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ACSM Newsbriefs

ACSM's Health & Fitness Journal: November-December 2004 - Volume 8 - Issue 6 - p 2
Departments: ACSM Newsbriefs

ACSM issues recommendations for protecting young football players from dehydration, overexertion, and other risks.

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New Youth Football Recommendations Emphasize Safety

Although the heat has subsided for the year in most parts of the country, new youth football and heat stress guidelines are now available to be in place for next summer. Experts say youth coaches are key to preparing training and practice safety in hot summer temperatures and now have the latest information to protect their players.

The guidelines are outcomes from a recent expert panel convened for an ACSM scientific roundtable on youth football and heat stress. ACSM experts say youth football coaches should adopt practice modifications and use a strategy to acclimatize players to perform in the heat, along with a fluid replacement strategy in anticipation of young players who begin practice already dehydrated.

Additional recommendations focus upon factors that contribute to heat stress, such as intensity and duration of exercise, body size, health and fitness level, as well as uniform configurations.

  • A player's core temperature on the field is primarily related to exercise intensity and duration, clothing and equipment, and environmental conditions. Therefore, practices should be modified to reduce intensity, durations, and equipment depending upon the environmental heat stress. The team support staff must closely monitor all players for signs and symptoms of developing heat-related injury during football practice or competition in stressful environments. Players who are not acclimated or aerobically fit, especially the large linemen with excessive body mass index (BMI), warrant closer scrutiny for heat illness.
  • Wearing a full or partial football uniform makes players overheat sooner, even when the temperature and humidity are not very high. To reduce the risk of heat injury during the football pre-season, there should be a gradual addition of the insulating parts of the football uniform and protective equipment to allow safe transition to full intensity practice in full gear. Players should wear less padding on very hot and humid days.
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  • Young football players often begin practice measurably dehydrated and sweat a lot on the field, so successive days of football practice can lead to additional dehydration and reductions in body weight, which may increase the risk for excessive body temperature and heat injury. Removing barriers to adequate drinking and providing optimal conditions for fluid intake will help prevent dehydration. Easy access to fluids and adequate time for drinking water and other beverages that are chilled, are flavored, and contain sodium will help promote fluid intake during and after training.

Other measures to help players safely acclimatize during pre-season and reduce the risk for heat injury during all practices include the following:

  • Schedule a pre-season of at least 2 weeks, with 7 to 10 practice sessions of gradual and increasing exposure to intensity, duration, and protective equipment. This will allow for proper acclimatization to the environment and these other factors that increase heat strain.
  • Avoid conducting multiple on-field practice sessions on consecutive days.
  • Regular breaks should be scheduled to limit excessive physical activity and allow fluid replacement.
  • Use the "buddy" system to monitor players (two players assigned to "keep an eye on" each other).
  • Use available shade during breaks.
  • A standardized pre-participation physical examination should be performed as part of routine health care on each football player. A review of the athlete's past medical history should include a history of medication and supplement use, cardiac disease, sickle cell trait, and previous heat illness.

In addition:

  • Heat cramps are usually prompted by sodium depletion, dehydration, and possibly muscle fatigue. Young, fit football players who cramp when sweating extensively may need to consume more salt and fluid, based upon their individual losses.
  • Special precautions for sickle-trait football players should include no first-day pre-season fitness runs, no timed distance runs, and no sustained sprints on the field, on hills, or on stairs. Assume that any cramping is due to red blood cell sickling until proven otherwise. Screening and precautions for sickle cell trait may readily reduce risk and save lives.
  • Education of coaches and support staff on how to prevent, identify and treat heat injuries should be done each year. An adequate number of staff (coaches or medical support) should be available on site to effectively monitor the number of participants for potential problems.

The full set of recommendations and references will be available at in 2005 and the Journal will keep you posted.

© 2004 American College of Sports Medicine