University of Connecticut University of UC Title Fallback Connecticut

Experts question why previous heatstrokes at Maryland colleges weren’t a wake-up call before McNair’s death (The Baltimore Sun)

The two football practices unfolded roughly four years and 40 miles apart.

At each one, a teenage football player ran drills outside, the temperature hovering in the 80s. When each started showing signs of exertional heatstroke, training staff applied cooling packs to the player’s armpits and groins. But the trainers stopped short of best practices: taking the athlete’s rectal temperature and immersing him in cold water.

About two weeks later, both student-athletes were dead.

Jordan McNair, a 19-year-old offensive lineman at the University of Maryland, College Park, died of heatstroke in June.

Marquese Meadow, an 18-year-old defensive lineman at Morgan State University, died of heatstroke in August 2014.

A year before that, a third football player in the state suffered heatstroke during practice. After a long hospitalization, Towson University’s Gavin Class survived, which he attributes to the trainers’ quick action in treating him with cold-water immersion.

Experts question why other major heatstroke incidents in Maryland college football didn’t serve as a wake-up call before McNair’s death — and they wonder what could be different now.

After Minnesota Vikings offensive tackle Korey Stringer died of heatstroke following a 2001 training camp practice, the NFL took a hard look at its protocols. No professional football player has died of heatstroke since. Meanwhile, according to the research institute named for Stringer, more than a dozen college football players have died of heatstroke since 2000.

“Reactive change is a problem. We need people to be proactive,” said Robert Huggins, president of research and athlete performance and safety at the Korey Stringer Institute, a University of Connecticut-based nonprofit that studies sudden deaths in sports. “We’ve had enough heatstroke cases, enough deaths, enough near-deaths to learn from and to serve as examples.

“Heatstroke is 100 percent preventable. We scream that from the mountaintops.”

McNair was attempting 10 repetitions of a 110-yard run during a May 29 practice when he started showing signs of exhaustion. Trainers eventually moved him to the football field house for treatment, about 30 minutes after the onset of symptoms. Another half-hour would pass before anyone called 911, records show. The trainers did not take his rectal temperature or use cold-water immersion treatment, which experts say are the two steps that could have saved his life. He died June 13.

After McNair’s death, media reports labeling the flagship’s football culture “toxic” brought more national scrutiny to campus, leading to a second investigation into allegations of bullying and abuse.

“I do feel the public eye is on the McNair case quite closely,” Huggins said. “I hope people really start to pay attention.”

The University System of Maryland’s governing body has been actively involved in overseeing the two investigations into the Terps’ football program. Board of Regents Chair James Brady spoke at a news conference last month, during which sports medicine consultant Dr. Rod Walters presented the findings from his review of the athletic department’s safety protocols.

Brady said the university system was “anxious” to learn from McNair’s death. He said Walters’ recommendations would be implemented not just in College Park, but at all other system institutions with football programs.

“We can and must learn from what happened,” he said, “and make any appropriate and necessary changes to make sure it never happens again.”

A University System of Maryland spokesman provided an emailed statement Wednesday, but it did not directly address questions about whether the heatstroke incidents involving Class and Meadow sounded alarms at universities across the state. Towson is part of the university system. Morgan State, though a Baltimore-based public institution, is not.

The system has already shared the Walters report with every campus, asking them to review the recommendations and implement any necessary changes to their procedures and protocols,” the statement read.

A University of Maryland spokeswoman was not immediately available to comment for this article.

Towson athletic director Tim Leonard said Walters was also hired to review Towson’s protocols after Class’ hospitalization in 2013. While the Board of Regents was provided with those findings, Leonard said, the system never assumed control of the investigation, nor were there attempts to broaden the scope beyond his school.

Class said he was disappointed other state institutions didn’t double down on heatstroke prevention and treatment awareness after his harrowing medical saga. He collapsed during an Aug. 12, 2013, football practice, and his body temperature reached an estimated 111 degrees. He arrived at the hospital in a coma, with significant organ failure. He was later transferred to the Maryland Shock Trauma Center, where his heart stopped and doctors resuscitated him. After he was stabilized, he required a liver transplant.

“It didn’t shake anybody until Jordan,” said Class, now an assistant strength and conditioning coach at Johns Hopkins University. “You’d think after Marquese dying, too, that things would’ve been shaken up, but nope.”

The law firm representing McNair’s parents wrote a letter to Brady last month demanding to know what the university system had gleaned from what happened to Class and Meadow.

“The facts that need to be disclosed now involve the systemic failures throughout the University System that preceded Jordan’s death, despite having actual knowledge that an incident like this had occurred before,” lawyer Billy Murphy wrote.

Much of the Board of Regents has turned over since 2014.

Dr. David Chao, who served as the head team physician for the San Diego Chargers for 17 years, said college football programs should’ve learned their lessons after Stringer died — and even more so when a heatstroke incident hit closer to home.

“One death of a child or adult from heatstroke playing football is one too many,” he said.

Since McNair’s death, a number of changes have been made within the Maryland football program.

The Terps added more on-site cooling stations and boosted the amount of medical staff on hand during practices and games. Student-athletes use a new tool that helps them monitor hydration levels and they have expanded access to cold-water immersion therapy. Walters led in-service training for athletic department staff on implementing emergency plans.

Walters’ review found the flagship’s athletics protocols on exertional heat illness meet standards, but proper steps were not followed May 29 in McNair’s case. The football team’s practice site was moved at the last minute, so the cold-water immersion tanks that are usually part of the field setup were not there on the day McNair fell ill. The university also didn’t monitor weather statistics in the recommended manner.

Walters said the failure of trainers to recognize McNair’s signs of heat illness was “a concern.”

Universities not only have to put the right protocols in place, Huggins said, but understand how to execute them properly.

In January 2012 — more than a year before Class was hospitalized — a group of leading athlete safety experts drafted a series of 10 recommendations for preventing sudden deaths in college sports.

They recommended conditioning periods be phased in gradually “to encourage proper exercise acclimatization and to minimize the risk of adverse effects on health.” McNair’s final workout was his first team activity in more than a month.

And they recommended that exercise and conditioning activities should not be used as punishment. Meadow fell ill while running during a “punishment practice,” according to a lawsuit filed by his mother.

The lawsuit, which ended in a settlement, states that Meadow attended a practice on Aug. 10, 2014, that was “scheduled to punish certain individuals on the team for team rule violations.” About an hour in, Meadow began stumbling and became disoriented — his temperature eventually reaching 106 degrees. At the hospital, he went into liver and kidney failure and suffered a brain injury because of the loss of oxygen. He remained in the intensive care unit on a ventilator for two weeks, before he died surrounded by family.

His mother, Benita Meadow, said when she saw McNair’s death reported in the news, it took her right back to the day her son fell ill.

“I couldn’t believe it was happening again,” she said in an interview. “The University of Maryland and Morgan State are like sister schools. It scared me and it made me angry — how is this still happening, so close and in the same way?

“This can’t be swept under the rug. … There has to be a change now.”

The Morgan State football team has since implemented new protocols, The Sun reported in August. Before practice, each athlete receives a 1-gallon jug of water. The players take two mandatory water breaks, without their helmets on. At the end of each workout, the players pile into ice tubs on the sidelines for a required 20-minute cool-down. Morgan State officials did not respond to requests for comment for this article.

After Class’ heatstroke, Towson also re-emphasized preventative measures, Leonard said. Mandatory breaks are written into the practice schedule. Coaches and trainers preach the importance of hydration. Officials are always monitoring for new evidence-based recommendations on avoiding heatstroke.

It remains to be seen what impact McNair’s death will have on other athletics department practices across the state.

But his grieving parents are hoping for change.

They’ve launched a foundation in their son’s honor, aimed at promoting awareness of heat-related illnesses, improving player safety and reducing heatstroke incidents among student-athletes. They say they don’t want any other parents going through what they are.

“While Jordan is not with us to build his legacy, as a family we are doing it for him,” his father, Marty, wrote in an open letter on the foundation’s website. “This is his legacy.”

Benita Meadow befriended McNair’s parents after their twin tragedies. She never imagined a friendship could stem from her grief, but she said their connection gives her renewed strength to talk about her son, whom she remembers for his drive, his big personality and his desire to be a humanitarian.

For years, it was too hard to tell her story. Now that heatstroke has struck another Maryland college athlete, it’s different.

“Marquese is telling me to help,” she said.

Source: The Baltimore Sun

The First-Time Marathoner’s Guide to Fuel and Hydration for Your Marathon Training (SELF)

First-time marathoners, if your training program is overwhelming you (and, if you’re anything like I was during training for my first 26.2, it is), I’m here to make one particular part of your marathon journey significantly less complicated and confusing: fuel. Specifically how to go about it when your runs get long.

When training for a marathon, people tend to focus on (and stress about) the obvious: running long and often. However, an overlooked—yet super important—component of crossing the finish line and staying healthy throughout your entire training cycle is midrun nutrition.

For some, it might seem simple: Can’t I just chomp down on half a banana during a long run? For others, it might be confusing: Is eating lots of sugar OK? What about GI issues, cramping, or bloating?

Use this as your guide to eating and drinking on the run, which is necessary for anyone training for a marathon. From gels to chews, hydration tabs to caffeine, here’s the deal, not only with what to consume while running, but why it’s one of the most important things to think about when it comes to crossing the finish line.

Note: This is specifically for athletes tackling a road marathon. Trail running—which typically equates to slower running with more elevation variation—usually means stomachs can handle different types of food and therefore follows a different race-day nutrition plan.

Midrun fueling—Why bother?

Before we dive into the what, let’s look at the why. Why the heck is it important to eat during a run? What’s going on inside our bodies?

“We only have so much glycogen stored, which is what the body uses for energy while running,” explains Kelly Hogan, M.S., R.D., who works with athletes and has run 11 marathons herself. “We can use up all of those stores in about two hours. That’s when people start feeling like they’re going to bonk.” (The bonk, by the way, is the point at which your body, brain, or both feel like they can’t take another step and it typically happens to endurance athletes especially when they’re not properly fueled.)

It’s important to start fueling well before our bodies are close to using up all our glycogen stores. For most runners, that’s 30 to 45 minutes into a long run. Still, every body is different, and it’s essential to practice fueling during your training runs so you don’t introduce something your stomach can’t handle on race day.

“The biggest mistake I see—by far—is people doing something different in their race versus training,” says Douglas Casa, Ph.D., professor of kinesiology at the University of Connecticut. He, too, has worked with athletes for years and is an avid trail runner. He continues: “Regardless of exact amounts—those are nitpicky things—a lot of ranges [for food and drink consumption] can be successful. Instead, it’s a matter of asking: Is your body ready for it? The crux of it is you have to rehearse.”

OK, I’m ready for rehearsal! Can I grab a Snickers?

Actually, yes! (Well, OK, maybe a mini Snickers.) The main rule of thumb for midrun food is to find something that will give you energy and is easy to digest, and kid-sized candy is actually something that many runners stick in their pockets before heading out the door. As a rule, the body needs fast-absorbing carbohydrates that will boost blood glucose levels and send sugars through the bloodstream and into the muscles.

It doesn’t have to be a candy bar, though. Most runners get their quick-digesting carbs from gel packets or sports chews (GU, Hammer, and Clif are great options), which are easy to slurp down while running. Other examples of easy-to-eat simple sugars include sports beans, fruit drops, and even thin, cookielike waffles. (In my opinion the Honey Stinger honey waffle will get anyone out the door for a long run.) You can also get sugars from a sports drink, like Gatorade or Maurten, a drink mix that’s an alternative to mainstream sports drinks and that’s used by many elite runners.

“I think GU and gels are getting knocked since they are processed sugar,” explains Hogan. “But it’s only sugar for a reason—we need it for running.”

That said, not everyone can tolerate the same types of foods. “It’s important to test different foods to see what your body can handle,” Hogan reiterates. If highly processed foods aren’t your thing, she recommends trying a less processed option, like dried fruit or pretzels. My personal go-to is Spring Energy gels, which use whole ingredients like rice, banana, and peanut butter, blended into a gel-like substance. As long as you can get over the fact is has the consistency of baby food, you’ll be set.

For coffee lovers, there are caffeinated fuel options! Certain energy gels also include caffeine; the amount typically ranges from 20 to 40 milligrams, though some are packed with up to 150 mg. (In comparison, a grande Starbucks coffee has 100 to 120 mg of caffeine.) While caffeine can give runners a nice jolt of energy, it isn’t a necessary additive to your fueling regimen. “Caffeine intake during the run is meant to give a bit of an energy boost, but is different in how it affects various individuals,” Hogan explains. “Starting out at the lower end of caffeine—that’s 20 to 30 mg—is a good idea to see how the body reacts, as opposed to going for a gel with 75 to 100 mg of caffeine right at the start.” Hogan also suggests alternating between noncaffeinated and caffeinated gels just to stay on the safe side. Unlike sugar in gels, caffeine stays in our system longer. “We don’t want to be up all night after a long run or race, or having lingering feelings of the jitters, nerves, or anxiety.”

So, what should I avoid?

As far as what should be on the “do not eat” list, foods that are too heavy on protein and fat might do more harm than help.

“Save the protein for after the race,” advises Hogan. “Calories from protein and fat won’t do much for your body. Fat especially can be the culprit of GI issues since we digest it the slowest.” Fiber could cause tummy trouble, too, since it also takes a toll on our digestive system.

For this reason, avoid foods like leafy greens, cruciferous vegetables (like broccoli and cabbage), and beans, along with red meats, fish, and cheese 12 hours before a long run or your race. Aim to have your prerace meal be about 75 percent carbohydrates, and stick to mainly carb consumption when you’re out on the course.

When should I eat? And also, how much should I eat?

Now that you know what to eat, when should you eat it? And how much is enough?

“The general idea is to start with consuming 30 to 60 grams of carbohydrates per hour,” says Hogan, which is the range our bodies can absorb glucose and varies slightly depending on how big you are, how fast you’re running, and how quickly you’re burning through your calories. This amount of carbs per hour could include two 1-ounce bags of sport beans or two energy gels. “For most people, start to fuel 30 to 45 minutes into the run to get a head start on your glycogen storage.”

If two gels seem too hard to stomach, go for a combo: a mixture of chews, beans, or a gel will also do the trick. Keep in mind that sports drinks, though they’re liquid, provide carbs, so you should factor that in when calculating your carb intake.

What’s the deal with water?

Hydration is another critical component of your fueling strategy. Casa recommends carrying water with you—whether in a hydration pack, fuel belt, or handheld water bottle—so you can sip water throughout your run versus relying on aid stations, where people tend to gather to chug down fluids.

“This allows you to drink whenever you want and you avoid the rush of people at the aid stations,” he explains. (I will vouch for him here; while aid stations volunteers are super helpful, and the tables are always stocked with food and drink, they sometimes can get overwhelmingly crowded.)

Just like calorie consumption, there isn’t a one-size-fits-all amount when it comes to hydration. In general, your fluid intake should depend on your sweat rate, which is the amount of fluid you’re losing through sweat while exerting energy. Sweat rates vary depending on body size, activity intensity, and environmental conditions. For example, a larger person who is running 7-minute miles in 80-degree heat might need 2 liters of water an hour, versus a smaller person running 10-minute miles in mild conditions might suffice with a half liter.

Luckily, there’s a foolproof method for figuring out your sweat rate at home. Simply urinate, get naked, and weigh yourself in kilograms. Then head out on an hour-long run without consuming any water or food. Once you return, weigh yourself again. The difference will show you how many liters you sweat per hour. For example, if you weighed 60 kg before your run and 59 kg after, you sweated 1 liter per hour. This is the amount of water you should drink every 60 minutes. That said, you definitely don’t have to use this strategy. The trial-and-error method is just fine, too.

Calculating this sweat rate not only ensures you’re drinking enough but protects you from drinking too much.

“Pay attention if your body feels super full and you have a sloshy feeling in your stomach,” Hogan says. “This is one of the first warning signs of hyponatremia.”

Hyponatremia is a rare and dangerous medical condition that occurs when the concentration of sodium in your blood is abnormally low, which can happen if you drink too much water. While Hogan notes that hyponatremia is rare, it’s important to understand the warning signs. When you’re drinking, make sure your body feels satisfied but not overly full. If you feel extra bloated and start to become dizzy and disoriented, it’s critical you pump the breaks and get medical attention. Casa echoes this sentiment; if you’re aiming for a five-hour finish time and the race conditions are mild, it’s easy to overcompensate and think you need to be drinking a ton. Figuring out your sweat rate will give you peace of mind and more confidence when you toe the line, because of course, you still do need to hydrate adequately throughout the race to avoid dehydration, another dangerous (and more common) condition.

A guideline I like to follow is taking in 3 or 4 long sips of water every 15 or so minutes. On long runs, I’ll often fill my hydration pack with water that has a hydration tab mixed in it, called Nuun, which has added electrolytes, like sodium. Electrolytes are minerals that keep our systems functioning and, in the case of extensive sweat loss, will need to be replenished. It’s easy to add electrolytes—especially sodium—into your running diet; sipping on Gatorade, using Nuun tablets, or even munching on some pretzels will help restore the electrolytes that become depleted in the body.

“Sodium is extremely helpful in a beverage,” notes Casa. “It keeps the thirst mechanism on longer so you replace the fluids you need, conserve urine, and replenish the sodium you’re losing in sweat.” Everyone loses different levels of sodium in their sweat. Casa says a gram of sodium per liter is generally a good amount, which is the serving size found in products like Nuun and Gatorade Endurance Formula.

Now that you know the why, what, and when of eating on the run, here are some handy tips to keep in your (running shorts) back pocket.

1. Practice your fueling and hydration strategy until you perfect it

Let’s be real. No matter what the guidelines say, it’s nearly impossible for anyone besides you to know exactly what your body needs. That’s why practicing your fueling techniques on long runs prior to your race is so, so important. Figure out what your stomach can handle, what you personally like to eat and drink, and how it makes you feel. Use your long runs as trial workouts before your marathon. You don’t want to introduce anything new to your body when you toe the line, so get it used to the exact things you’ll consume.

2. Find out what will be provided on the course and after you finish.

Check the race website or contact the race host to see what food and drink will be available on the course. Many races supply water, Gatorade, and gels at different aid stations, but it really depends on the race. See if there’s a course map that tells you what’s available and where, so you can figure out what you need to carry with you versus what you can snag at the aid table.

3. Figure out how to carry your fuel.

Speaking of carrying fuel, it’s important to decide how you’re going to do that. Embarrassingly, for my first marathon I stuffed a few Gu gels in my sports bra, and after the race, I had cuts on my breasts from the hard plastic poking into my skin. Nowadays, there is running apparel with plenty of pocket options for small snacks, or you can choose to run with a hydration belt, handheld water bottle, or even a hydration pack. As Casa reminded me, carrying water and sipping it throughout has its benefits, and most packs are designed so you don’t even feel like you’re carrying extra weight.

4. Get comfortable with the idea that you really do need more carbs (usually in the form of sugar), to keep running long and hard.

The most important takeaway is simply that your body needs calories while you’re running long, especially if you’re a new marathoner, which means it’s your first time putting your body through a 26.2-mile race. Trying to run long with too few calories will likely make it tough (if not miserable) to finish the race without bonking. Plus, it will make it much harder to recover from the race, says Hogan.

For your first marathon, remember what Hogan told me: “Carbohydrates are your friend, sugar is your friend.” Don’t be afraid to consume sugar on the course, drink moderate amounts of fluids throughout, and pay attention to how your body reacts to it. Although staying fueled while running can get complex, it really comes down to tuning into your energy levels, checking in on your stomach, and getting used to the types of foods your body really craves while hitting the pavement. Whether that’s an energy gel, handful of raisins, or Snickers bar is up to you and your gut.

Source: SELF

30 NCAA Football Players Have Died During Workouts Since 2000, HBO Reveals (American Council on Science and Health)

By Erik Lief — September 28, 2018

When writing about this topic three weeks ago, our focus was mostly on the failure of high schools to protect student-athletes from potentially-fatal heat stroke.

Little did we know what the big boys – for a much longer time – were failing to do as well.

With a key preventive measure being so simple – the availability of a tub full of ice water – it defies all logic that this simple step isn’t being taken everywhere strenuous workouts are being held.

But now comes the revelation that NCAA football players are being worked so hard during practice that they’ve been regularly dying of heat stroke since the beginning of this century.

This week, the HBO newsmagazine show “Real Sports with Bryant Gumbel” reported that “since the year 2000, 30 players have died as a result of college football workouts.” The cause: heat stroke, which is completely preventable if college officials overseeing grueling practices – usually athletic trainers – can identify a stricken player’s physical distress while it’s happening and immediately have him immersed in a nearby ice bath.

Yes. Thirty dead players in 18 years, or nearly two every year.

And inevitably, when grieving parents ask what could have been done to prevent such a senseless tragedy, they are always – always, 100 percent of the time – presented with this overlooked remedy. A solution so simple, in fact, that is must make their loss even more painful.

“A tub, ice and water would have saved their child’s life. That simple,” states Dr. Douglas Casa, who is “among the leading experts of sudden death in sports,” according to correspondent Jon Frankel. “It will save their life, every time.”

And yet, having icing tubs available during practice is not mandated by the NCAA.

Even more frustrating, HBO‘s Frankel revealed that Dr. Casa, who leads the Korey Stringer Institute, a leading organization on heat stroke and its link to player fatalities, has collaborated with colleagues in drafting a list of specific recommendations that detail how these type of fatalities can be prevented.

The document, “The Inter-Association Task Force for Preventing Sudden Death in Collegiate Conditioning Sessions: Best Practices Recommendations,” was sent in 2012 to the NCAA, which has failed to enact the practices, in their entirety or even partially. The organization said the changes would be too difficult for member colleges and universities to implement.

In the meantime, college football players continue to die from heat stroke. Most recently it was Jordan McNair, a 19-year-old at the University of Maryland, whose core body temperature soared to 106 degrees during a May 29 workout while undergoing intensive conditioning that included repeated 100-yard sprints. The freshman was not placed in an ice bath while awaiting EMTs and died 15 days later.

In addition, there’s this: “The rise in the deaths during workouts has corresponded with another sharp rise,” Frankel noted, “the rise in the prominence and pay of strength and conditioning coaches.” Men in these positions have been given ever-greater influence to push football players to their physical limits, and they’ve been doing just that.

But Frankel tells us that there’s one substantial shortcoming with their professional education in this field: strength and conditioning coaches can get certified without learning anything about player health. All they have to do is pass a 13-hour course – one that includes no safety training at all.

“The deaths, at this point in time, absolutely it’s predictable. They’re going to occur. It’s disturbing. It’s really inexcusable,” said Scott Anderson, the longtime athletic trainer for the University of Oklahoma. “Without question, the role of the strength and conditioning coaches has grown over time. There should be some accountability that comes with that.”

In the wake of these 30 deaths, the NCAA has yet to mandate any safety or medical training for strength and conditioning coaches, HBO reports. And not one has ever been disciplined as a result of a player fatality during their watch.

Source: American Council on Science and Health

Football safety not scoring high enough in schools (USA Today)

You can add the name Jordan McNair to the list of college, high school and middle school players who might have needlessly died for the love of football.

A simple, well-known procedure — immersing McNair, 19, in a tub of ice water — when he collapsed at an off-season University of Maryland workout in May could well have saved his life. But it didn’t happen. This failure drew national attention to how unprepared many football programs are to keep their players safe.

The focus on concussions can obscure the deaths that continue to occur each year. Last year, 13 high school and college players died from incidents that include heat stroke, head injuries and sudden cardiac arrest.

Just two weeks ago in Crowley, Texas, Kyrell McBride-Johnson, 13, collapsed at a middle school practice and died that night. His mother told The Dallas Morning News that he was signaling for water before collapsing. An autopsy has not been completed, but the death of anyone so young raises troubling questions.

OPPOSING VIEW: We’re working to make football even safer

The simple truth is that player safety at too many schools and colleges comes in a poor second to winning. Even as the climate warms, colleges, high schools and middle schools are starting football season earlier than they used to.

Five decades ago, Notre Dame and Michigan opened their seasons on the third Saturday of September and Ohio State on the fourth Saturday. This year, spurred by longer seasons and lucrative TV schedules, all three teams played their first game Sept. 1, necessitating practices in midsummer heat. High schools and middle schools mimic the college schedules. (In 1968, the NFL season began on Sept. 14; this year, it kicks off this Thursday.)

Starting the season later could by itself reduce the number of heat stroke deaths. But even with the current schedule, schools know how to prevent potentially fatal incidents and to rescue students if they occur. In 2013, more than a dozen leading sports medicine groups and the National Federation of State High School Associations endorsed a list of best practices to prevent injuries and save lives.

Grading states against that list and other smart practices, the University of Connecticut’s Korey Stringer Institute found that 28 states have failed to put in place half the measures to keep students safe. Even the states that scored highest in the 2018 study — New Jersey and North Carolina — have less than 80% in place. California and Colorado, with the worst records, employ less than a third of them.

That’s inexcusable. If states have the wherewithal to run high school football programs, they have the wherewithal to do more to ensure that students don’t die.

Many of the policies are based on common sense and carry minimal costs. Preventing heat stroke, for example, requires players in hot weather to acclimate: no more than one practice a day, and no practice lasting more than three hours. But the majority of states don’t require this, according to Douglas Casa, the Stringer Institute’s CEO. Nor do all states require cold-water immersion tubs be on hand; a tub costs about $150, can be purchased at a hardware store, and is known to save lives. Many don’t have an emergency plan posted on the field and known to all school staff.

And just a handful require an athletic trainer on site for all “collision/contact” practices. Yes, this costs some money, but if a school can afford to maintain a football field and pay for coaches, insurance, uniforms and travel, the cost of a single staff member with medical training is not too much to ask.

More than 110 years ago, after at least 18 college players died during a single season, President Theodore Roosevelt saved the game by pressing for commonsense safety measures.

Today, everyone knows what the solutions are. It’s long past time for state athletic officials and lawmakers to act.

USA TODAY’s editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.

Source: USA Today

The Woes of Training for a Marathon in New Orleans’ Summer Heat (SELF)

Here’s how I’ve finally been making it work.

I had just returned from my first long training run and instead of giving myself a high-five, I felt more like I was on the losing end of a MMA fight. I just had my ass kicked by the steaming heat of summertime. To be honest: It’s my own fault. I jogged out the door hungry and thirsty (from the previous night’s happy hour) at 9 A.M. I wore black leggings and forgot water. Basically, I was completely unprepared.

I’m training for my first-ever marathon—I’ll be running the TCS New York City Marathon thanks to getting a free slot on the New Balance team. And sure, it will land on a (hopefully) crisp November day in New York, but my training has started in the middle of summer and I nearly passed out on my first long run. Oh, and did I mention that I live in New Orleans?

After that run, I wondered: Is it possible to train for a marathon in one of the most hot and humid cities in the U.S.?

First, I decided talk to an expert on athletic performance in hot environments, who could help me understand why my run felt so unbearable.

I reached out to Rebecca L. Stearns, Ph.D., the chief operating officer at Korey Stringer Institutewithin the department of kinesiology at the University of Connecticut, who told me that the reason heat and humidity impact us so much during exercise is because our bodies already produce a lot of heat while working out as a result of the mechanical processes happening inside our muscles and body when we use energy. (They call it “burning” energy for a reason.) Stearns explained that sweat—specifically, the evaporation of sweat off the surface of our skin—is the release of this heat and the main way the body cools itself during exercise.

When the environment around us is also very hot, it makes it harder for our bodies to cool off through this process. “[Environmental] heat becomes dangerous because it can result in a scenario that we refer to as uncompensable heat stress, where your body is gaining heat faster than it is being dissipated,” said Stearns. So even if your cooling mechanisms are working, the external heat can throw you over the edge and be too much for your body to handle.

To make matters worse, humidity in the air makes it harder for sweat to evaporate. “The more saturated (with humidity) the air is, the less availability there is for evaporation, meaning it will just drip off the skin, which doesn’t allow the body to cool,” Stearns said.

Being in New Orleans, I’m faced with both heat and debilitating humidity. In August, most locals retreat to air-conditioning or spend the day in a swimming pool. How would I ever manage to prep for a marathon?

I’d just have to get my body used to training in the heat. But how?

Luckily, New Balance hooked me up with a remote running coach, John Honerkamp, founder and CEO of J. R. Honerkamp Consulting & Coaching, who I immediately reached out to after that first run. Honerkamp said that while your body can acclimate to running in the heat over time, it can be difficult when you first start. “I always say I am pretty good at running in the heat eventually, but out of the gates I struggle,” he said. This made me feel a little bit better.

So then, how could I get my body acclimated enough that my runs feel more bearable? Stearns said that generally, it takes most people approximately 10 to 14 days of being active in the heat to get adjusted to it. Of course, this all varies by person and the intensity and frequency of activity, and different adaptations—like changes in perceived exertion, sweat rate, blood volume, and heart rate—happen at different points during that rough time frame.

Honerkamp also suggested that I start by slowing down my pace. Considering that I run a 13-minute mile, I tell him I’m wondering if I should speed walk. But he assured me that not having a time goal for my first marathon is a good thing, and that it’s more important to focus on the effort than speed.

So, for the next two weeks, I focused on slower and shorter runs. I also shopped for a new running wardrobe.

Honerkamp told me that less clothing is better in the heat, but that I should add a hat specifically for running (to protect myself from the sun) and wear sunscreen. Stearns said that comfortable and loose, light-fitting clothes will allow air movement across my skin which helps sweat evaporate.

Armed with new information, I purchased a pair of ’80s-style biker shorts and a breathable white hat, and applied broad-spectrum SPF. It’s true, clothing (or lack thereof) made a difference and after a few short runs, the heat actually started to feel less oppressive.

Before my next long run, I asked Stearns what precautions I should take to stay safe.

Longer duration exercise can provide a greater opportunity for your body’s temperature to rise to an unsafe level, Stearns said. She suggested I give myself opportunities to rest, rehydrate, and adjust the intensity depending on how I feel. These things are “all important to avoid potentially dangerous body temperature elevations.”

I asked Stearns about what warning signs may signal I’m starting to overheat. “You might start to feel hot, unusually tired, irritated, or your mental functioning might decrease (feeling confused or disoriented),” she said. The symptoms of severe dehydration are similar, so it’s important to listen to your body and take a break and rehydrate if you start to notice any of these signs.

In one of my daily training emails from Honerkamp, I got a tip to weigh myself (naked) before and immediately after the run to calculate my sweat rate. The goal is to lose no more than 0-2 percent of my initial body weight, he said. So, if I were to lose more than 2 percent of my initial body weight, that means I’m not taking in enough fluid during the run. Quick note: You don’t have toweigh yourself to make sure you’re hydrating enough. It’s just a tool that some experts suggest, and that comes in handy when you’re training for long periods of time in the heat.

But you probably don’t need to overthink it. Most experts (including Stearns) say, quite simply, that healthy adults can usually stay hydrated by listening to their bodies and drinking water when they feel thirsty. “Generally, if you have readily available fluid, drinking to thirst will keep you at a safe hydration status,” Stearns told me. It may not be the best solution, though, if you’re running in a race and only have limited scheduled breaks for water. That’s because when you’re forced to delay your fluid intake, you may end up not drinking as much as you truly need once fluid is available. A simple solution is to just bring water with you on a training run or during the race, Stearns said, so that you are able to drink whenever you feel thirsty. If that’s not possible, though, Stearns said that calculating your sweat rate like Honerkamp suggested (here’s an online tool you can use) is actually the best way to make sure you’re drinking enough when you’re working out hard in the heat with infrequent access to water.

Stearns added that while the best amount of fluid to drink will be different for everyone, generally the stomach will handle small doses of fluid at greater intervals better than lots of liquid all at once.

Also, I’d be remiss to not mention that properly hydrating also means drinking before and after a run, not just loading up on it once you’re unbearably thirsty. So, I decided to skip Friday happy hour and, instead, pre-hydrate leading up to my long Saturday run.

On the first day of August, I set out on a 10-mile run, during which I felt much more comfortable in the heat—and with the idea of slowing down and taking breaks.

I left my house at 6 A.M., and stopped at the park’s water fountains along the way for small sips of water. There were times when I felt like I was jogging in cement, but my body didn’t hate me. In fact, I had a reserve of energy and sprinted the last block home. Did I mention that the heat index was at 109 degrees?

Post-run, I celebrated with lunch beers. Of course, less alcohol is better when you’re trying to keep yourself fully hydrated, but I figure that that doesn’t mean I can’t enjoy a drink or two when I really want it. (Keep in mind that I’m not a doctor or a dietitian and I’m only making choices for myself. If you’re wondering if you can drink after you have a tough workout, check with your doctor.)

By my third or fourth long run, I was way more comfortable in the heat and kept my hydration in check. (I’m sure that my improving cardiovascular fitness also plays a part in making my runs feel less miserable.)

I’ll be honest, after most long runs, I still want nothing more than to dunk my body into a cold pool of pamplemousse La Croix and sleep for an hour—but the long distance feels doable and occasionally enjoyable. Plus, there’s always happy hour at the finish line.

Source: SELF

As Temperatures Soar, High School Football Coaches Are Cracking Down On Safety (Hartford Courant)

With temperatures surpassing 90 degrees and potentially reaching record levels this week, many high school football coaches are taking precautions to ensure player safety.

“My attitude is, don’t put any kid in danger,” said Harry Bellucci, the coach at HartfordPublic. “If there’s some shade in the area, do some work in the shade. It’s not worth anybody’s health to be out here when it’s like this.”

Hartford Public, as well as teams across the state, will need more than just shade this week with temperatures expected soar. Gary Lessor, assistant director of the weather center at Western Connecticut State University, said air quality could also being an issue. Lessor said actual air temperatures in the area around Hartford and Enfield could reach 96 degrees with a heat index close to 105 on Tuesday. Wednesday might be even warmer, Lessor said.

To avoid the extreme heat, Bellucci, who has coached for more than 38 years, said he starts practice in the early evening instead of midday. If necessary, the team will practice indoors to avoid the sun. Bellucci said players are allowed to stop practicing for water breaks whenever needed and that conditioning is done without pads and helmets if temperatures are too high.

While heat is often a concern, there is increased awareness following the death of University of Maryland football player Jordan McNair. The offensive lineman died in June, two weeks after collapsing during a team workout. McNair suffered a heatstroke during the workout. Members of the Maryland athletics staff are on administrative leave during an external review.

“When that happens, it makes me even more aware of those circumstances of the heat, of making sure that you’re watching kids,” Bellucci said. “Making sure that you’re watching for signs of heat exhaustion or heatstroke. It raises your awareness level after you see something like that.”

Glastonbury coach Scott Daniels is taking similar precautions. He’s giving players longer breaks between reps, and he’s advising players to hydrate and to dump water on their heads to cool off.

The Tomahawks practice on both turf and grass. Daniels said that he and his staff will test the turf before players go on it. If it’s too hot to touch, he’ll have the players work out on grass.

In Southington, coach Mike Drury has been in contact with the athletic trainers before the potential heat wave. The Blue Knights wore full pads Monday. On Tuesday, they’re likely to go just uppers.

“Whatever the trainers, the professional staff say we should do, we’re going to do,” Drury said. “We’re out here to win and get better, but also, we want to be safe in the meantime.”

The Korey Stringer Institute, which is on UConn’s campus, provides research and education on safety and sudden death prevention to athletes and coaches around the country and is named after the former NFL player who died after an exertional heatstroke following a Minnesota Vikings practice. The institute’s CEO, Doug Casa, said there are preventative measures teams should take from staying hydrated to avoiding practicing during the highest temperatures. Casa added that more can be done, including having cold water immersion tubs and instituting an emergency action plan. Maryland did not have cold water immersion tubs available.

Casa has been critical of the Connecticut Interscholastic Athletic Conference, which governs high school athletics in the state, because it does not require either.

The CIAC, which could not be reached Monday, previously told The Courant it allows school districts to impose requirements.

“We’re not an association that imposes requirements such as trainers at every single event, or requires certain [weather] measurement systems, because frankly we think that districts are best able to decide what’s appropriate for them and, truthfully, what they can afford,” then-CIAC executive director Karissa Niehoff said, adding that the CIAC requires education for parents and student-athletes on concussions and cardiac arrest.

According to Daniels, Glastonbury has taken matters into its own hands. All preseason, a cold water immersion tub was up in the locker room for players. He, the athletic director and principal are constantly in contact and checking the heat index level. Casa said some other schools have followed suit.

Bellucci said when he was a player in the early 1970s, water breaks weren’t a thing, and they’d be running around in the upper 90s with full pads and helmets on. Even then, he thought something wasn’t right. Daniels echoed Bellucci’s thoughts on the way the game used to be played.

“Our player safety is our No. 1 concern, period,” Daniels said. “The old school days of running through doubles and all that stuff — those days are over.”

Source: Hartford Courant

‘His Entire Body Was Shutting Down.’ New State Rankings Show Gaps in High School Athlete Safety (TIME)

By mid-afternoon on August 1, 2017, the temperature in Stockton, Calif. was at least 105 degrees. Thirteen-year-old Jayden Galbert complained to his mother, Shynelle Jones, about the heat, but didn’t want to skip preseason football practice and hurt his chances of making the freshman football team. Instead, he showed up, pushed himself to participate, and then collapsed on the field. “He started vomiting and he was shaking,” Jones says. “He couldn’t see. He was trying to focus, but he couldn’t.” Jayden was eventually airlifted to UC Davis Medical Center, where he was diagnosed with exertional heat stroke, which in turn led to rhabdomyolysis, a dangerous condition in which muscle breakdown can cause kidney damage. “His entire body was shutting down and I almost lost him,” Jones wrote on Facebook shortly afterwards.

At the time, California’s high schools were not required to follow national best practice standards for preventing and treating heat stroke — guidelines that include having cold water tubs on hand in case players overheat, among other cooling treatments. And they’re still not, according to a new study conducted by the Korey Stringer Institute at the University of Connecticut that ranks all 50 states and the District of Columbia on whether they’ve implemented key sports safety policies that can prevent serious injuries and deaths of high school athletes. California ranks nearly last on the list and hasn’t implemented any of the best practice policies for preventing heat stroke, but many other states also fared poorly.

The policies included in the study cover “the four Hs: head, heart, heat and hemoglobin,” which together account for 90% of all sport-related deaths, says Samantha Scarneo, vice president for sport safety at the Korey Stringer Institute. But these policies aren’t uniformly implemented, which leaves many of the nation’s high school athletes at risk as students head back to school. No one knows just how many student athletes have been hurt or died in each state due to the lack of implementation, because those numbers are not tracked.

“They’re not sitting back and waiting for a kid to die to make these changes.”

In California alone, there were more than 808,000 high school sports participants during the 2017-2018 school year, according to information released earlier this month by the California Interscholastic Federation. The state has several important measures in place, like requiring automated external defibrillators (AEDs) for cases of sudden cardiac arrest, and detailed return-to-play policies for players who are diagnosed with a concussionBut California also has the dubious distinction of being the only state that doesn’t regulate athletics trainers in any way. Trainers are often the ones to make calls about pulling a kid off the field or prescribing treatment. Despite several past legislative attempts, “the biggest concern in California is that the state does not require athletics trainers to be licensed,” Scarneo says. “Without any type of knowledge of who they are and what their training is, it makes it really difficult to actually trust that they know what they’re doing.”

States can look to New Jersey as a role model, which ranked No. 1 in the study and which Scarneo called “one of the most proactive states in the nation.” New policies enacted in New Jersey in the past year require cold-water immersion tubs, detailed steps for return to play, and strength and conditioning limits throughout the year. “They’re not sitting back and waiting for a kid to die to make these changes,” Scarneo says.

Overall, 21 states have made improvements since 2017 on policies in the key areas of sudden cardiac arrest, traumatic head injuries, exertional heat stroke, appropriate medical presence at games and practices, and emergency preparedness, Scarneo says. However, no state has a perfect score: even New Jersey only received 79.03% (by comparison, California scored 26%).

One reason states vary so widely on student-athlete safety policies is that there isn’t one overall group that can require them. Unlike at the college level, where the National Collegiate Athletic Association oversees policies for its member schools, the National Federation of State High School Associations (the umbrella organization for the state high school associations) has no such authority. (Though there are still problems in college sports — the recent heat stroke death of Maryland offensive lineman Jordan McNair is under ongoing investigationFive Division I football players have died of heat stroke since 2000.)

But at the high school level, adoption of the best practice guidelines is left to each individual state. Some policies are enacted by the state’s high school association and some by its legislature, with the decentralization of oversight leading to tremendous variation that often leaves out important best practices.

There is some hope: since concussions have become a focus of public concern, lawmakers jumped to action, and it’s making a difference. Every state now has some type of a concussion law, which generally requires concussion education, immediate removal from play if it’s suspected that a player has a concussion, and medical clearance before that athlete can play again. A study last fall found a significant drop in the number of repeat concussions after the laws had been in effect for a period of time.

There’s also research showing that state heat acclimatization policies work. A study released by the National Athletic Trainers’ Association in June found that high-school football players were 55 percent less likely to be diagnosed with exertional heat illness (which includes heat stroke as well as heat exhaustion and heat cramps) during the preseason in states with guidelines for this timeframe.

To evaluate each state’s sport safety policies, the Korey Stringer Institute used the best practice guidelines established in 2013 by a task force representing the nation’s leading medical and sports safety experts. The institute, named for the Minnesota Vikings player who died of heat stroke during training camp in 2001, was one; others included the National Athletic Trainers’ Association, American College of Sports Medicine, American College of Emergency Physicians, and the National Federation of State High School Associations.

“It is unacceptable to me that there are still high schools in the United States that don’t have AEDs and also unacceptable to me that there are high schools that don’t have a comprehensive emergency response plan for cardiac arrest on their campus,” says Dr. Jonathan Drezner, a co-author of the 2013 recommendations on behalf of the American Medical Society for Sports Medicine, who also directs the Center for Sports Cardiology and is a professor of family and sports medicine at the University of Washington.

The results of a recent study Drezner co-authored show that there were about 50 cases per year of sudden cardiac arrest in high school athletes between July 2014 and June 2016, although Drezner believes the actual number is likely higher. “School staff and coaches need regular (at least annual) reminders on where the AEDs are located, when to use them, and how to recognize sudden cardiac arrest,” he wrote in an email.

“It is unacceptable to me that there are still high schools in the United States that don’t have AEDs.”

But another author of the 2013 best practices questioned whether ranking the states will be effective. Dr. Joel Brenner, medical director of the sports medicine program at Children’s Hospital of The King’s Daughters and an associate professor of pediatrics at Eastern Virginia Medical School, who co-authored the guidelines on behalf of the American Academy of Pediatrics, thinks it would be far better for each state to evaluate its own progress, given that circumstances and resources vary, instead of being rated and compared. “If the purpose is to see what’s being done and what’s not being done and help the states, I’m not sure a public ranking is going to be helpful,” says Brenner.

Also, he points out, there may be state policies that help protect players but aren’t reflected in the rankings, if they weren’t explicitly part of the 2013 best practice recommendations. For example, California has in-season limits on the number of full-contact football practices and a ban during the off-season, but didn’t receive points for these in KSI’s study.

Even though the rankings don’t represent the whole picture of what’s being done in each state, Drezner believes that requiring these policies at the state level is ultimately the right approach. “When we just raise awareness and we provide help and we do all of these other things, it doesn’t impact change enough,” he says. “For the state associations that have the authority to be decision makers, I think the ranking is working,” he says. “It’s pushing people to do more and come closer to the policy guidelines. We’re all working toward the same goal.”

In the meantime, there are often long-term impacts for athletes like Jayden. A year later, he still regularly goes to therapy for PTSD from the ordeal. And although he’s largely physically recovered, he still walks with a limp and has residual pain in his legs from the rhabdomyolysis he suffered. “Some days are better than others,” his mother says.

Jayden stopped playing football for the first time since he was 6 after the injury, but still hopes to play again at some point in high school. But after what he went through — and the environment Shynelle knows he’d be going back to — his mom has already made up her mind that the answer is no.

Source: TIME

Researching Heatstroke In Athletes (NPR)

The death of a University of Maryland player is among a number of training deaths in college football recently. Melissa Block speaks with Douglas Casa who has researched the causes.

MELISSA BLOCK, HOST:

In June, a 19-year-old freshman on the University of Maryland football team died in a hospital of heatstroke. Jordan McNair had collapsed two weeks earlier after running long sprints during training. His body temperature when he arrived at the hospital was 106 degrees. The university has opened an investigation, and head coach D.J. Durkin has been put on administrative leave. Many blame an abusive, toxic coaching culture at the university for McNair’s death. And it’s not just Maryland. According to the National Center for Catastrophic Sport Injury Research, a dozen college football players in addition to Jordan McNair have died just from heatstroke since 1995. That figure is higher if you include things like sudden cardiac arrest and asthma attacks. Douglas Casa studies heat illness and sudden death in sport at the Korey Stringer Institute at the University of Connecticut. And he joins me now. Mr. Casa, welcome to the program.

DOUGLAS CASA: Yeah. Thank you very much for having me.

BLOCK: And what do you make of the case of Jordan McNair? This was an offseason practice. This was not during a game.

CASA: Yeah. That is correct. It is during a collegiate conditioning session, which is really the place where we’re having the most problems right now dealing with sudden death in sport.

BLOCK: According to reports that have come out, when Jordan McNair had trouble standing after these long sprints, one of the trainers reportedly yelled, drag his ass across the field. Is that – does that speak to a culture that you find very common in college football?

CASA: Thank God that’s not common. But, you know, did that potentially delay the appropriate care? It may have. And we know in the world of exertional heatstroke that when you cool somebody down to under 104 degrees within 30 minutes, survivability is 100 percent in all the people that have ever been studied. So it’s a complete shame when you don’t have the correct, you know, treatment being done for the person on the field at that time.

BLOCK: The institute where you work is named for Korey Stringer. He’s the NFL lineman. He died of heatstroke in 2001 in a workout. And since then, as I understand it, there has been no NFL player that’s died of heatstroke. So what is the NFL doing that college football apparently isn’t?

CASA: There’s probably a few things to consider that I would say are things to consider to model. One is the NFL, after the death of Korey Stringer, thankfully, made sure that the best practices were being utilized by all 32 teams with the prevention, recognition and treatment of exertional heatstroke. So that’s obviously helpful. Second, the players, in conjunction with the NFL, have developed appropriate policies to make sure that they stay safe. So in a sense, the players have rights in the NFL. And the players have no voice and no rights in college football. College conditioning coaches and college football coaches can literally do anything they want, you know, during a conditioning session. But in pro football, the players and the teams, you know, work together in unison, I think, a lot better.

BLOCK: I’ve seen the term used in terms of how these workouts are conducted at the college level – this term irrational intensity workouts – in other words, pushing people well past the point of anything being helpful or useful in their training.

CASA: That’s correct. Back in 2012, we convened a task force. And all the top sports medicine organizations in the country attended and endorsed the document that was called “Preventing Sudden Death In Collegiate Conditioning Sessions.” But the NCAA did not endorse that document. If they had endorsed it, I’m sure we would not be having this conversation right now. And we wouldn’t have had a lot of those deaths that we’ve had in the last six years. But they have not done enough to make collegiate conditioning sessions of more a controlled environment. Right now, it’s the Wild West.

BLOCK: I’m thinking about a column that Sally Jenkins wrote in The Washington Post in which she essentially accused college coaches of working these kids to death on the field. Do you agree?

CASA: Yeah. In lot of cases, that’s true because you’re doing workouts that are not intuitive for what you need at that time. I’ll give you a great example. In 2013, the University of Iowa – in the first day back in January when they were doing a workout, they had the football team do 100 squats. And they had 13 people hospitalized within a day. Those players could have done 100 squats if they had trained for it properly over a few weeks but not on the first day back. So that happens across the country all the time. But the NCAA needs to make the big steps to make some big policy changes so that we can protect all of these college athletes in football and in every sport.

BLOCK: That’s Douglas Casa. He’s CEO of the Korey Stringer Institute at the University of Connecticut. Thanks so much for speaking with us.

CASA: Thank you – pleasure to be on.

Source: NPR

Prehistoric college football coaches are killing players. It’s past time to stop them (Washington Post)

“They get to dictate these things, and we get to keep burying athletes until we make definitive changes to the culture,” said Dr. Douglas Casa, a kinesiologist who serves as CEO of the Korey Stringer Institute at the University of Connecticut.

Since 2000, there have been 40 athlete fatalities in conditioning sessions in multiple sports across the NCAA, yet not a single death on the field, according to Casa. This despite the fact that schools have all the education and tools to prevent it: Heatstroke exertion is 100-percent survivable with a thermometer and some ice. The NFL has eliminated it altogether and to its credit continues to consult with the Stringer Institute on research and best practices to prevent sudden deaths. The NCAA, on the other hand, has remained lethally antiquated. Unlike NFL players, collegians have “no voice, and no rights,” Casa pointed out. McNair was forced to run 10 sprints of 110 yards, until his body temperature was 106. It was a nonsensical workout that had zero football relevance and demonstrated nothing about his character except that he was willing to work himself into a coma for fear of punishment from an all-powerful authority figure. “It’s a totally unregulated environment,” Casa said.

New Jersey boasts nation’s top health and safety policies for student-athletes (USA Today)

As student-athletes across New Jersey resume practice for fall sports this week, they can do so with confidence knowing the statewide athletic association of which their high schools are a member boasts the country’s most comprehensive health and safety policies.

The New Jersey State Interscholastic Athletic Association is the best in the nation in the area of managing injury risk to high school student-athletes, according to the Korey Stringer Institute’s second annual national ranking of statewide athletic associations.

Korey Stringer Institute researchers found many states are not fully implementing safety guidelines intended to protect student-athletes from heat stroke, sudden cardiac arrest and other potentially life-threatening conditions that may be prevented with proper policies. The institute, housed at the University of Connecticut, ranked states according to the extent to which they met a series of evidence-based best practice guidelines.

The NJSIAA, which has long been a leader in implementing and adopting safety protocols, improved its ranking from fourth to first out of 51 statewide athletic associations, according to the institute’s 2018 High School Sports Safety Policy Rankings.

New Jersey wrested the top spot from North Carolina, whose state university runs the National Center for Catastrophic Sports Injury Research. Last year, the Korey Stringer Institute determined the North Carolina High School Athletic Association had the most comprehensive health and safety polices in place for secondary school athletics.

Among the statewide athletic associations governing the nation’s 7.8 million student-athletes, North Carolina was ranked second this year, followed by Massachusetts (third), Kentucky (fourth) and Florida (fifth).

“We are very encouraged by the positive changes that have occurred across the nation,” said Douglas Casa, CEO of the Korey Stringer Institute and a professor of Kinesiology at the University of Connecticut who is one of the nation’s foremost authorities on the prevention of exertional heat stroke and other serious injury in sport. “However, we need to continue to be vigilant. We are fully committed to working with individual states on adopting these important guidelines.”

Source: USA Today