Heat the Certified Athletic Trainer’s Perspective

1. Heat the Certified Athletic Trainer’s Perspective Hi I’m Dr. Feder Jim Clover, MED, ATC, PTA Coordinator SPORT Author “Sports Medicine Essentials”

2. www.ropsports.comwww.sportclinic.md

3. The Quest • Not to Kill anyone • To provide a healthy Environment for the Athletes • To get the best performance out of the athlete Secondary • Reasonable cost • With in the limitations of the staff (Coach’s, Athletic Trainer, students , etc.) • With the resources available

4. Changes in blood flow

5. Temperature Regulation The hypothalamus is a small organelle within the brain which adjusts bodily functions through hormones which: -Increase heart rate -Begin the sweating mechanism -Increase blood flow to the skin surface

6. One Problem The Black Helmet / Uniform

7. Personal Safeguards, cont’d

8. Consistent daily monitoring of body weight • This allow athletes to recognize water deficits which require consumption of fluid • -2 to -3% of body weight, reduction of training duration/intensity • -4 to -6%, or consultation with an experienced physician • in excess of -7% out till cleared

9. How Much Water to Bring • Calculate Sweat Loss via Weight Charts • Weigh in before practice and out after in the same dress “shorts”

10. Problems • Two a Day – Three a day (needs to stop) • Both Male and Female (playing same sports) • What do they do in-between Practice • Not having a ATC on staff • Not knowing the sweat rate of each of your athletes

11. How to dress for a Hot Day

12. Turf vs Grass

13. All Athletes are not built the same

14. How much is enough? • More than you want just to satisfy your thirst • Sources of water are: 1. Fluids - 1 cup or 8 oz = 240 mL every 20 min • Foods - fruit & veggies are 90% water Add up the number of athletes, number of cooler (size of cooler) and figure about how much should be taken out and consumed Bring their own

15. What to drink & Eat • Electrolyte drinks (e.g. Gatorade) are usually not needed for typical North American diet (can be used for first aid). • Stay away from caffeinated, carbonated, diet drinks, and alcohol as they take water out of your body. • Water is the best; juices and/or no caffeine sport drinks are also good (juices contain energy restoring glucose). • Eat 4 meals a day

16. Things to check • Look for typical heat strain symptoms; feeling over-heated, fatigue, headache, nausea, weakness, dark concentrated urine, etc. • Sweat that drips off your body no longer allows for cooling by evaporation; thus, unless there’s another medical reason for it, this is a sign that your body is heating up • Let the athlete change t-shirts.

17. Providing the H2O

18. How & What To Provide

19. Water Access

20. Different Ideas

21. Control methods -Drinking adequate amounts of fluids -Protective clothing (light colors reflect heat) -Protective equipment (vests, fans) -More?

22. TMS Temperatur Management System

23. Sideline Cooling Fans

24. What else are they doing? • The commissioner banned players with minor-league contracts from taking ephedra in the wake of Bechler‘s death

25. Administration Wants a number • Temperature 100 -106 degrees (Based on what?) • Heat Index (does it work everywhere?)

26. There is a number www.hqinc.net

27. The History ofTHE PILL • The Core Temp Ingestible Core Body Temperature Sensor was developed in the late 1980s by HQ Inc., of Palmetto, Florida • Costs around $30 each • The pill relies on a temperature-sensitive quartz crystal temperatures ranging from ­60 °C to 150 °C.

28. Is This A Special Sports Pill?NO! Sports physiology Firefighting Research & medicine Agriculture Occupational safety Food Production & Safety Military Industry

29. The Process • Upon swallowing, the vitamin-size pill acts as an internal thermometer, providing continuous readings of a player's body temperature, which can be picked up by a sensor placed against the low back. • Pills are ingested a couple of hours before the start of practice, allowing the capsules time to reach the small intestine, where core body temperature readings accurate to within 0.1 °C can be taken. • The capsule remains in the body for only 24 to 36 hours before it is eliminated.

30. TheScience • Temperature readings are transmitted wirelessly to a handheld data recorder. • The receiver is held to the low back, and the handheld device's antenna retrieves the original temperature data.

31. Core Temp Over Timea.m. vs. p.m.

32. Heat Monitoring • Allows for real-time on-site monitoring • Provides absolute vs. relative data immediately • Temperature patch reflects internal (core) body temperature • SportsTempThermostrip • www.sportstemp.com • $1.50 each

33. Acclimatization • Heat acclimatization is specific to the stress imposed on the human body. For example, passive exposure to heat induces some responses, notably an improved ability to dissipate heat. • Complete heat acclimatization requires up to 14 days, but the systems of the body adapt to heat exposure at varying rates.

34. Acclimatization • The early adaptations (initial 1-5 days) involve an improved control of cardiovascular function, including expanded plasma volume, reduced heart rate, and autonomic nervous system which redirects cardiac output to skin capillary beds and active muscle • Excess dietary water and electrolytes do not speed the process of heat acclimatization.

35. We do it for the kids