Sports Specialist: SSOR's Dr. Daniel Lorenz 6/17

By Dr. Dan Lorenz Director of Physical Therapy at Specialists in Sports & Orthopedic Rehabilitation
Posted: June 17, 2013 - 10:01 AM

Oh, that summer heat will be beating down on us soon. The heat is so oppressive, athletes sweat doing nothing, almost suffocating them from the humidity.
Young football players have a choice – stay inside where it’s cool and play video games or go outside and condition for football. When it’s really hot, the choice is clear – stay cool. However, the problem is that practice will get going soon and the athlete will have to transition from sitting inside all summer to running and conditioning in the heat. The body needs time to acclimate to the conditions outside to prevent heat illnesses.
This week’s column will focus on heat acclimatization for the football player. All forthcoming information is adapted from the National Athletic Trainer’s Association Consensus Statement on Pre-Season Heat Acclimatization for Secondary School Athletes.
The heat acclimatization phase lasts 14 days – the goal of 14-day acclimatization phase is to increase heat tolerance and enhance the ability to safely and effectively perform in heat conditions.
Here are the guidelines:
  1. For the first five days, there should be no more than one practice per day. Total practice time should not exceed 3 hours per day. A one-hour walk-through is allowed, but only if there is a three-hour recovery period between practice and walk-through.
  2. The first two days should be helmets only.
  3. On days three through five, only helmets and shoulder pads should be worn.
  4. On day six, all protective equipment/full pads can be worn. Beginning at day 6 and till day 14, a two-a-day practice should be followed by a single practice the next day. Walk-through is permitted on the single practice day.
  5. During two-a-days, practice should not exceed 3 hours and total practice time should not exceed 5 hours. Two practices in the same day should be separated by 3 hours in a cool environment. Weight training, conditioning, and warm-up/cool down activities are included in the 5 hours.
  6. Water breaks should be frequent. A good guideline is every 15-20 minutes.
Hopefully, if athletes and coaches adhere to these guidelines, heat illnesses should be minimized. Plus, it is best case scenario to have a Licensed Athletic Trainer at practices to help watch for the signs of heat illnesses.  However, sometimes an athlete can be overcome by the heat and coaches and teammates need to act fast. If an athlete is suspected of heat illness, the following recommendations are suggested:
  1. Remove the athlete from the outdoors and get him in a cool environment. If none is available, shady areas are the next best option.
  2. Remove wet clothing. Wet clothing will not allow the sweat to evaporate and makes dissipation of heat more difficult.
  3.  Cool the athlete as quickly as possible with cold towels, fans, and ice bags in the armpits, groin, low back, back of the neck, and midsection.
  4. Provided he is conscious, alert, and oriented, provide cold fluids, preferably electrolyte drinks.
  5. Monitor for consciousness and call 911 if the athlete’s condition starts to fade.
One more tip: if you can be disciplined enough, have your athletes weight themselves before and after practice or the practice day. The difference is water weight lost. For every pound lost, replace with 8 ounces of water. Without doing so, the athlete will be at risk for heat illnesses.
Stay safe out there this summer!
Dan Lorenz is a former physical therapist and assistant athletic trainer for the Kansas City Chiefs. He is currently the owner and Director of Physical Therapy for Specialists in Sports and Orthopedic Rehabilitation in Overland Park. For more information on SSORKC go to