Using Heads in the Heat of Competition
December 20, 2013
By Rob Kaminski
MHSAA benchmarks editor
With so much recent attention to the risks and recognition of concussions in collision sports, athletic leaders have put their heads together to address far more common – but often overlooked – threats to the health of our student-athletes: heat and sudden cardiac arrest.
The No. 1 killer of young athletes is sudden cardiac arrest, while heat stroke victims can surpass that during the year’s hottest months. While the moment of impact leading to a concussion is totally unpredictable, athletic trainers, coaches and administrators have the ability to diminish the occurrences of cardiac arrest and heatstroke. Typically, there is a pre-existing condition, or family history suggesting probabilities for sudden cardiac arrest, which can be treated when detected. And, the perils associated with hot weather – heat stroke, prostration – are almost always completely preventable.
The MHSAA has addressed both issues recently. With assistance from numerous medical governing bodies, the annual pre-participation physical form was revamped and expanded prior to the 2011-12 school year to include comprehensive information regarding participants’ medical history.
In May, the Representative Council adopted a Model Policy for Managing Heat & Humidity (see below), a plan many schools have since adopted at the local level. The plan directs schools to monitor the heat index at an activity site once the air temperature reaches 80 degrees and provides recommendations when the heat index reaches certain levels, including ceasing activities when it rises above 104 degrees.
The topic of heat-related illnesses receives a lot of attention at the start of fall when deaths at the professional, collegiate and interscholastic levels of sport occur, especially since they are preventable in most cases with the proper precautions. In football, data from the National Federation of State High School Associations shows 41 high school players died from heat stroke between 1995 and 2012.
“We know now more than we ever have about when the risk is high and who is most at risk, and we’re now able to communicate that information better than ever before to administrators, coaches, athletes and parents," said Jack Roberts, executive director of the MHSAA. “Heat stroke is almost always preventable, and we encourage everyone to avail themselves of the information on our website.
“Schools need to be vigilant about providing water during practices, making sure that students are partaking of water and educating their teams about the need for good hydration practices.”
All of which is not to say concussions aren’t a serious matter; they are. In fact, leaders in sport safety can take advantage of the concussion spotlight to illuminate these additional health threats.
A recent New York Times story (May 2013) by Bill Pennington featured a February 2013 gathering in Washington organized by the National Athletic Trainers Association. In the article, Dr. Douglas J. Casa, professor of kinesiology at the University of Connecticut and Chief Operating Officer of the Korey Stringer Institute (founded in the late NFL offensive lineman’s name to promote prevention of sudden death in sport), suggests just that.
“All the talk about head injuries can be a gateway for telling people about the other things they need to know about, like cardiac events and heat illness,” said Casa in the article. “It doesn’t really matter how we get through to people as long as we continue to make sports safer.”
Education and prevention methods need to find a permanent place in school programs if those programs are to thrive and avoid becoming targets at which special interest groups can aim budgetary arrows.
Dr. Jonathan Drezner, the president of the American Medical Society for Sports Medicine, said in the New York Times piece that sudden cardiac arrest is “so incredibly tragic and stunning that people aren’t comfortable putting it into the everyday conversation. I do wish, to some extent, it was something people talked more about because we are getting to a place where we could prevent many of these deaths.”
When it comes to heat-related deaths or illnesses, the prevention efforts can be even more successful by educating the masses. And, these efforts can be done at minimal cost to schools.
“That’s the thing about curtailing exertional heat illness: it’s 100 percent preventable, and unlike other health threats to athletes, the solutions can be very low-tech and inexpensive,” said Dr. Michael F. Bergeron, the director of the National Institute for Athletic Health & Performance at the University of South Dakota’s Sanford Medical Center, in the New York Times story.
To assist with cost and data maintenance, the MHSAA has teamed with Sports Health to provide schools with psychrometers (heat measurement instruments) at a discounted rate, and has built online tools to track heat and humidity conditions.
Managing heat and humidity policy
- Thirty minutes prior to the start of an activity, and again 60 minutes after the start of that activity, take temperature and humidity readings at the site of the activity. Using a digital sling psychrometer is recommended. Record the readings in writing and maintain the information in files of school administration. Each school is to designate whose duties these are: generally the athletic director, head coach or certified athletic trainer.
- Factor the temperature and humidity into a Heat Index Calculator and Chart to determine the Heat Index. If a digital sling psychrometer is being used, the calculation is automatic.
If the Heat Index is below 95 degrees:
All Sports
- Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire.
- Optional water breaks every 30 minutes for 10 minutes in duration.
- Ice-down towels for cooling.
- Watch/monitor athletes carefully for necessary action.
If the Heat Index is 95 degrees to 99 degrees:
All Sports
- Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire.
- Optional water breaks every 30 minutes for 10 minutes in duration.
- Ice-down towels for cooling.
- Watch/monitor athletes carefully for necessary action.
Contact sports and activities with additional equipment:
- Helmets and other possible equipment removed while not involved in contact.
- Reduce time of outside activity. Consider postponing practice to later in the day.
- Recheck temperature and humidity every 30 minutes to monitor for increased Heat Index.
If the Heat Index is above 99 degrees to 104 degrees:
All Sports
- Provide ample amounts of water. This means that water should always be available and athletes should be able to take in as much water as they desire.
- Mandatory water breaks every 30 minutes for 10 minutes in duration.
- Ice-down towels for cooling.
- Watch/monitor athletes carefully for necessary action.
- Alter uniform by removing items if possible.
- Allow for changes to dry T-shirts and shorts.
- Reduce time of outside activity as well as indoor activity if air conditioning is unavailable.
- Postpone practice to later in the day.
Contact sports and activities with additional equipment
- Helmets and other possible equipment removed if not involved in contact or necessary for safety.
- If necessary for safety, suspend activity.
Recheck temperature and humidity every 30 minutes to monitor for increased Heat Index.
If the Heat Index is above 104 degrees:
All sports
- Stop all outside activity in practice and/or play, and stop all inside activity if air conditioning is unavailable.
Note: When the temperature is below 80 degrees there is no combination of heat and humidity that will result in need to curtail activity.
PHOTO: The Shepherd volleyball team includes hydration during a timeout in a match this fall.
Taking a Healthy Approach to Sports
By
Rob Kaminski
MHSAA benchmarks editor
November 8, 2013
During election years, it’s a familiar rallying cry: “Four more years! Four more years!”
It’s become commonplace following the third quarter of football games around the country for members of the leading team to march down the gridiron with four fingers raised on one outstretched hand as teams switch ends of the field to signify, “Fourth quarter is ours; finish the job.”
The number four also is significant in education with school terms identified as freshman, sophomore, junior and senior years.
To that end, the MHSAA is imploring everyone involved in educational athletics to go back to school in 2013-14 with a four-year mission in mind: “Four Thrusts for Four Years.”
The goal is to attain and maintain advanced degrees in sports safety, positioning Michigan schools in the center of best practices for ensuring the health of our product and students, today and beyond.
“Just a brief look around all levels of today’s athletic landscape reveals heightened awareness of health and safety issues,” said MHSAA Executive Director Jack Roberts. “Interscholastic sports as a whole – and particularly school sports in Michigan – has long led the charge to employ the safest contest rules and provide the healthiest environments for our games and participants.
“But, to put it in athletic terms, we can’t sit on the lead,” Roberts added. “We can, and must, improve our games in order to guarantee their existence for future generations. That is our goal, our thrust in the coming years.”
Following are the focal points for this four-year plan:
- Implement heat and humidity management policies at all schools for all sports.
- Require more initial and ongoing sports safety training for more coaches.
- Revise practice policies generally, but especially for early in the fall season.
- Modify game rules to reduce the frequency of the most dangerous play situations, and to reduce head trauma.
The directive actually kicked off last March, when the Representative Council approved a heat management policy for MHSAA tournaments and a detailed model policy for schools. While not setting requirements for member schools during the regular season, it suggests actions based on heat index – the degree of felt discomfort derived by combining temperature and humidity measurements – that are designed to minimize the risk of heat-related illness during interscholastic participation.
The policy is mandatory for all MHSAA tournaments beginning this school year, and the MHSAA plans to monitor schools’ adoption of the plan throughout the year to determine best policies moving forward.
Laminated cards containing the policy and heat index chart were printed and mailed to schools in June and continue to be disseminated at statewide meetings this fall. Two publications, Heat Ways and Safety Blitz, were published, mailed and posted to MHSAA.com, heightening awareness of healthy practice regimens, and schools have been offered discounted psychrometer prices through the MHSAA to assist in their efforts to properly monitor weather conditions.
“This action was significant; but it’s just the next step in a continuous series of actions being taken to make school sports as healthy as possible for students,” said Roberts.
The MHSAA’s proactive movements toward a safer tomorrow are taking place concurrently, rather than sequentially. While the heat and humidity plan is the most developed of the four “thrusts,” other initiatives are underway. Today’s climate prompts such action.
From the NCAA’s new “targeting fouls” to the NFL’s “crown” rule, and of course Major League Baseball’s Biogenesis/PED debacle, the headlines off the field in August centered on protecting the games rather than simply playing them. Like it or not, it’s the type of news fans need to get used to as their favorite sports audible to option plays in order to steer clear of the endangered species list.
The situation can’t be overstated. Athletics at all levels has been approaching a crossroads for years, and the time to heed the signals has come.
“Let’s make one thing abundantly clear: The people in charge of football at all levels are wise to craft rules that make the game safer, even if those rules will be controversial,” wrote Andy Staples for SI.com College Football on July 23.
The story continued: “As more information arrives about the long-term dangers of the headshots football players absorb at the high school, college and pro levels, something has to change. The next few years will be messy. The game needs saving, because if it continues as it has, it will get decimated by lawsuits and by parents of young children who decide the potential adverse effects aren't worth the risk.”
When kids stop playing, numbers at the high school level and beyond are bound to diminish as well. To trumpet the vast benefits of interscholastic football while easing parents’ minds on safety concerns, the MHSAA formed a Football Task Force in the spring of 2013. The task force is the first of several to be convened during the next four school years, and the objectives of each are to promote the sports involved as safe, low-risk, competitive athletics through the development of better practice policies and modification of playing rules.
“These task forces will be central to the overarching mission of preserving sports for years to come,” said Roberts. “We believe the MHSAA Football Task Force has set a foundation on which to build. Our discussions involving revised practice policies have reached the draft stage, and we intend to have formal proposals ready to present to the Representative Council in March 2014.”
The work of the 13-member task force – made up of football coaches and school administrators from around the state – will be reviewed by the Michigan High School Football Coaches Association, the MHSAA Football Committee and at the MHSAA League Leadership meeting for fine-tuning prior to reaching the Council.
“It is important that we provide opportunities for children to participate in interscholastic athletics and crucial that we do all we can to ensure they will be safe when they do,” said Football Task Force member Tammy Jackson, principal at East Jordan High School, who has a sports medicine background. “The MHSAA has taken an active role in promoting safety by convening the Task Force to examine current rules and consider modifications to further protect children.”
With so much publicity concerning football safety, the football group was a natural to become the first of several task forces to be assembled.
“We must educate the public on the benefits of all school sports,” said task force member Bill Chilman, superintendent of Beal City Schools. “In the case of football, it must be impressed upon people that it is statistically a very safe game when taught and played properly. The Football Task Force being proactive rather than reactive to this safety movement is key to promoting the lifelong values of football and all school sports.”
And within that public is a group which has the most vested concerns: the parents.
“There is more information available to the general public regarding sport and sport injuries, and unfortunately parents and kids all too often hear about the negative side of sport,” suggests Mike Bakker, athletic director at Fenton High School, and another member of the MHSAA Football Task Force. “It is imperative for the integrity of the sport of football to have coaches and administrators provide information about the safety of the game and the steps we take to keep kids safe. We must educate parents about the proper way to play the game and the signs to look for if problems arise.”
Without getting into the minutia of the new NCAA and NFL playing rules regarding use of the helmet, suffice it to say this will be an interesting fall during which to monitor penalties and their effects on injury numbers, particularly when it comes to concussions.
The rules changes have been reported and debated at the national level ad nauseam, and the mood seems to inexplicably tilt toward skepticism and criticism from the very group that would stage a revolt of epic proportions if football ever became extinct: the fans.
Case in point: six targeting fouls were called in 75 games during the opening weekend of college football over Labor Day Weekend (one ejection was overturned by replay), and the outcry began. Analysts and fans are afforded frame-by-frame replays which onfield officials do not have the luxury of seeing before throwing the flag.
Like it or not, the rules are in place. And, they have been implemented to protect the future of the game. The impetus now falls to the caretakers of the game – the officials – who no doubt will bear the brunt of disapproving masses in the stadiums. Yet, football is their livelihood too; both players and officials are expected to make adjustments.
At Officiate Michigan Day and the ensuing National Association of Sports Officials Summit this past July in Grand Rapids, the theme was clear: “The game has changed, and the officiating has to change with it.”
From NFL Referee Jeff Triplette to SEC Coordinator of Officials Scott Shaw to Big Ten Referee Alex Kemp and Fox Sports NFL Rules Analyst Mike Pereira – people who have been around the block – the message delivered was that the changes are necessary for the health and growth of football.
“We’re talking about taking out a specific type of play that, quite honestly, you didn’t see that much of before about 10 years ago,” Triplette said during a player safety panel at the NASO Summit. “They still played defense, there were still great hits. But somehow, these violent types of tackles began to get notoriety – whether it was all the ESPN highlights, YouTube, and maybe a combination of all of that stuff – and players started to celebrate those hits, and that became the goal.”
Not only can the game become safer; it might even become better by going retro. In recent comments on The Sports XChange, NFL analyst and former coach John Madden said, “You are always concerned how any change will impact the game. In this case, players are not going for the head shot, that big hit. They are keeping their heads up. Better tackling has become the unintended consequence. That's a good thing. Good for football. Good for kids watching. Players are tackling the way they are supposed to, with their shoulders and wrapping up. The big hit, the big replay had become so popular that tackling suffered.”
In high school, the most notable rule change involving helmets involves penalties for players who lose their helmets during a play. However, illegal helmet contact continues to be a point of emphasis and carries a minimum of a 15-yeard penalty as it has for many years. In the NCAA the mantra on helmet-to-helmet blows is, “When in doubt throw them out,” as the foul now carries with it a player ejection.
That is not the high school rule—yet—but officials at all levels need to be on the lookout. Kemp was quick to warn a roomful of prep football officials during Officiate Michigan Day, “We’ve been told to err on the side of safety, and these plays will result in ejection,” while also adding that such plays will be reviewed by replay officials. “That portion of the rule isn’t there in high school yet, but be ready for it; it’s coming, so when it happens in your games take notice and determine the severity.”
Which brings us to contest rules for safer play. During the next few years, various sport groups will be assembled to follow the MHSAA football task force’s lead in scrutinizing rules and developing proposals for revisions or additions to be submitted to the National Federation of State High School Associations. Initial football discussions receiving some traction involve changing the enforcement spot on post-interception penalties and limiting the number of yards teams can run up on free kicks. Before any submissions are made to the NFHS Football Committee, the task force will conduct research and present findings to Michigan committees.
“We can make changes ourselves – through MHSAA sport committees – for the subvarsity level, but our committees can only make recommendations to national rules committees for varsity level play,” explained Roberts. “Over the next four years, we will be asking our sport committees to give more time to the most dangerous plays in their sport – identifying what they are and proposing how to reduce that danger.”
While the football task force here at home is finalizing practice policy proposals targeted for implementation in the fall of 2014, Texas and Illinois are two states which launched restrictions with the opening of football this season. Spokespersons from both states indicate that coaches and school administrators have been pleased with the new formats.
Coaches no doubt will need to adjust practice itineraries and budget time wisely. Administrators need to remind staffs that the new era is dawning in the name of player safety, which is paramount to all parties.
“In game situations, coaches want our officials to throw the flag on late hits, low hits and other illegal contact,” Roberts said. “These are incidents that they have no control over. They do have control over practice time and teaching fundamentals; so let’s encourage safety measures that we can control, and employ those tactics to help the game prosper.”
Education will key the efforts to align coaches of all sports – and all levels – in the movement toward a healthy future. School will be in session during the next four years as the MHSAA implements effective and practical means for raising coaches’ preparedness. Three avenues are on the map:
First, the Representative Council mandated that beginning with the 2014-15 school year, all assistant and subvarsity coaches at the high school level must complete the same MHSAA rules meetings currently only required of varsity head coaches or, alternatively, one of the free online sports safety courses posted on or linked from the MHSAA Website that is designated as fulfilling this requirement.
Second, it is proposed that by 2015-16, MHSAA member high schools will be required to certify that all of their varsity head coaches have a valid CPR certification.
Third, it is proposed that by 2016-17, any person who is hired for the first time to be the varsity head coach of a high school team, to begin after July 31, 2016, must have completed either Level 1 or Level 2 of the MHSAA Coaches Advancement Program. The MHSAA is preparing to subsidize some of the course cost for every coach who completes Level 1 or 2.
Together, these changes will move Michigan from one of the states of fewest coaching requirements to a position consistent with the “best practices” for minimizing risk in school sports and providing students a healthy experience.
At stake in these four thrusts – whether for an administrator, coach, official, student-athlete, parent or fan – are the environments that offer so many lessons and the games for which we root.