of exertional heat stroke have been reported at the Falmouth race.

Casa is proud of the fact that no runner has ever died in Falmouth who was treated at the race’s on-site medical tent where staff follow his mantra – “Cool first, transport second” – in their treatment protocols. Death from exertional heat stroke is 100 percent preventable, he says, if a person is immersed in a cold water ice bath within minutes of the illness’s onset.

Exertional heat stroke is one of the leading causes of deaths among athletes and is characterized by a body temperature greater than 104 degrees Fahrenheit and central nervous system dysfunction ranging from headaches and confusion to altered states of consciousness, vomiting, and collapse.

In-depth research

Joining Casa in Falmouth this year will be a team of nearly 30 researchers, athletic trainers, medical professionals, and students, almost all of them affiliated with UConn. Some of the team will be supporting on-site medical staff with race triage, while others will be gathering blood samples, medical information, and other data for three scientific research studies related to heat stroke.

One of those studies, led by the KSI’s assistant director of research Rachel Katch, is looking at whether athletes who train in warm weather conditions up to four weeks prior to a race perform better in hot weather races than athletes who are less acclimatized.

The second study, conducted by KSI vice president of operations and education Rebecca Stearns and KSI staff member Luke Belval, will track heat stroke survivors to see what physiological conditions may have precipitated the heat stroke, and what health concerns the survivors encounter in their long-term recovery.

“We hope this study will be beneficial to athletic trainers, exercise scientists, and medical professionals,” says Yuri Hosokawa, director of communication and education at KSI. “There is very sparse evidence right now that dictates when and under what conditions someone can return to activity after having an exertional heat stroke.”

The third study will look at runners’ RNA and DNA to check for the presence of possible genetic biomarkers that could be associated with an athlete’s ability to tolerate and perform well in high temperatures. UConn assistant professor of kinesiology Elaine Choung-Hee Lee, Hosokawa, and Katch are investigators on this study, along with Casa.

The genetic study is part of a larger investigation being conducted by KSI researchers into a medical malady known as malignant hyperthermia. Malignant hyperthermia is a potentially fatal, inherited disorder usually associated with the administration of certain general anesthetics and/or the drug succinylcholine. Some individuals also develop malignant hyperthermia through exercise and exposure to hot environments. Without proper treatment, mortality is extremely high.

The Korey Stringer Institute will host an international symposium on malignant hyperthermia in Storrs on Sept. 17 and 18.

But for now, the focus is on Falmouth.

A lab of 12,000

“The Falmouth race is an amazing opportunity for us to conduct research on two big ticket items,” Casa says. “One, it allows us to work with people who have had a heat stroke because obviously we can’t induce heat stroke in the lab. Second, from a research perspective, it is a race where people get really, really hot. So it’s an opportunity for us to study exercise-induced hyperthermia where you basically have a lab of 12,000 people who just exerted themselves and got really hot.”

Dr. John Jardine, co-medical director for the Falmouth race and now also chairman of the KSI’s Medical and Science Advisory Board, says he was impressed with Casa and the KSI team when he watched them in action.

“Each year, Doug came with a larger group of volunteers,” says Jardine, who is trained in emergency medicine. “I began to understand that what we were doing actually had science behind it. I studied Doug’s research on heat illness, and our discussions over the years turned into new research ideas and projects.”

Several athletic trainers from other states also will join the KSI team in Falmouth this year. Casa says it’s an opportunity to train others and help spread the word about the importance of cold water immersion in treating heat stroke. Those who visit Falmouth bring the emergency protocols back to other races around the country.

Casa says Falmouth was “the place where that whole concept of cold water immersion came to life for athletes suffering exertional heat stroke. If we get their temperature down really fast, we don’t have to worry about other issues.”

Source: UConn Today

Jackson Prep leading way in player safety initiatives (The Clarion-Ledger)

In the hours and days following the death of Jackson Prep defensive tackle Walker Wilbanks on Aug. 25, 2014, athletic director Will Crosby spoke with anyone who observed or had contact with the junior the day of the Patriots’ season-opening football game against Oxford.

Wilbanks died from hyponatremia, a severe sodium deficiency that caused the two-sport athlete’s brain to swell because of his body’s inability to regulate water and salt concentrations in the blood stream.

It wasn’t just a matter of making sure Prep did everything in its power to recognize and respond to the situation in the best manner, but to learn from what happened.

Medical professionals and leading experts in the field determined there was nothing Jackson Prep could have done that Friday night to prevent Wilbanks from dying.

But that didn’t satisfy the desire of Jason Walton, Prep head of school, to make sure he and his staff were doing everything they could to put student-athlete safety in the forefront and prevent another tragedy.

“The steady current of conversation went on for 12 months,” Walton said. “How are we going to be ready? Are we going to be ready? I can’t do this again.”

Nearing the one-year anniversary of Wilbanks’ death, Jackson Prep is setting a precedent for high schools in Mississippi with new player safety initiatives.

The Mississippi Association of Independent Schools, of which Jackson Prep is a member, and the Mississippi High School Activities Association provide several guidelines and recommendations for athlete safety, but some high schools in Mississippi are better prepared to handle injuries, from acute to catastrophic, than others.

Through a partnership with the University of Connecticut’s Korey Stringer Institute, an organization founded on preventing sudden death in sport, Jackson Prep is leading the charge in developing the gold standard for protecting the health and safety of its student-athletes.

“Seeing what this community went through and knowing who Prep is and who Prep is in the MAIS, I think it’s incumbent upon us to be a leader,” Walton said. “I think we’re looked at by some schools as the example. This is one of those areas we want to be leading in. To the extent that we can know more than we knew, we wanted to. To the extent that we could do more than we were doing, we wanted to.

“We want the moms and the dads and the prospective families to know that we’re restless here at Jackson Prep. We’re feeling for the cool side of the pillow. We’re looking around the corner. If there’s more, we want to do more.”


Crosby and Walton first established a relationship with Douglas Casa, the chief operating officer of the Korey Stringer Institute and one of the leading researchers on the prevention of sudden death in sport, when he spoke to athletic training students at the University of Southern Mississippi last October.

In January, Casa spent two days on Jackson Prep’s campus going over the measures taken when Wilbanks fell ill to the days following his death. He also helped devise a plan for the Patriots to become better equipped to handle the health and safety of its student-athletes.

“I give them credit. They had a tragedy last summer, and they were reflective,” Casa said.

“I didn’t come to critique what happened in the previous summer, it was about moving forward. … If you’re playing the odds in Vegas, what is everything they should be doing to realistically keep their athletes as safe as possible?”

Casa drew up a plan with five health and safety recommendations. The first was installing automated external defibrillators on campus.

Since cardiac issues are the leading cause of death in sport, AEDs needed to be easily accessible.

Now, anyone on Jackson Prep’s campus has access to seven AEDs, all of which are no more than a 60-second walk.

“(With cardiac), every minute that passes, the survivability goes down 10 percent,” Casa said. “You have to have them accessible. That’s why we had them staged all around campus not just for athletics, but for anybody who might have a problem.”

According to Casa, it’s common for most high schools across the country to have accessible AEDs on campus.

State Rep. David Baria proposed a bill during the 2015 legislative session that would require all public and private high schools in Mississippi to have an AED on school grounds. The bill died in committee.

Casa’s other recommendations included each AED having an emergency action plan with it — something to help guide a person on the steps to take to let medical personnel know where they are and how to administer help.

He also recommended coaches receive regular training regarding emergencies in sport, encouraged the Patriots’ football staff to be certified in Heads Up Football (a program developed by USA Football to make sure coaches meet a minimum set of standards related to proper tackling technique, receiving blows/tackles, equipment fitting, heat illness, cardiac issues, concussions, hydration, etc.) and that Jackson Prep have a full-time certified athletic trainer on staff.

That last recommendation could possibly be the biggest game changer of all.


On a given football Friday night, it’s likely a certified athletic trainer will be roaming sidelines in Mississippi during a game.

This isn’t a coach who also doubles as an ankle taper. It’s a trained professional hired and paid through a third party (usually a hospital) at little to no cost to schools.

Medicomp Physical Therapy provides full- or part-time trainers to 16 high schools across the state, ranging from Brandon to Okolona.

In the past, Mississippi Sports Medicine has provided Jackson Prep with a trainer for several of its sporting events.

To ensure its student-athletes will be under regulated care at all times, Ricky Clark was hired through Medicomp in July to be a full-time trainer at Jackson Prep.

Prep is the only school in the MAIS to have a full-time athletic trainer. Several schools in the bigger classifications of the MHSAA have these individuals on staff, but it’s a rarity across the state.

Clark came to Jackson Prep after working at Warren Central as an athletic trainer for four years. He will be responsible for the health care and well being of every student-athlete in the 13 sports Jackson Prep offers.

With students enrolled from sixth through 12th grade, it’s not just the junior varsity and varsity sports that will receive his attention.

“(Elementary and secondary sports are) totally neglected in most parts,” Clark said. “They don’t get as much attention as the varsity sports and junior varsity sports. But that will change here.”

Clark’s duties extend beyond game day. Part of his daily routine will be to attend every practice, be available for rehabilitation and treatment, determine if it’s too hot to play or practice by taking a reading with the Wet-Bulb Globe Temperature monitor (which takes into account ambient temperature, relative humidity, wind and solar radiation from the sun), and make sure athletes are receiving the required amount of water breaks and rest periods.

“There’s that sense of security,” varsity boys and girls soccer coach Jon Marcus Duncan said. “We can’t prevent every injury, but I guess there’s that level of security, not that we felt insecure. But after we went through something as tragic as what happened last year, I think we’ve taken extra precautions.”

This fall, Clark will be at every home and away football game. For other sports, home events will take precedence, but Clark will always have hold on what’s going on with athletes.

“Just the other day, one of our girls rolled her ankle at our game at Canton (Academy),” softball coach Cory Caton said. “Ricky already knew about it because he talked to the trainer that saw her there.”

The coaches are not certified athletic trainers. Despite their knowledge of injuries and health and safety, nothing compares to having a professional on staff.

“A large percent of the population doesn’t understand that athletic trainers are licensed medical professionals who have specifically been prepared to prevent, recognize, treat and oversee the return from athletic injuries,” Casa said. “No parent would want their coach making life-or-death decisions for their child in serious circumstances.”


Clark’s presence provides peace of mind at Jackson Prep, but it comes as part of an overall emphasis on safety. Any person who wears a whistle around the neck, be it the head coach or a first-year assistant, is now certified in AED use and administering CPR.

Prior to the start of school last week, Prep’s coaches spent two days in hands-on AED/CPR training. They also learned from experts at the Korey Stringer Institute, via Skype, about recognizing signs of the leading causes of sudden death in sport, such as heat illness, exertional sickling and anaphylaxis management.

Like most of the Patriots athletic staff, Jacob Land, a third-year assistant football coach, has never had to administer CPR.

But now if the situation arises, he’ll be able to handle it.

“The hardest part is mentally preparing yourself that one day this might actually happen,” Land said. “You have to learn this stuff and take it seriously. With everything that happened last year, all of these situations now become surreal because you realize that they could possible happen, that I could have to do this.”

Source: The Clarion-Ledger

Recent KSI Initiatives


By Rachel VanScoy, Assistant Director of Sport Safety Policies

The Korey Stringer Institute (KSI) is keeping busy this summer. Here is a look into what we are up to:

  • On June 22nd, the NATA and KSI publically launched the Athletic Training Location and Services (ATLAS) database. This is an interactive map allowing athletic trainers’ to view their service location and coverage. For more information and to include/confirm your high schools information visit the KSI
  • KSI recently announced our online course on Preventing Sudden Death in Sports and Physical Activity through Jones & Bartlett Learning. For any Athletic Trainer looking to complete their Evidence-Based Practice CEUS or just looking to learn more about the preventing sudden deaths in sport then check out this course!
  • Andrea Fortunati, Assistant Director of Elite Athlete Health and Performance, continues to work with UCONN Men’s Soccer team as preseason is fast approaching.
  • Yuri Hosokawa, Director of Communication and Education, and Rachel Katch, Assistant Director of Research, will be running a study at the Falmouth Road Race August 16th, 2015. This will be the 3rd consecutive year that KSI will conduct research at this amazing race. The race consists of 7 miles and roughly 12,000 runners along the Falmouth, MA shoreline.
  • William Adams, Director of Sports Safety Policies, is running a study examining non-invasive biomarkers to assess physiological changes during and after exercise in the heat.
  • Yuri Hosokawa and Luke Belval, Director of Military and Occupational Safety are investigating the use of temperature monitoring devices and thermal imaging, and the use of two cooling methods to optimize the early recognition and management of Exertional Heat Illness.
  • Samantha Scarneo, Director of Youth Sports Safety is leading a study following concussion throughout the fall season within collegiate club and varsity athletes.
  • The Korey Stringer Institute is also testing athletic clothing to investigate efficacy and performance benefits of various fabrics in a hot environment.


Stay tuned for updates and publications on all of our initiatives!


Recovery, return of UM’s Hunter Knighton ‘nothing short of amazing’ (Miami Herald)

Hunter Knighton’s temperature hit 109 degrees on Feb. 24, 2014.

His brain swelled. His kidneys and liver failed. He had seizures. He fell into a coma.

That the 6-6, 295-pound University of Miami offensive lineman was alive Sunday to tell his story is a miracle in itself.

That he is destined to play football this season for the Miami Hurricanes is what drives him.

“I wouldn’t really be complete if I wasn’t able to do this,” Knighton, a redshirt sophomore backup center, said after a two-hour practice Sunday afternoon amid temperatures that soared into the mid-’90s.

“Football is my favorite sport in the world. Every moment away was hard, and finally getting back to this moment feels really good.’’

Knighton spent 12 days in a coma at UM Hospital after collapsing from heatstroke during an outdoor offseason team workout in February 2014.

“Three drills and then blackness and then it kind of felt like a dream for 12 days,” Knighton, 21, said.

“The first question I asked the doctors when I woke up: ‘How long am I out?’”

Knighton was cleared to practice for the first time this past Thursday, the start of fall camp. His mother, Southwest Airlines flight attendant Carole Knighton, told the Miami Herald by phone Sunday that she has been asked endlessly, “How could you let him go back out there?’’

Carole Knighton, who along with Hunter’s father, Jeff, flew from their home in North Coventry Township, Pennsylvania, to stay by his side in the hospital, knew she didn’t have a choice.

“He told me when he got out of the hospital, ‘I came to Miami to be a player, not a patient, and I’m going to play.’ So as a mother, I had to do everything I could to make sure he could.

“Prayer, faith and hope, that’s what has gotten me through from the moment I got the call and got on a plane and prayed that he’d still be alive when I got there, to now.”

Hunter’s mother said his rehabilitation, some of it at the Korey Stringer Institute at the University of Connecticut, “was gut-wrenching.

“When he first got out of the hospital, he couldn’t swallow, couldn’t eat, couldn’t drink, couldn’t talk,” she said. “The recovery was excruciating.”

Carole Knighton has become an advocate for the Korey Stringer Institute, recently telling Hunter’s story as a guest speaker at the NFL headquarters. Stringer, a former Minnesota Vikings lineman, died of exertional heatstroke in 2001.

Knighton said he lost 55 pounds during those two weeks but is now in the best shape of his life. “I was doing blood tests for about six months,” he said. “Everything [is] back to normal.”

Several players this past week said Hurricanes coaches have been extremely vigilant about proper nutrition and daily hydration — before, during and after practice. Water breaks occur often.

The night before practices, Knighton swallows pills that allow trainers to use a sensor to reflect his internal temperature while he’s playing. “The only thing they have to do is walk up to me,” he said.

Knighton and his parents don’t blame the UM coaches, who were present that day when he collapsed. As it turned out, Knighton had the flu and didn’t realize the severity.

“There’s not a coach in this country that cares more for his players than Al Golden,” Carole Knighton said. “If it weren’t for Al Golden and [offensive line coach] Art Kehoe, I don’t know if I would have ever gotten through this. Al lived in that hospital day and night.”

Knighton said that the first day he “really remembered everything,” his mom was out of the room and he began to have trouble breathing.

“Coach Golden was there for what felt like hours,” he said, “almost coaching me through breathing. He really helped me.”

Golden called Knighton’s recovery “nothing short of amazing,” and Kehoe said “He’s right in the hunt” for playing time. “God bless him.”

Knighton missed his freshman season after shoulder surgery and is still waiting to get on the field for the first time. He believes that time is near.

“It’s good to see him back going full speed,” said quarterback Brad Kaaya, the player to whom Knighton snaps the ball. “It has always been his dream to play football here. He almost lost that dream.

“He’s not taking any rep for granted. He’s giving it his all.”

Source: Miami Herald

Miami Lineman Speaks of His Heatstroke Ordeal (Associated Press/ABC News)

Hunter Knighton once went a week without sleeping, afraid to close his eyes because the nightmares were inevitable. Panic attacks were common. Memories were hazy. Breathing was a struggle.

The dark, scary moments are still in the recesses of his mind.

But he’s about to take another step toward escaping them for good.

A year and a half removed from nearly dying on the Miami practice field because of heatstroke, Knighton returns to that same field Thursday for the start of Hurricanes’ training camp. The offensive lineman — after undergoing intense rehabilitation on both the physical and psychological fronts — has been cleared for a full-fledged return to the team, something that became official just days ago after successfully completing one last round of tests.

“It is definitely a big weight off my shoulders and I’m so thankful that God has given me a second chance to showcase what I can do.,” Knighton said. “Once I take the field, I’ll just have a lot of joy. But at the same time, I still have a long way to go.”

But after working with both doctors and other officials at Miami, as well as being evaluated and treated at the Korey Stringer Institute in Connecticut — the facility named for the Minnesota Vikings lineman who died of exertional heatstroke in August 2001 — Knighton is back in the game.

That’s victory in itself.

“I get emotional just thinking about it,” Miami coach Al Golden said. “Words can’t describe. … What he went through, everything he’s done to get back. He’s had the best care in the world. Everything in terms of his integration has been handled from the highest levels. And it will be an incredible day to have him out there again.”

Everything changed for Knighton on the morning of Feb. 24, 2014. It was around 70 degrees at 8 a.m. that morning in South Florida, with a bit of cloud cover helping make conditions seem downright comfortable by Miami standards. Put simply, for Miami, it wasn’t hot. As Knighton — who unknowingly was trying to fight through the flu and dehydration during that practice — would soon learn, the temperature didn’t matter.

“A lot of people think of the typical heatstroke as an older person in the house or a baby locked in a car,” Knighton said. “There’s a difference between that and exertional heatstroke.”

He remembers completing two conditioning drills that morning. Teammates remember him getting through as many as eight. Knighton has no recollection of the others. He also has no recollection of punching teammate Shane McDermott, who was trying to help him onto a cart that would take him from the field to a waiting ambulance.

“They took me over there,” Knighton said, gesturing to where some benches had been set up on the edge of the field. “I was becoming very hostile. A symptom of heatstroke is irritability. And they couldn’t get my hands off the bench to get me on the cart. They said I had a death grip, fighting people and stuff.”

With every second, his condition seemed to worsen. Knighton was breathing but not responding to paramedics. His temperature was soaring to 109 degrees. Golden could see in the paramedics’ faces that the situation was suddenly very critical.

“The enormity of what we were getting hit with became apparent,” Golden said. “What I saw, it’ll never be erased.”

Knighton’s parents were summoned from the family’s Pennsylvania home. They were first told he was having seizures. Soon they were told that the situation was turning dire. They were there when Knighton woke up. He thought 12 hours had passed. It was actually 12 days. He was in a coma, losing 55 pounds in his sleep and unsure of what happened.

“The worst memory of the hospital was when I first woke up I couldn’t breathe,” Knighton said. “I had the tube in there; it was like I was suffocating. Every breath I thought was going to be my last. I was trapped in my body. Couldn’t talk. Couldn’t breathe. Everything was fuzzy. It felt like I was dying.”

These were dark days for Miami. A day after Knighton collapsed former Hurricanes standout JoJo Nicholas was involved in a horrible car crash in Miami Beach and eventually died from his injuries. Golden was going from one hospital room to the other for those days, trying to console two grieving families while trying to hold his emotions together.

Months later, Golden’s wife would have a serious health scare and needed hospitalization. By coincidence, she was placed in the same room that Knighton had months earlier.

“The irony,” Golden said. “Strange. It’s very strange.”

Kelly Golden survived. So has Knighton. Some would say he’s thrived. He’s bigger and stronger than ever.

“I’m expecting big things from him,” Miami quarterback Brad Kaaya said.

Knighton sat out 2013 because of shoulder surgery. He missed last season because of the heatstroke, and said it was often unbearable to not be able to help his team — especially when the offensive line was decimated by injuries.

These days, he chooses to think about what he gained and not how his life was nearly lost. His faith grew deeper in the last 18 months. He values family and friends more. He became a better student, no small feat since when he first returned to school his brain was still so fogged that he likened a simple business class to rocket science.

“I definitely take things less for granted,” Knighton said. “I appreciate being able to play this game again. There’s no way I’m not playing. I’m a Miami Hurricane and I’m going to play.”

Source: ABC News

Ironman Lake Placid

Lake Placid Team KSI

By William Adams, Director of Sport Safety Policies

A few representatives from KSI traveled to Lake Placid, NY for the annual Ironman Lake Placid race on July 26th. For those that are unfamiliar with an Ironman race, it involves a 2.4-mile swim, 112-mile bike ride, and a 26.2-mile run. Competitors have 17 hours to complete the race and if successful can be proud to call themselves an Ironman.

Ironman Village

This year’s race was unique in a number of ways; 1) there were no professional triathletes that raced, allowing the overall male and female finisher to be an amateur athlete and 2) the environmental conditions became very hot (above normal for Lake Placid) halfway through the bike portion of the race, making the race much more stressful than anticipated, and 3) this year’s race saw an athlete suffer from exertional heat stroke which is normally an uncommon sight at a race of this length and duration.

Kestrel at Mirror Lake

KSI’s trip to Lake Placid for the 2015 race was to volunteer to assist in the medical tent at the finish line to treat the athletes that became injured during the race. This year’s race saw a variety of injuries that came to the medical tent throughout the day. Injuries that were treated inside the medical tent included dehydration, hyponatremia, musculoskeletal injuries, and many others.

Medical Tent

The most fortunate part of this experience was being able to see medical providers from various fields of expertise, from various geographical locations and settings come together to provide top-notch medical care for the 2,600 athletes participating in this year’s race. Without these volunteers, the race would not have been a success.

Korey Stringer’s Sacrifice and the Battle to Stop Football Heat Stroke Deaths (Bleacher Report)

We can never forget Korey Stringer, who collapsed on a Minnesota practice field on a sweltering July afternoon in 2001, died of heat stroke early the next morning and reminded the world that football players are not indestructible.

Stringer died 14 years ago, a victim of oppressive heat and national misunderstanding of—and indifference about—a dangerous-but-preventable ailment that still claims the lives of too many young athletes each year.

Stringer’s death opened eyes and minds about the dangers of dehydration and heat stroke. It prompted immediate changes in how the NFL and NCAA treat their athletes during steamy summer practices, changes that trickled down to prep and youth levels. It even changed the tone of the national football conversation, creating an awareness of the perils of playing football that has carried over to other health and safety issues.

Stringer’s death saved countless lives. But there are many more lives to be saved. We can never forget Stringer: his career, his sacrifice, his legacy.


The Beauty of Everyday Things

Rookie Korey Stringer was ready for anything the NFL could throw at him except Reggie White.

Stringer was not yet 21 years old when the Vikings selected him in the first round of the 1995 draft. He was one of the youngest players ever drafted, and he became a starter at right tackle early in the 1995 season.

He fared well in his first starts, but White already had one foot in the Hall of Fame.

The press built up the “Reggie versus Rookie” narrative during the run-up to that October game. The Minneapolis Star-Tribune profiled Stringer’s preparation for White; the rookie pounded his feet while jogging on a treadmill at 6:45 a.m. to shed weight and thumbed through a phone bill listing $579 worth of homesick calls for the month.

“Everyone acts like it’s going to be my funeral this week,” Stringer told Selena Roberts.

Stringer started the game but had to exit with what was called a stomach injury in the newspapers.

The details of the injury? “He had food poisoning,” fellow lineman David Dixon recalled in a recent interview with Bleacher Report.

A backup replaced Stringer but was hopeless against White.

“I said, ‘Hell, let me go out there,'” said Dixon, a guard by trade. “So I played right tackle, and Reggie White just gave me the infamous ‘hump’ move. He took me out of the way, hit Warren Moon, made him fumble the ball. They scooped it up for a touchdown.”

The Sean Jones fumble recovery gave the Packers a 35-14 lead, making the game a rout.

“[Coach] Denny [Green] said ‘Get your butt back in at right guard,'” Dixon remembered.

Stringer and Dixon recovered from the experience. They became training-camp and road-trip roommates.

“We were just two young players trying to find some cohesiveness,” Dixon recalled.

Back in 1995, the left side of the Vikings line boasted Pro Bowlers Todd Steussie and Randall McDaniel. Center Jeff Christy was also a three-time Pro Bowler. Over the years, Dixon and Stringer grew into their roles on the right side. By 1998, the Vikings were a 15-1 team, and Randall Cunningham suffered just 20 sacks behind one of the NFL’s most stable lines.

By 2000, Christy and Randall were gone, Stringer and Dixon were veterans and the Vikings still had one of the league’s best offenses, now with second-year quarterback Daunte Culpepper pulling the trigger and hurling bombs at Cris Carter and Randy Moss.

Matt Birk, Christy’s replacement at center, got some predictable Welcome to the NFL treatment from Stringer when he arrived as a late-round rookie.

“He was tough at first, on purpose,” Birk recalled. “It wasn’t hazing, but he was like, ‘Hey rookie, do this, do that, you gotta earn your way around here.’

“But quickly thereafter, he would sit there and answer questions about life, relationships. He was always very open, very honest and very approachable, even though he had a rough exterior.”

Stringer had what Dixon called a “quiet” sense of humor. He performed impressions of Vikings staffers, though he never took the impersonations too far. “He found the humor and beauty in everyday things,” Birk said. “Little things that you’d never even notice, he’d point out and thought they were so funny or so joyous.”

Stringer and Birk made the Pro Bowl for the Vikings in 2000, as did most of the skill-position stars of that high-powered offense. But the Giants dismantled the Vikings 41-0 in the NFC championship game, with Stringer having a rough game against Michael Strahan. The Vikings offense went to Honolulu, then arrived in Mankato training camp the next summer eager to prove they could do more than produce fantasy statistics.

Then, on a sweltering morning in July, Stringer collapsed and everyone’s priorities changed.



“It had been a scorcher of a morning,” wrote Brett Knapp in the Rapid City Journal on the morning Stringer died. Humidity was high, temperatures were in the low 90s.

“It was hot,” Birk remembered, but no more so than any other day in training camp. “Hot days in Mankato, Minnesota, in summer are nothing new.”

It was a Tuesday. Practices began in earnest that Monday. Even players who participated in the team’s offseason workout program were just trying to cope, and Stringer had not been a full participant.

“I was struggling too,” said Dixon. “It wasn’t like I was 100 percent either.”

Coaches ordered the offensive line to participate in extra work after a practice session that lasted over two hours. Dixon relayed the bad news to Stringer on the field. Both would have to “suck it up” and practice a little more.

Birk was hot and tired as well.

“Korey was just like everybody else,” he said. “And then, one time, he slowly went down to the ground. He went down to the knee and then rolled over.”

Birk asked Stringer if he was OK. Stringer asked for a trainer.

“He was very calm,” Birk recalled.

Knapp reported that he left an interview session to watch the extra lineman drills. The reporter was just leaving for the air-conditioned media center when Stringer nearly knocked him over in his rush to the trainer’s room.

“In truth, he wasn’t so much walking as he was lurching and stumbling, his eyes a bit glassed over and his face contorted with pain,” Knapp reported. “By the time he reached the door and walked through, Stringer looked barely able to keep moving under his own power.

“They would be some of the last steps he ever took.”

Birk thought little of Stringer’s status that afternoon. There was nothing that unusual about a player needing an IV or even brief hospitalization in the sweltering early days of camp. Teammates often showed up for dinner after treatment.

Dixon had not even noticed that Stringer, his roommate and the player who lined up beside him for years, had left the field. When Dixon saw that several teammates were missing from afternoon meetings, he realized the severity of the situation and headed to the hospital.

Teammates were not allowed to see Stringer. There were whispers and rumors. Dixon returned to training camp.

Stringer died at 1:35 a.m. on the morning of Aug. 1. His body had reached a core temperature of 108 degrees. He had lost consciousness sometime after asking Birk for help and tumbling past the freelance reporter who ultimately broke the story of his death.

“It was just disbelief,” Birk said. “Disbelief that that could happen.”

Within hours, heat stroke and dehydration—a pair of dull medical subjects few people wrote or talked about—became the only topics anyone was talking about.


Preventable Killer

Heat stroke occurs when a person’s core body temperature exceeds 105 degrees Fahrenheit. Nausea and disorientation are the most common early symptoms. The longer the core body temperature stays high, the greater the risk of serious, permanent consequences. The high heat makes organs swell and shut down and wreaks havoc on the nervous system. Without cooling and rehydration, a heat stroke victim is likely to lapse into a coma, then die.

Doctor Douglas Casa suffered his first heat stroke as a teenager, running a 10K race at the Empire State Games in the 1980s. He stumbled late in the race from dizziness, rose to his feet, then fell again. After receiving successful treatment, he devoted his studies to exertional heat illnesses. Casa is now the chief operating officer of the Korey Stringer Institute, as well as a professor of kinesiology at the University of Connecticut.

Casa’s goal is to get youth, prep, college and pro coaches, trainers, athletic associations and school boards to adopt some simple protocols and standards that can all but eradicate the risks of heat stroke deaths.

“Obviously, having a home that’s named after Korey Stringer’s legacy gives us more reach,” he said.

Treatment of heat stroke is somewhat counterintuitive. It’s one of the few illness for which rushing to the hospital is a bad idea.

“You actually want to treat it on site,” Casa said. “We call it cool first, transport second. If you have 30 minutes to work with, you can’t wait 10 minutes for an ambulance.”

Submerging a heat stroke victim in a cooling tub can immediately start lowering the core body temperature. Casa’s research reports a 100 percent survival rate in cases where the core body temperature was cooled to below 105.5 degrees in the first half hour.

The best way to prevent heat stroke deaths is to prevent heat stroke. Casa and the Korey Stringer Institute list what Casa calls “four big-ticket items” for heat stroke prevention:

Hydration: Drinking plenty of the right kinds of fluids before, during and after exertion is an obvious and important way to prevent heat stroke, but it is not a cure-all. “That’s only one piece of the puzzle, and it distracts people. They think that it’s the only element to prevent heat stroke.”

Heat Acclimatization: There’s more to getting used to the heat than mentally preparing to be all sweaty. “Your body actually goes through some amazing physiological changes in that first week to protect you,” Casa said.

In football terms, heat acclimatization means eliminating two-a-days early in the practice season and generally ramping up exertion levels in high-risk conditions to ensure that, for example, a high school freshman doesn’t go straight from a July of swimming and air conditioning to a week of six-hour, 95-degree practice in August. Casa reported that 90 percent of all heat stroke deaths, like Stringer’s, occur during the first three days of activity.

Work-to-Rest Ratios: “This is not rocket science,” Casa said. “If it is brutally hot out, we are going to have more rest breaks.”

Body Cooling Throughout the Session: Drink breaks, ice packs, shaded areas, some cold wet towels for the player’s neck and back.

The Korey Stringer Institute’s unofficial fifth “big-ticket item” is education. The NFL changed its heat-illness priorities soon after Stringer’s death. The NCAA adopted a sweeping reform in 2003. The mistakes that led to Stringer’s death—immediate high-intensity exertion at the start of camp, hydration on a have a drink when thirstybasis, transportation before cooling—were addressed and reduced or eliminated.

NFL and college players can count on the presence of immersion tubs close to the practice field and trainers who recognize symptoms and best-treatment practices and practice routines that reflect modern heat stroke research.

Unfortunately, high school players may attend a school that does not even have athletic trainers, with a school board that never approved an emergency heat stroke protocol, in one of the 36 states that do not meet the KSI’s minimum safety standards, with a coach who thinks six-hour introductory practices toughen the kids up.

The NFL hosted a heat stroke seminar for the leaders of all 50 state high school athletic associations early this year.

“That was probably the most useful two days of my whole career,” Casa said.

State officials compared notes and learned what their neighbors were doing. The NFL’s involvement gave the seminar clout (the NCAA will host another one next year), and Stringer’s legacy carried influence among the attendees.

“Most of the people were between 35 and 55 years old,” Casa said. “They all, in the front of their minds, remember Korey Stringer.”


The Worst Wake-Up Call

David Dixon didn’t feel so good. It was Vikings training camp in 2002 or 2003, a year or two after Stringer’s death, and the heat was taking its toll on the veteran lineman. He asked for some Gatorade. After a drink, he still felt sick.

“They took me out,” Dixon said. “They put me in the medical tent. They put IVs in me. They put some ice bags underneath my armpits and in between my legs.”

Dixon wasn’t scared. He understood the symptoms of dehydration and knew that he and the training staff got a jump on the condition. He was more concerned about the next day’s weigh-ins.

“I told them, ‘Get this damn IV out of me! I’ll be five pounds over my weight from all this fluid going into my system!'”

Dixon was excused from weigh-ins so he could finish his treatment.

Needless to say, times changed after Stringer’s death, not just in Minnesota but at football camps at all levels around the country. Unless he was an All-Pro, no NFL player would have risked asking for a Gatorade break and some ice packs for a little thing like dizziness a decade earlier. Dixon chuckled at the probable response: “Here’s your pink paper. You can go home.”

Birk remembers the changes occurring almost overnight. “After that, they pulled the soda machines out of the dining hall,” he said. “It was almost instant change all over the league.”

Teams began to focus on hydration. They measured player’s specific gravity. They even tested urine. Colleges and many high schools began following the NFL’s lead. After some lawsuits and acrimony, the NFL made peace with Stringer’s family and lent its muscle to the founding of the Korey Stringer Institute.

The tone of training camp reports changed, too. After a summer when every beat writer in the nation grilled the local coaches on what they were doing to prevent heat stroke deaths, there was a lot less talk about hefty linemen sweating off the flab and a lot more awareness of the need to practice safely and properly.

Dixon is now a high school football coach. Awareness of hydration and heat stroke concerns has reached the point that he does not need memories of his training camp roommate to remind him to provide cool zones and rest breaks.

“There are a lot of courses that we take now,” he said. “We try to identify situations where the temperature, heat index and humidity are dangerous.”

But there is still work to be done. The National Center for Catastrophic Sports Injury Research reported 13 heat stroke deaths during football practices or games from 2010 through 2014.

“Despite an awful lot of effort in that area, and despite people tracking that area closely, we still see it as a major problem,” said Dr. Robert Cantu of the NCCSIR. “A majority of these heat stroke deaths are at the high school level, and that’s where the education isn’t as good as it is higher up the chain.”

Casa said that there are still states where high school football season begins with three three-hour sessions per day in the midsummer heat. There are still schools without athletic trainers and coaches without an understanding of the risks. Meanwhile, in the 14 states that meet Korey Stringer Institute minimum guidelines, there have been zero heat stroke deaths.

“That’s the most staggering piece of data I can tell you,” Casa said. “We basically have saved 20 to 25 lives in those states in the last four years.”

Stringer’s death saved lives not just by forcing changes, but by changing opinions. Awareness of the dangers of heat stroke paved the way for awareness of the dangers of concussions among NFL players—who began prioritizing safer, shorter, less frequent practice sessions in collective bargaining negotiations—coaches at all levels and the public at large.

You can still hear outdated tough-guy attitudes about playing through heat exhaustion (or a seemingly minor head injury) shouted from the backs of sports bars or the bottoms of comment threads, but you don’t hear them during telecasts or meet-the-coach nights often anymore. Stringer’s death forced many of us to be smarter about the risks football players take for our entertainment.

“The whole NFL community was rocked by it,” Birk said. “You know football’s dangerous, but to play it you have to fool yourself into thinking, ‘That’s not going to happen to me. It’s not going to happen to anybody.’ Then, when something does happen, it’s like you realize that you kind of forgot that this can happen. It shakes you. It shakes everything about you. When you go on the field, you think about it. You think, ‘What if that was me? What about my wife?’

“I don’t want to say it’s a good wake-up call. It’s a shitty wake-up call.”


Mike Tanier covers the NFL for Bleacher Report.


Source: Bleacher Report