Now that summer practices are over and football games are being played across the country, concerns for heat illness are dropping. It is still hot in many areas, especially the South. It is important that athletic trainers and team physicians who cover high school and college football stay vigilant to the possibility of exertional heat stroke in high school football.

A majority of recorded deaths from exertional heatstroke in football have occurred in the south. Should guidelines regarding summer football practices be adjusted depending on the location? A new study looking at exertional heat illness during high school football practices at 12 high schools in North Central Florida offers insight into that question.

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Heat stroke in high school football is a real possibility.

Number of heat illness episodes

Athletic trainers at the 12 schools treated a total of 57 athletes for heat illness at in the one season studied.70% had heat cramps, while about 23% had heat exhaustion and 7% suffered heat syncope. No cases of exertional heatstroke occurred at those schools that season.

Weather conditions

As you might expect, the temperatures, humidity and the mean wet bulb globe temperature (WBGT) were highest in August and dropped gradually over September and October.

Correlation between heat illness and conditions

The rates of episodes of exertional heat illness were highest in August and dropped in September and October.

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Correlation between heat illness and practice length

Many practices in August involved practice sessions that lasted longer than the three hours recommended by state guidelines. Athletes in these longer practices were 9.84 times more likely to suffer a heat illness episode than athletes in shorter practices. In fact, of the 28 practices that exceeded three hours, over 96% of them were held in conditions that fell into the high- or extreme-risk categories.

Wide receiver on grass football field

Take home point about heat stroke in high school football

This data specifically applies only to North Central Florida, but it does demonstrate the danger of summer football practices held in hot and humid conditions. It will be useful to gather similar data in other states so that athletic trainers and physicians can properly create acclimatization guidelines and adjust for practice lengths and environmental conditions. Still, coaches and teams’ medical staffs must use extreme caution during summer practices to prevent heat stroke in high school football.

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Tripp BL, Eberman LE, Smith MS. Exertional Heat Illnesses and Environmental Conditions During High School Football Practices. Am J Sports Med. Published online ahead of print August 11, 2015.