NATA Re-Releases "Preseason Heat-Acclimatization Guidelines for Secondary School Athletics Concensus Statement

DALLAS, August 2, 2012 – As part of an ongoing effort to reduce the number of heat-related illnesses among secondary school athletes, the National Athletic Trainers’ Association (NATA) has re-released an inter-association task force consensus statement which includes comprehensive recommendations on heat-acclimatization guidelines for secondary school athletics programs. The statement was initially published in the Journal of Athletic Training, NATA’s scientific publication.
 
The National Collegiate Athletic Association in 2003 adopted guidelines to prevent heat-related deaths, and the heat acclimatization guidelines instituted have met with remarkable success. There are currently no similar standardized national guidelines for secondary school sports. According to the Korey Stringer Institute, there have been 18 exertional heat stroke deaths in the five-year period from 2005 to 2009 (all but one at the high school level), the most in any five year block over the past 35 years, and twice the five-year average.
 
Nearly 7 million high school students nationally participate in sports, with an estimated 715,000 high school sport-related injuries occurring each year. If athletes are not properly acclimatized for play and treated properly, they can have chronic if not fatal consequences. With the proliferation of deaths in recent years from heat-related illnesses, this statement is believed to be the first ever set of high school-specific guidelines published in a scientific journal. To date and in the past 14 months, seven states have adopted the guidelines including Arkansas, Arizona,  Connecticut, Georgia, North Carolina, New Jersey and Texas.
 
Heat-related fatalities are preventable: every second and every minute count. A life can potentially be saved by the protocols below. The athletic trainer is often the health care professional on site when an athlete goes down on the field, yet only 42 percent of high schools have access to athletic trainers.
 
The 14-Day Heat Acclimatization Period
 
The heat-acclimatization period is defined as the initial 14 consecutive days of preseason practice for all student athletes. The goal of the acclimatization period is to increase exercise heat tolerance and enhance the ability to exercise safely and effectively in warm and hot conditions. This period should begin on the first day of practice or conditioning, prior to the start of the regular season. Any practices or conditioning conducted before this time should not be considered a part of the heat-acclimatization period.
 
Regardless of the conditioning program and conditioning status leading up to the first formal practice, all student athletes (including those who arrive at preseason practice after the first day of practice) should follow the 14-day heat- acclimatization plan.
 
Consensus Statement Recommendations
 
The consensus statement lists seven key recommendations for a 14-day heat-acclimatization period prior to full-scale athletic participation by secondary school students, as follows:
 
1.     During the first five days of the heat-acclimatization process, athletes may not participate in more than one practice per day.
 
2.     If a practice is interrupted by inclement weather or heat restrictions, the practice should recommence once conditions are deemed safe, but total practice time should not exceed three hours per day.
 
3.     A one-hour maximum walk-through is permitted during the first five days of the heat-acclimatization period;
however, a three-hour recovery period should be inserted between the practice and walk-through (or vice versa).
 
4.     During the first two days of the heat-acclimatization period, in sports requiring helmets or shoulder pads, a helmet should be the only protective equipment permitted (goalies, as in the case of field hockey and related sports, should not wear full protective gear or perform activities that would require protective equipment). During days three through five, only helmets and shoulder pads should be worn. Beginning on day six, all protective equipment may be worn and full contact may begin.
 
5.     Beginning no earlier than the sixth day and continuing through the 14th day, double-practice days must be followed by a single-practice day. On single-practice days, one walk-through is permitted, but it must be separated from the practice by at least three hours of continuous rest. When a double-practice day is followed by a rest day, another double-practice day is permitted after the rest day.
 
6.     On a double-practice day, neither practice’s duration should exceed three hours total, and student-athletes should not participate in more than five total hours of practice. Warm-up, stretching, cool-down, walkthrough, conditioning and weight-room activities are included as part of the practice time. The two practices should be separated by at least three continuous hours in a cool environment.
 
7.     Because the risk of exertional heat illnesses during the pre-season heat-acclimatization period is high, the consensus statement strongly recommends that an athletic trainer be on site before, during, and after all practices.
 
In addition to NATA, the task force that developed the consensus statement comprised seven other groups, including American Academy of Pediatrics, National Strength and Conditioning Association, United States Army Research Institute of Environmental Medicine, American Orthopaedic Society for Sports Medicine, American Medical Society for Sports Medicine, American College of Sports Medicine and Gatorade Sports Science Institute.