Facing Changes

Whether by choice or by rule, coaches at all levels are altering preseason practice schedules to help their players beat the heat while still getting ready for the opener.

By R.J. Anderson

R.J. Anderson is an Assistant Editor at Coaching Management. He can be reached at: rja@MomentumMedia.com.

Coaching Management, 14.4, April 2006, http://www.momentummedia.com/articles/cm/cm1404/changes.htm

Few things worry Greg Nesbitt, Head Coach at Hickman (Mo.) High School, as much as the effect of heat on his players during preseason practices. After enduring a number of scares over the years in which he had to take overheated and underhydrated players to the emergency room, Nesbitt decided in 2000 that it was time to rethink his preseason philosophy.

Since that time, Nesbitt has approached the preseason with an eye toward acclimatizing his players to the heat, their uniforms, and the rigors of rounding into game shape. Nesbitt, whose team won the 2004 Missouri 5A state title, has used what he calls a “common sense” approach to practices: fewer two-a-days and more pads-free practices to help players get used to exerting intense effort in the heat.

This approach is similar to what college coaches have done following sweeping changes—including a ban on consecutive days of double sessions and an increased acclimatization period—made to NCAA rules governing preseason practices three years ago. Now it appears that high school coaches may soon face similar restrictions. The American College of Sports Medicine (ACSM) recently recommended stricter controls on preseason high school football practices, and the University Interscholastic League (UIL), which regulates most high school football in Texas, has adopted many of those recommendations beginning this summer.

The details and timing will vary greatly by state, but it appears likely that rules to protect players from the danger of heat illness will only get stricter. Coaches are left to wonder: What kind of changes will be made? Why are these changes necessary? And how can I best prepare my team while keeping my players safe?

Addressing a Hot Topic
Heat illness has received plenty of media attention over the last few years—especially since 2001, when Minnesota Vikings tackle Korey Stringer died after suffering heat exhaustion in the team’s second preseason practice. Despite many newspaper articles and TV reports chronicling Stringer’s death and the dangers presented by heat illness, young athletes continue to perish. Since 2003, heat stroke has claimed the lives of at least four high school players. During the 2005 preseason, two severe incidents, one resulting in death, occurred. And in nearly every case, the incidents took place during the first couple of practices, when most players hadn’t yet reached prime physical condition.

Michael Bergeron, Assistant Professor at the Medical College of Georgia and a fellow at the ACSM, grew tired of reading about young athletes losing their lives to heat illness and decided to do something about it. As chair of an ACSM roundtable of sports medicine experts, Bergeron was the primary author of a paper recommending new standards for high school preseason practices that appeared in the August 2005 issue of ACSM’s journal, Medicine & Science in Sports & Exercise.

According to the ACSM article, “The overwhelming majority of serious heat illnesses occur in the first four days of preseason football practice (especially on the first and second days), when players are not acclimatized to the heat, the intensity/duration of practice, or the uniform.” Similar to NCAA rules, the ACSM recommendations would prohibit two-a-days during the first week and multiple workouts on consecutive days after that. The ACSM’s guidelines also include recommendations to:

• Limit single on-field practices to no more than three hours, including conditioning drills.

• Limit total practice time for multiple sessions to no more than five hours a day.

• Require a minimum of three hours between sessions.

• Prohibit wearing full uniforms and pads, which can increase the risk of heat illness, until day six.

• Prohibit full-contact practices until week two.

Since its release in August of 2005, the ACSM’s message has caught the attention of high school association officials at both the state and national levels. Jerry Diehl, the National Federation of State High School Associations’ (NFHS) Assistant Director and staff liaison to the Sports Medicine Advisory Committee, says that management of heat illness is a point of concern for his organization. Along with re-evaluating its current guidelines, which do not include any language pertaining to two-a-day practices or session length, the NFHS is examining the ACSM’s recommendations, Diehl says.

Bergeron hopes the ACSM proposals will gain traction and that regulations will find their way onto high school fields within the next couple of years. “Hopefully with the NFHS’s support, we can get a lot more attention for this so that the guidelines can make an impact,” says Bergeron. “We’re hoping to make the guidelines available on the NFHS Web site, and we’re working on a poster that would include an abbreviated version of the recommendations that could be sent directly to every state association or the schools themselves.”

Bergeron says since the NCAA adopted its guidelines, there is evidence of players losing less practice time due to heat-related problems. “There’s no reason to think the same thing wouldn’t happen at high schools,” he adds.

After examining the dangers of heat stress and dealing with heat-related fatalities, some state associations are taking steps to address the issue. In Texas, where a player died of heat stroke in 2004, the UIL recently adopted some of the ACSM’s recommendations. Starting this preseason, Texas high schools will adhere to the three- and five-hour limits on practice times. “We’ve also added mandatory time breaks between two practices if they are held on the same day,” says Mark Cousins, Athletic Coordinator of the UIL. And according to Cousins, the UIL is considering more preseason changes within the next couple of years.

The Early Danger
To grasp the intentions behind the ACSM’s recommendations, Bergeron feels it’s important that coaches take the time to consider the risks and scenarios that prompt a player to collapse or die. “It’s not just the heat,” Bergeron explains. “It’s acclimatizing to the intensity and duration of practices, as well as the uniform and all of the protective gear that they wear. When you read about somebody being taken to the hospital or dying, usually it’s on the first day or two of practice and they’ve gone three hours or even six hours during those first few sessions wearing full gear—including helmets and pads.”

Mike Ferrara, an athletic trainer and a kinesiology professor at the University of Georgia, is entering the final year of a four-year study examining heat illness in college football. Athletic trainers from 28 Division I and III teams record heat injuries on a day-to-day basis along with the environmental conditions surrounding the injuries.

Since beginning the study in 2003, Ferrara has noticed a few trends from his initial data analysis. One is a spike in heat-related injuries on the second day of preseason. “They go through their first day without too many problems, then on day two we see a bit of an upward trend in the number of heat illness cases,” says Ferrara. “There is an increase on day two, then it comes down on days three, four, and five.”

Ferrara has also noticed a gradual increase in the number of heat-related illnesses during the second week, when teams are allowed to start full sessions with pads as well as two-a-days—though not on consecutive days. “There’s a gradual uptick to about day 12, then it goes down,” says Ferrara, who thinks that the decrease is a result of players getting used to practicing in the heat and wearing all of their protective equipment.

Bergeron says these figures should give pause to coaches who like to use preseason practices to weed out the weak. “Coaches have to recognize that their players need to be gradually introduced to the environment, the intensity and duration of the workouts, and the uniform configuration in a very progressive manner,” says Bergeron. “Unlike in college football, where athletes tend to be better conditioned when they begin camp, high school kids often come in fairly unfit. When you take somebody who’s not fit and not acclimatized to the heat, and you give him a hard, long workout in a uniform, or even a partial uniform, you’re asking for trouble.”

The effects of helmets and pads should not be overlooked. Bergeron says it’ll take more research to pin down the thresholds of weather and uniform conditions that trigger heat-related injury. But it’s already clear, he says, that coaches need to understand that football equipment can dangerously compromise the body’s cooling system and needs to be gradually introduced in preseason. “I’m not sure that people really appreciate the degree of stress that a uniform and helmet put on a person,” he says.

Nesbitt agrees. In Missouri, the only equipment that can be worn for the first three days of practice is a helmet. “We take it a step further,” says Nesbitt. “We might wear helmets the first day, then only wear shorts and T-shirts on the second day or during the second session of a two-a-day so their bodies can adjust to the temperature without overheating.

“And we always tell our players to take off their helmets between drills to help cool down,” says Nesbitt. “We feel that if we can get them through those first three or four days, the odds are in our favor that they’ll be better adjusted to the heat and minimize their chance of injury.”

Avoiding Double Trouble
Coaches from the high school to professional level are also approaching preseason scheduling differently than their predecessors. In Atlanta, Falcons Head Coach Jim Mora begins camp with a single afternoon practice, followed by a double session on the second day, then alternates single-double-single sessions each day after that. Mora also tries to avoid holding padded workouts during both parts of a double session.

Mora is not alone in his two-a-day cutbacks. An informal poll conducted by ESPN.com concluded that two-thirds of NFL teams have eliminated consecutive two-a-days. The reasons behind the changes include ramped up off-season conditioning programs and a desire to reduce injuries.

“It’s just being smarter in managing your time, getting things accomplished when you’re on the field, then getting your players out of the sun,” Mora told ESPN.com. “Sure, it’s a break from tradition. But everything changes. When you get to September, you don’t want a team that’s already burned out because of what it did in July and August.”

As Mora points out, the benefits of changing the preseason routine may go beyond reducing the risk of heat illness. By gradually bringing his players along and getting them used to both the heat and the intensity of practice, Nesbitt has experienced fewer problems with strains and sprains during those first couple of weeks.

However, Nesbitt says he didn’t always operate his preseason with such restraint, and before scaling back on two-a-days in 2000, such injuries were a big hindrance to his preseason preparation. “I used to come out and bust you like the dickens that first day and work you till you dropped,” says Nesbitt, the 2004 Missouri 5A Coach of the Year. “Then, invariably, we’d have injuries. We’d have a couple of hip flexors, a groin pull, and maybe a bad hamstring or two. There’s nothing worse than having eight or 10 guys standing on the sidelines during that first week of practice.

“Now we place an emphasis on acclimatizing to the conditioning as well as the heat,” he continues. “We start a little slower, but by the middle of the second week, we have it completely ratcheted up and are doing full-fledged conditioning sessions at the end of practice.”

Nesbitt says that since eliminating consecutive two-a-days and implementing a stricter preseason acclimatization period, the number of heat-related episodes has dramatically decreased, and his team has not suffered physically. “I haven’t noticed any drop in our conditioning and preparedness since we did away with consecutive two-a-days,” he adds. “We’ve been ready and prepared in our openers. The practice or two that we take off certainly hasn’t gotten us behind, and I think the reduced practice time has been well offset by a decrease in injuries and by the freshness of our players.”

Learning From Experience
High school coaches seeking examples of how to adjust their preseason practice routines can also look to their colleagues at the college level. Since NCAA restrictions on preseason practices went into effect in 2003, college coaches have been working to find the right formula to prepare players for competition. While most coaches have their routines dialed in at this point, it hasn’t always been smooth sailing.

Steve Mohr, Head Coach at Trinity University, a Division III school in San Antonio, Texas, says that the rule changes caught him off guard initially and that the 2003 preseason was a bumpy one for his team and his staff. “We found in the first year that we had more non-heat-related injuries with the restrictions than before,” says Mohr. “I don’t know if it was a fluke, but for some reason it took a long time for our kids to attain optimal conditioning.”

One reason for that, says Mohr, is that many players didn’t come to camp in adequate shape. In anticipation of the five-day acclimatization period, which banned two-a-days, protective equipment, and practicing longer than three hours, Mohr says it’s possible that his players may have slacked off a bit in their summer conditioning, even if subconsciously.

Mohr and his staff remedied that problem by taking a new approach to the summer workouts they gave the team. “Before the 2004 preseason, we stepped up the conditioning component of the workouts that we gave them to take home in the summer,” says Mohr. “We asked them to do more running and I think it paid off. Probably 80 percent of the kids followed it pretty diligently, came back in a lot better shape, and helped start our season on a much better foot.”

With fewer two-a-days and an overall crunch on practice time, coaches across the NCAA were forced to change the structure of their preseason workouts. “The most obvious thing is that we have many more meetings and get the X’s and O’s of our offense and defense done on the chalk board,” says Scot Dapp, Head Coach at Moravian College. “For the multiple sessions, we vary them so that we break the day. We’ll have a day with a couple of two-and-a-half-hour practices, but we might follow it up with a day consisting of a two-hour practice, then a one-hour practice, then wrap up with another two-hour session. To me, it’s all about utilizing every moment you’re allowed with your guys.”

One adaptation that Mohr and Dapp both made was placing more emphasis on weightlifting during the preseason. “Before, many coaches would have their players work hard in the weightroom coming into the start of preseason camp, then cut back on their lifting once camp starts because there isn’t as much time and the players are worn down,” says Dapp. “As a result, players usually lost strength during that time. Now, we can schedule weight training sessions on days we don’t have two-a-days, which allows players to maintain their strength throughout the course of camp.”

While spending less time on the practice field bothers both Mohr and Dapp, Nesbitt feels that the reduced preseason workload has really helped his high schoolers. “I didn’t see any disadvantage to how we’ve changed our preseason approach,” says Nesbitt. “When I first made the changes, I was a little concerned because I knew I would end up with three or four fewer practices than opposing coaches.

“But I’ve realized that if you have an organized system, eliminating three or four practices isn’t going to make a difference in winning or losing if you’re practicing smart and hard,” Nesbitt adds. “To me, it’s all about quality over quantity.”

By running organized, fast-paced practices, and giving his players more recovery time, Nesbitt is able to stay away from the emergency room and prepare his team for the season. “Believe me,” he says, “by the time our first game rolls around, our kids are in shape—just ask our opponents.”

SIDEBAR: Harping On Hydration
A leading contributor to heat illness injuries, including cramping, is dehydration. And it often results from players not sufficiently restoring their hydration levels between workouts.

Michael Bergeron, Assistant Professor at the Medical College of Georgia and a fellow at the American College of Sports Medicine (ACSM), says his studies have shown that during a two-hour practice players typically lose at least one percent of their body weight despite consuming two liters of water during that time. He says that in most cases, the players failed to replace that weight before the next practice session.

“We found that athletes are often dehydrated even before that first practice,” says Bergeron. “Then they come back the next day, and it’s even worse. I can take any group of athletes in any sport and prior to a practice or a game more than half of them are dehydrated—and to a fairly significant level.”

So how do you make sure your players are rehydrating adequately? Greg Nesbitt, Head Coach at Hickman (Mo.) High School, says it’s not enough to simply have water and sports drinks available throughout practice and to weigh athletes before and after each session. Nesbitt feels coaches need to preach a message that is repetitive, reviewed, and starts at the top. “We harp on it constantly,” says Nesbitt, who emphasizes the importance of hydration at a parents’ meeting held the night before the first preseason practice.

“I tell the parents about bad experiences I’ve had and I talk about the experience of taking a kid to the emergency room with cramps,” he adds. “Even if it’s not life-threatening, it can be a very scary situation. I tell parents that as a coach, I’m not around the kids once practice ends, so they need to take the baton and make sure their kids are getting enough fluids when they go home at night.”

For more detail on American College of Sports Medicine recommendations for avoiding heat stress, go to: www.acsm.org/publications/newsreleases2005/GuideFootball.htm.

For a list of definitions for varying stages of heat stress and accompanying treatment options, go to: www.nfhs.org and type “heat stress” into the search window.

For articles on heat illness and cooling from our sister publication Training & Conditioning, go to our Web site at: www.AthleticSearch.com and type “heat illness” into the search window.