The Hottest Issue in Youth Sports

We chat with a renowned expert to break it all down.

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The list of issues across youth sports is thicker than 100 blue whales. Some are more prevalent than others and some apply only to subgroups of young athletes. (Hello puberty!) But there is one omnipresent issue that is only on the rise across the US and the world: the temperature.

It’s hot out there and only getting hotter. The NOAA (National Oceanic and Atmospheric Administration) reported that June was Earth’s 13th straight record-hot month. The breadth of unbearable climate is widening which means a larger chuck of the youth sports calendar is oppressive.

Right now baseball and softball are in full swing and training for fall sports like football and soccer have begun. Not to mention sports camps and other camps that take place outside and require general physical exertion. If you’re like me, you’re concurrently reminding your kids to drink more water while questioning what the hell we’re doing thrusting them into such unpleasant heat.

I’ve heard from a slew of concerned parents with anecdotes like their catcher playing games in triple-digit temps in Central California or their daughter starting cross-country team training in New Mexico’s severe humidity.

Parents are scared and rightfully so.

Here are a couple of anonymous posts from youth sports parent groups and message boards I follow.

Do you know if there are any laws about playing in the heat? Would it be a league or city law? We live in Vegas and yes our kids are used to hot. But it's impossible to get used to above 100 hot. This week and next it is up to 118 degrees and the city was issued an excessive heat warning. However, baseball and football have BOTH been having normal practices. Football from 6-8pm. Both sports are playing on turf which can make it feel 40-70 degrees hotter. To me this is atrocious especially in helmet and pads. How have they not canceled this stuff? For the safety of my kids we will likely not be attending practices in this heat. And yes. I know they will likely be benched but I'd rather that than my kid die of a heat stroke. I just don't understand and I know if I say something they'll just say then don't come if your kid can't handle it, you know, implying we have wimpy kids.

Mama's we are in a HEAT WAVE and my 13 y.o. qb and cf has summer workouts. Tues - Thur from 8 a.m. - 12 p.m. He got sick today around 10:30 after running sprints for 15 min. I know he was over heated. What can I do to help him stay cool and make it thru the summer ??

How are you keeping your kiddos okay in this heat. My 8 year old had a lesson at 9 this morning and he said he was shaky and then threw up as soon as we came home. I’ve been having him drink plenty of water all day but he seems to not be able to handle the heat at all.

This is all terrifying as is the fact that it’s Lord of the Flies out there. I don’t know about all of you but not once in either of my kids’ youth sports journies to date have any of their teams or clubs provided clear heat guidelines. It’s largely up to us to figure out what is acceptable and when to pull them (toggling the sad reality that in some cases missing practices could result in less playing time).

My personal breaking point came the other day when my son went to a baseball tryout in 99 degree weather. I could have offered him some simpatico by standing in the heat watching with the other parents. Instead, I beelined to an air-conditioned Brazilian cafe and enjoyed a delicious açaí bowl. As the tryout lingered (for THREE hours) the voice inside my head that said WTF am I doing grew from a simmer to a boil. Ridden with guilt, I went back to monitor. He seemed fine. But was he?

The issue isn’t necessarily the heat, it’s that most of are clueless when it comes to how to guide our kids when temperatures spike.

To provide some insight and guidance, I turned to the Korey Stringer Institute at the University of Connecticut. It’s been almost 23 years since Stringer, a seemingly healthy star offensive tackle for the Minnesota Vikings, died of complications from heat exertion. Stringer practiced in full pads the morning of 7-31-2001 as the heat index reached 99 degrees. Despite vomiting on multiple occasions he gutted out the 2.5 hour practice until he later became dizzy. Stringer’s body temperature was 108 upon arrival to the hospital. He tragically died of organ failure the next morning.

In many ways Stringer’s death was a turning point for the sports world as it pertained to heat-related illnesses. Awareness increased and eventually the NFL did away with two-a-days (two practices a day) during training camp.

In 2010 the Korey Stringer Institute was founded as a non-profit hub for heat-related research and education for athletes, laborers, and military at all levels. Through its partnership with the University of Connecticut’s Department of Kinesiology featuring a faculty renowned for research and expertise in the areas of heat and hydration, injury prevention, and strength and conditioning, KSI has become an essential resource in this space.

One key faculty member is kinesiology professor and President of KSI, Dr. Christianne Eason. Dr. Eason was kind enough to offer some clarity by answering my questions about how rising temperatures impact youth athletes and the protocols us parents should follow. (This conversation has been lightly edited for clarity.)

….

Good Game: First off, what key improvements have been made to heat management in sports since the death of Korey Stringer?

Christianne Eason: Since Korey’s tragic passing the NFL has made numerous changes to the way they train in practice, including the number of practices in the day, the length of practices, rest, and water breaks. They have the capability to do some pretty advanced physiological monitoring that most other sports levels do not have access to. They also have specific acclimatization protocols and environmental monitoring to help prevent heat illnesses and then also in the event of an exertional heat illness they have cold water immersion tubs on site and practice cool first transport second. In addition, their medical staff has had very extensive trainings and education on topics specific to heat illnesses and monitoring.

Since Korey’s death, the National Athletic Trainers’ Association has released several position statements to guide best practices in the prevention and treatment of exertional heat illnesses. We are trying to get these same protocols followed in all colleges and high school and youth sports leagues, but we still have a lot of work to do.

GG: What are KSI's protocols for high school programs conducting summer workouts, particularly football? 

CE: There are three primary things: heat acclimatization, environmental monitoring using a WBGT, and appropriate prehospital care of an exertional heat stroke (EHS).

Heat Acclimatization is the process of improving heat tolerance and performance that comes from gradually increasing intensity and/or duration of activity in the heat. The best way to acclimatize is to gradually increase workload in the heat over a two week period.

KSI’s heat acclimatization plan:

Infograph: KSI

Environmental Monitoring with a WBGT (wet bulb globe thermometer). A WGBT Incorporates humidity, radiant heat, ambient temperature, and wind speed

Appropriate Pre-Hospital Care for exertion heat stroke which is rapid cooling given that cells in our body can only survive at critically high temperatures for up to 30 minutes. Rapid cooling involves removing equipment and clothing and whole body ice water immersion.

GG: How different are guidelines for younger athletes, say 6-13 year olds?

CE: We would recommend all of the same guidelines for youth athletes as we would for adults. In addition, it is very important to encourage youth athletes to drink and build in rest/water breaks as thirst is not a good indicator of hydration status. So teaching them to drink (and what to drink – beverages with electrolytes) when they are sweating, even if they are not very thirsty can be an important educational piece.

GG: How does extreme heat impact a child as opposed to an adult? Or even a 7-year old vs. a 16 year-old?

CE: Children produce more heat relative to their body mass compared to adults and they also have a low capacity to sweat, and often their core temperature can increase more significantly when they are hypohydrated [uncompensated loss of body water] vs. adults. This all hypothetically puts them at risk for heat illnesses. However, there is not adequate data comparing the incidence of heat related illnesses in adults compared to children.

GG: Is there a certain temperature or humidity threshold in which activity should cease? 

CE: Yes – but it is different depending on where you live. We encourage all groups to follow-region specific activity modification guidelines. There are three regions that were developed based on geographic climatology data. So parts of the country, like Maine or Alaska for example where it is cooler and individuals are not exposed to heat all year have lower WBGT thresholds than areas like Louisiana or Florida that are warmer. Here’s a chart:

GG: How much has the growing for profit nature of youth sports made it harder to get organizations and coaches to adhere to KSI's advice? 

CE: I’m not sure. What I can tell you is that youth sports has been a challenge in regard to sport safety policy adoption because there is minimal oversite in regard to overseeing bodies. At the high school level there are state high school athletic associations, at the college level you have the NCAA, and then you have professional sports leagues and Olympic level organizations that can adopt policies and will help with adoption.

What I would add is if there is a level of pay-to-play at the youth sport level, it's frustrating that they are not investing in essential emergency equipment and tools that can help protect their athletes.

GG: What measures can coaches take to check the hydration levels of athletes?

CE: Weigh ins and weigh outs. You can track how much sweat is lost during a practice by comparing weight before practice and weight after practice. Kids are not losing weight via fat loss during one practice, they are losing water weight through sweating. Research has shown that > 2% body mass low equates to hypohydration and that 3-5% body mass loss will impact cognitive performance. (Of note: weights should be taken in dry clothing – if the clothes are soaked with sweat or kids are wearing equipment the post weight will be inaccurate.)

Coaches can also encourage students and parents/guardians to check the color of their own urine. Apple juice color (darker) is hypohydrated whereas lemonade (lighter) indicates good hydration status.

GG: What happens to the body during a heat stroke? 

CE: If metabolic heat production is more than the body can dissipate a cascade of things that will happen. The body wants to stay in homeostasis and ultimately will prioritize blood pressure at the expense of muscular and thermoregulatory function. There are 6 parts of the body are most affected in a heat stroke; 1) heart, 2) brain function, 3) kidney, 4) liver, 5) thermoregulatory system, and 6) muscular function.

GG: Is one gender or subgroup more susceptible to dehydration/heat stroke? 

CE: We see higher rates of EHS in males and football, particularly linemen. Individuals with lower fitness levels, who are overweight or obese, have a fever, have a history of heat illness, pre-pubescent, and have inadequate acclimatization are more susceptible to EHS.

GG What can parents do nutritionally to help their children prepare for playing sports in the heat?

CE: Replenish fluid lost – drink beverages with electrolytes (like Gatorade). Lots of fruits and vegetables. Throw a little salt on food to replace what is lost in sweat assuming there are no preexisting cardiac issues. Don’t let kids skip breakfast if there’s an early morning practice. It’s important to fuel and hydrate their body.

GG: Finally, what are the key red flags parents should look out for when joining an organization that practices/plays in extreme temps?

CE: Do they have an emergency action plan, do coaches have first aid/CPR/AED training? If not, that’s a red flag. Are coaches willing to shorten practice or add more rest breaks when it’s hot, do they encourage kids to drink and build in rest breaks? If no, that’s a red flag.

Thanks to Dr. Eason for all the insight. For even more on this crucial topic, visit KSI’s website. Please ask your child’s coach or club’s director to share their plan for dealing with extreme heat.