Deadly Practice: Heat Still Stalks Athletes

MECHANICSVILLE – Former football players of a certain age can remember the “good” old days when water was the enemy, and when asking to drink water during the broiling August two-a-days was a sign of weakness.

Back then, however, athletes died as dehydration compromised the body’s natural cooling system: sweating. It is just like a car with a radiator leak that overheats. No coolant, no cooling. The difference was that, while the car just stopped working – preferably without permanent damage to the engine – an overheated human can literally cook from inside. Cells die, tissues die, and, in too many cases, the affected person dies.

MECHANICSVILLE – Have changes in training regimens reduced the risk of athlete deaths from heat-related illnesses?

Maybe yes, maybe no. The data needed to clearly back either argument remain elusive.

Area high schools came alive this week as fall sports tryouts attract thousands of student-athletes. Faced with the dog days of summer, what guidelines are provided to trainers and coaches to assist in the safety in the heat of all involved?

The National Federation of High Schools’ latest statement on minimizing risk for exertional heat illness, released last year, focuses on several areas, including continually monitoring one’s weight and subsequent weight loss, to determine risk.

ASHLAND – While athletic programs closely monitor players during the dog days of summer, looking to prevent an exertional heat health emergency, is it possible that a test whose roots date back almost a century could be key to discovering which players most susceptible to such an event, and, more important, give coaches a system to not only test student-athletes, but then improve their ability to perform?

What is known as “VO2max testing” – a test of the maximum amount of oxygen a person can use during intense exercise – would not be possible without the work of Archibald Vivian Hill and Otto Fritz Meyerhof, who shared the Nobel Prize for Physiology or Medicine in 1922. Hill was honored “for his discovery relating to the production of heat in the muscle,” while Meyerhof shared the prize “for his discovery of the fixed relationship between the consumption of oxygen and the metabolism of lactic acid in the muscle,” according to the Nobel Foundation.

MECHANICSVILLE – What is a maximum oxygen consumption (VO2max) test like?

I decided to find out with the help of Mike Craven, owner of Mike’s Olympic Gym.

ASHLAND – An individual’s fitness level has long been recognized as one of the key factors predisposing one to exertional heat illness and heat stroke, and maximum oxygen consumption, or VO2max, has likewise been long recognized as one of the best measures of fitness.

“Since exercise and heat stress can stress the cardiovascular system to the limits of its regulatory ability, the first major problem is what constitutes a ‘maximal’ cardiovascular adjustment,” wrote Loring B. Rowell in an article in Physiological Reviews in 1973. “The solution depends on our ability to establish some objectively measured, reproducible, and specifically defined index of maximal cardiovascular function. Maximal O2 consumption (VO2max) appears to be such an index.”

MECHANICSVILLE – When I took the VO2max test with Mike Craven at Mike’s Olympic Gym, the goal was very short-term. Mike had described the test in some detail, but I could not visualize it from the description. I needed to take the test in order to understand it enough to write about it.

But after taking the test – and finding out I scored a bit below average for my age group – I had another question: How does one improve his or her VO2max scores?

MECHANICSVILLE – As Richmond-area football teams begin 2019 regular-season play with high temperatures near 90 degrees, how well have Virginia’s schools prepared their student-athletes in conditioning, and, specifically, in handling any heat related issues?

The Korey Stringer Institute at the University of Connecticut, named for the former Minnesota Vikings lineman who died of exertional heat stroke in 2001 during training camp, conducts annual surveys of state policies regarding several physical safety issues, including prevention of exertional heat illness, judged against the Institute’s preferred standards.

MECHANICSVILLE – Sometimes it takes outside pressure to force change. The sports world – especially in tradition-bound sports like football – is not immune from the human tendency to keep doing things the way they’ve always been done, and in some areas, the resistance to change is not a problem.

But, when the resistance to change leads to preventable deaths and injuries – as it has over the decades with respect to heat stroke and heat illness – someone has to step in and get everyone’s attention.

MECHANICSVILLE – Great strides have been achieved over the years in improving heat safety among athletes, but, as we have reported in the “Deadly Practice” series over the past few weeks, more progress remains to be made.

As our reporting has found, most of the reforms since the 1970s have addressed three main contributing factors to exertional heat illness: hydration, heat acclimatization, and limiting outdoor practices when weather conditions make it all but impossible for athletes to properly cool themselves on the field.

MECHANICSVILLE – In the fifth installment of the Deadly Practice series, “How does VHSL rank on exertional heat safety?,” The Local reported that the Virginia High School League scored low on the Korey Stringer Institute’s high school safety rankings with respect to heat safety.

The Local also reported that tweaks rather than an overhaul would be needed to greatly improve the VHSL’s scores.

MECHANICSVILLE – The Richmond metropolitan area is all too familiar with stories of athletes felled by heat injuries during practices or competition. Despite great strides in understanding many of the risk factors and how to manage them, athletes continue to sicken, even die, from overdoing it in the heat.

Most of the Deadly Practice series so far has focused on conditioning and fitness screening to identify athletes at risk of heat injuries. But so far, the nation has done little to grapple with what may be the single biggest threat to outdoor athletes in the coming decades: climate change.

MECHANICSVILLE – When I began work on the Deadly Practice series, Mike Craven of Mike’s Olympic Gym had been preaching the gospel of fitness testing as a way to: a) identify athletes at risk of heat injury; and b) to help design conditioning programs to lessen the risk of heat injury.

And Craven was – is – a fervent disciple of the usefulness of VO2max testing for that purpose. But at the time, I did not understand what the test was, so I did what any respectable journalist would do: I had myself tested to get a feel for it.