EmailPrintOpen Extended ReactionsAs football practices ramp up amid hotter-than-normal temperatures for much of the country, two organizations are calling for a different approach to prevent heatstroke in linemen, who make up 90% of heatstroke deaths in high school and college.The National Athletic Trainers' Association and National Federation of State High School Associations urged coaches to adopt preventative tactics such as excluding linemen from mile runs, serial sprints and other preseason performance testing during the first few weeks of the season. They also cautioned against using exertion drills as punishment, which were cited as a factor in 37% of football heatstroke deaths.Within the past two months, two 14-year-old high school linemen -- in Arkansas and Louisiana -- have been hospitalized due to heat-related incidents, according to local media reports and social media posts.The average number of deaths per year has remained steady over the past few decades despite greater awareness and other improvements, according to Scott Anderson, director of special projects for the College Athletic Trainers Society and former head athletic trainer for the University of Oklahoma."If we look from about 2000 to present, they've gone from about 2.1 per year to 2.6 per year," he said. "So the bottom line is we're not preventing fatalities."Linemen are particularly vulnerable to heatstroke because of their size and weight."We need big, strong individuals to play the position. The characteristics that make them successful are the same characteristics that put them at risk," Anderson said.The National Federation of State High School Associations told its state associations in June that prior guidelines calling for wearing cooler and lighter clothes at practice, increasing hydration and giving athletes more time to acclimate to the conditions were important but that they weren't enough to prevent fatalities because they don't account for the linemen's specific risks."Linemen face unique vulnerabilities, including larger body mass, lower aerobic fitness, greater metabolic heat production and reduced cooling efficiency," NATA noted in a statement titled "Preventing Exertional Heat Stroke Death in American Linemen," which was published in the medical journal Sports Health.Anderson said deaths happen during practice rather than competition and recommended that linemen should be trained based on what is demanded of them during a game. Coaches should also consider allowing them access to air-conditioned venues during hot practices, he said."They stand at the line of scrimmage and in a sense have a wrestling match," he said. "There's some movement, but they're not out there sprinting up and down the field like a receiver or running back or defensive back."Earlier this summer, the Rankin County School District in Mississippi settled a lawsuit filed by the parents of Trey Laster, a high school senior football player who died of heatstroke in 2022, according to court records. The lawsuit specifically mentioned Laster's higher risk due to his position as a lineman. The school district did not respond to a request for comment or further details on the settlement.Cases of football players with non-fatal heat-related illness are estimated to be in the thousands, but definitive data is lacking without a centralized reporting system. Overall annual hospitalizations for heat-related illness have been climbing with higher temperatures, according to the Centers for Disease Control and Prevention.Houston-area high school senior and lineman Jarvis Spires, 18, is still recovering from a near-fatal heatstroke last summer that he suffered during practice with a personal trainer that left him in a coma for several days, according to his mother, Alzadia Spires."I've heard of people having heatstrokes, but it was never something that crossed my mind that would happen to any of my children," Spires said.She said athletes like her son are often reticent to speak up even if they are struggling."I think they are, especially being a high school athlete, trying to make it to the college level ... they're trying to stick it out," she said. "They don't want to make their coaches upset, or they don't want to seem like they're too 'soft.'"Rebecca Stearns, chief operating officer of the Korey Stringer Institute and NATA task force chairwoman, said the new recommendations help team performance in the long run."If you can avoid preseason injuries and outcomes that take away weeks or maybe years of an athlete's participation, then we've strengthened the team," she said. "We don't need linemen who can run a mile in eight minutes."Alabama High School Athletic Association assistant director Brendt Bedsole, who oversees football coaches at more than 750 middle and high schools, said he is most concerned about heatstroke risk over the next few weeks. He said many coaches, especially those competing at the highest level, already have tailored workouts for linemen, he said, though some may still resist."You're going to have some [coaches] that are just old school who are brought up differently in their life and might not be as receptive," he said. "They probably look at me and say, 'He's soft.' No, I'm smart."
