Athlete Deaths In Workouts Lead To Changes

The Associated Press

http://www.washingtonpost.com/national/health-science/athletes-deaths-in-workouts-prompt-new-guidelines/2012/07/02/gJQAT5bPKW_story.html

The most dangerous time for amateur athletes may not be during the heat of the game or even in rigorous practices. Rather, it’s the conditioning workouts that get athletes ready for their season. Twenty-one college football players have collapsed and died during conditioning workouts since 2000 — many on the first few days, when even the fittest players are often pushed too hard.

There’s little regulation of these sessions, and coaches “just run willy-nilly” trying to make men out of boys, said Douglas Casa, the athletic training education director at the University of Connecticut. “A lot of them are not focused on health and safety issues.”

Conditioning sessions typically include running sprints, lifting weights and performing endurance exercises. Games and practices have more oversight and safeguards. These include heat acclimatization rules that limit the equipment that is worn and the intensity and number of sessions. Between 2000 and 2011, there were no deaths among top-level college football players in regular practices or games.

Now, health and sports professionals are seeking to make conditioning sessions just as safe. They have collaborated to create the first consensus guidelines on preventing sudden deaths during these workouts. The sessions last about two hours each and most run from January to June or July, depending on the sport, though some teams schedule them throughout the year.

The football conditioning deaths “generally occurred with excessive exercise under the direction of a coach, often in extreme conditions, and in some cases with staff inadequately prepared to deal with the emergency in a timely or appropriate fashion,” said Jolie Holschen, a Chicago emergency medicine and sports medicine specialist and co-author of the new guidelines.

The same recommendations are good advice for high school and younger athletes, too, not just to prevent deaths but to keep players safe at every stage in every sport, said Casa, who helped draft the guidelines.

The most common causes of the 21 collegiate football deaths were heatstroke, heart conditions and a genetic trait related to sickle cell anemia. Under ordinary conditions, that trait doesn’t cause problems, but it can disrupt the blood’s ability to carry oxygen to muscles, which can be deadly for athletes pushing too hard. Casa said about 10 percent of black athletes carry the sickle cell trait; smaller proportions of whites and Hispanics have it, too.

U.S. infants are tested at birth for the trait, and the NCAA in 2010 began requiring blood tests for it in Division I athletes after Rice University football player Dale Lloyd II died during a conditioning workout in 2006. The requirement for Division II athletes took effect this year.

“At the high school level, we still have to rely on birth records,” which coaches may not have access to, Casa said.

The new recommendations stress that conditioning workouts should be phased in rather than start at maximum intensity on day one. Exercise should not be used as punishment. Conditioning coaches should be trained in health and safety issues; certified in first aid, resuscitation and heart defibrillation; know which athletes have sickle cell trait; and know how to recognize signs of and treat exercise-related complications from the condition. And they should be present during all conditioning sessions.

The recommendations come from several groups, including the National Athletic Trainers Association, the Collegiate Strength and Conditioning Coaches Association, the American College of Sports Medicine and the American College of Emergency Physicians. They were released last week at the National Athletic Trainers Association annual meeting in St. Louis.