It’s hard to believe, but preseason practice for high school sports will be starting soon. This is an exciting time of year for athletes, coaches, and fans alike. Unfortunately, even the fittest young athletes can suffer injuries (or worse) during preseason training and competition during the season. Among the biggest concerns are the rigorous training schedule, exercise in the heat, and head injury. Fortunately, there are steps that coaches and parents can take to ensure the safety of young athletes during practice and games. This is the topic of my Health & Fitness column in the Aiken Standard this week.
Preseason practices typically emphasize conditioning—getting athletes in shape for the season. While coaches may expect players to arrive at practice already in shape, the reality is that many athletes still need to improve their strength, endurance, and flexibility. Preseason conditioning usually consists of vigorous exercise designed to improve fitness rapidly. Many coaches also use this time to “toughen up” the players or to weed out those who are not suited for the sport. For most young athletes this approach is safe and effective, but there is a risk of injury or, more rarely, collapse or death with intense training.
The risk of injury or death is made worse by the high heat and humidity that is common at this time of the year. For this reason, many coaches hold conditioning sessions in the morning or evening, when it is cooler. Even then, exercise alone poses a challenge to maintain a normal body temperature. Adding equipment such as pads and helmets for football players increases the risk for hyperthermia, which is even greater in the sun on a hot day. A high sweat rate makes dehydration more likely, so frequent water breaks are essential. Unfortunately, some coaches may be tempted to limit water breaks in a misguided effort to build toughness. This is absolutely inappropriate! Dehydration and hyperthermia can lead to heat stroke, which can be deadly.
This topic was covered in an NPR interview with Dr. Douglas Casa of the Korey Stringer Institute at the University of Connecticut in Storrs, Connecticut. You can also watch a video in which Dr. Casa discusses hydration and preventing heat illness in young athletes.
Another concern, especially among football players, is the risk of concussion. It turns out that concussions are more common than previously thought in football players and repeat concussions, even “minor” ones, can cause long-term problems. New recommendations for all levels of football call for a better assessment of athletes who suffer head injuries and prevent injured athletes from returning to play. This is important during practices as well as games. While the focus is on football, nearly all sports that involve contact have a risk of concussion.
The topic of concussion is addressed in this video of a lecture given by Dr. Kevin Guskiewicz, Professor of Exercise and Sport Science at UNC-Chapel Hill and MacArthur Foundation “Genius” award winner.
These risks can be reduced by good year-round conditioning, altering practices to reduce heat injury risk, education to reduce the likelihood of concussion, and careful assessment when a concussion is suspected. These responsibilities fall on the coaching staff and the certified athletic trainers who should be present at all practices and competitions. Certified athletic trainers have the knowledge and skills to assess environmental conditions and monitor athletes for signs of heat stroke, concussion, and other injuries. You can learn more about sports injury prevention and the role of certified athletic trainers in keeping young athletes safe from the National Athletic Trainers Association (NATA). All athletic trainers working in our area are certified by the NATA.
All players should also undergo a physical exam prior to participation in sports. The risk of injury can be further reduced by making sure all players are in shape prior to the start of practice. Coaches should find incentives to motivate their players to build strength and endurance in the off-season. Parents should make sure their young athletes are prepared for the physical requirements of their sport and aware of the risks of participation.
While injury is always possible, the risks can be minimized through careful planning and communication among coaches, parents, athletic trainers, and the athletes themselves.