Athlete death toll rises after summer training

BY LAURIE RANDELL

The spotlight was on the football world for much of the summer, but nobody was smiling for the cameras. The close-knit college football community was shocked by the Wed., Jul. 25 death of running back Eraste Autin, an incoming Florida freshman, from heatstroke. The tragedy foreshadowed what would become a nationwide mourning period for five more football players, including Minnesota Vikings' Pro Bowl tackle Korey Stringer and Northwestern's Rashidi Wheeler '02. Stringer's death on Wed., Aug. 1 was also attributed to heatstroke, adding to a national debate over holding intense two-a-day football practices in the stifling heat of summer. Yale football was spared any tragedies, but other schools weren't so lucky.

SCOTT HALLERAN/NEWSMAKERS Korey Stringer's death shed light on heatstroke

Football is known to be a dangerous sport; hardly any player who has competed on the gridiron has gone injury-free. Until recently, however, death was not a commonly accepted risk. The only other professional football player to die in training camp was J. V. Cain, a St. Louis Cardinals tight end, who succumbed in 1979. In contrast, 18 high school or college football players died from heat-related causes between 1995 and 2000. Fourteen were still in high school. Three more high school football players died this summer, one of heatstroke and two from heart conditions that may have been aggravated by the extreme Texas heat.

The tragedies of the summer forced many football programs to reevaluate how they conduct practices. For others, including Yale, the deaths of so many promising athletes served as a potent warning. "I addressed the issues of what had happened to Korey Stringer in our startup meeting," Yale football Coach Jack Siedlecki said. "Our medical people addressed the group that night also, and the annual message to the players is constant hydration and attention to nutrition during preseason."

FOOTBALL COACHES AT EVERY LEVEL OF THE GAME have come under fire for their training methods. After the death of Stringer, questions arose as to why the 300-lb. tackle remained at practice even after vomiting several times, one of the most well-known warning signs of severe heat-related problems. But most coaches and trainers agree that awareness of proper hydration techniques is at an all-time high, with trainers and aides forcing water on many players who would not otherwise stop to rehydrate their bodies. Unfortunately, beginning practices in the summer is a necessity, given that the football season begins so early. Replacing water and electrolytes in the body can only do so much if a player is losing them at a greater rate. This past summer was especially punishing to football players' bodies, with the Midwest in the grip of a record-breaking heat wave and the South's typically searing temperatures.

"This was not a particularly hot preseason," Siedlecki said of the weather in the Northeast. "If we had started two weeks sooner, the weather would have been brutal this year. Last year's preseason was very cool with a lot of rain. It really varies from year to year, but we enter preseason prepared for the worst."

The Yale football team began practice on Sat., Aug. 25, when even the slight heat of the Northeastern summer had already begun to fade. High temperatures averaged in the low 80s with low humidity, rarely rising above 75 degrees in the mornings. In contrast, the heat index in early August in Mankato, Minn., where the Vikings held training camp, was routinely over 100 degrees. On the day of Stringer's collapse, the heat index peaked at 103 degrees. Other colleges start practice much earlier than Yale in order to be ready for late-August kickoffs, and high schools routinely begin practices in mid-August. In Texas, where two high school football players died within a day, schools often begin classes in August, forcing earlier football practices.

Heat alone can't be blamed for all the summer tragedies. According to the American Medical Association, heat illness progresses through heat cramps, heat exhaustion, and heatstroke, all of which are serious but can be survived if detected promptly. Summer football practices routinely feature water stations and staff in charge of keeping players hydrated. Professional football teams often employ dozens of aides responsible for hydration. According to Siedlecki, the Yale football team would go through almost 70 gallons of water during each half of a two-a-day, and they "have and always have had water available at every coaching station during practice." Most teams, including Yale, weigh in their players before practice, and weigh them out after, to determine how much fluid they are losing.

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Proper hydration can't protect from all forms of heat illness, such as "exertional" heatstroke, which results from exercising so hard that the body cannot regulate temperature. Nonetheless, teaching players to keep hydrated is fundamental to keeping them healthy in summer practices. According to Head Athletic Trainer at Columbia University Jim Gossett, the key is to "have competent medical people involved in all aspects of your programs." Siedlecki said that during the preseason workouts, several players were held out of practice by the Yale medical staff due to too much water loss. "We are very fortunate to have an outstanding medical staff, trainers, and doctors, and they do an outstanding job addressing the health concerns of our players," he said.

BUT IS GIVING ATHLETES WATER ENOUGH TO prevent future players from literally practicing themselves to death? Across the country, hydration procedures have not changed significantly over the years. Of the football tragedies this summer, several were tied to undetected heart problems that may have been aggravated by the heat. Devaughn Darling '04, a lineman at Florida State, died in February during an offseason conditioning drill from a cardiac arrhythmia (irregular heartbeat). Steven Taylor, a 15-year-old high school tight end in Texas, died of a heart attack on Fri., Aug. 17. The next day, Leonard Carter, 14, died after returning home from morning football practice from what was later ruled to be an enlarged heart. But doctors later said he had a temperature of 107 degrees, which might have been an indication of some form of heat illness.

At Columbia University, in one of the first studies of its kind, all football players received cardiac exams in addition to normal physicals. Two private organizations—the Chad Foundation for Athletes and Artists and the Living Heart Foundation—underwrote the exams, which cost up to $2,000 per person. The Chad Foundation is interested in educating the public about sudden death in young athletes, and it has recently expanded its Cardiovascular Screening Program. Columbia football players received an echocardiograph (ECG), an EKG, and an electronic measurement of blood pressure—all designed to detect cardiac risk factors. Gossett, the Columbia trainer, described the less-than-20-lb. ECG machine used as "a truly innovative way to look at these factors. While it is not truly portable, the quality seems to be as good as in hospital machines." Out of 110 screenings of Columbia football players, eight abnormalities were detected and are being followed up on by Columbia and Living Heart doctors. While none of the irregularities appear to be serious, identifying them at this stage in an athlete's life can be crucial later.

The partnership with Columbia is a well-suited one; Columbia was the first of the Ivies to have automatic external defibrillators (AED) on the sidelines of all football games. Harvard, and now Princeton, have followed the Lions' lead, while Columbia has continued to add AEDs to its recreational sports facilities and new varsity athletic centers. Although the benefits of the cardiac screening program might seem vague, Gossett believes that they offer an advantage over simple preseason physicals for players. "There are many questions, because physicals nationwide tend to be done in mass," he said. "In the case of blood pressure, after sitting for six or seven hours listening to test after test, anyone's ears would be sore. Something might be missed." The electronic blood pressure measurements taken at Columbia offered quantitative, reproducible results for physicians.

WHILE THE JURY IS STILL OUT ON WHETHER THE screening used at Columbia can prevent sudden deaths like those of Darling, Taylor, and Carter, one thing most agree on is that anything to protect athletes' lives is a good investment. "If funding and technology all come into line, then maybe we should start looking," Gossett said. With the heat waning and the NFL season starting, it seems that the dangerous days are over for heat-related illnesses this football season. But teams seem to be taking the issue to heart. "The events that occurred prior to us practicing made these messages [of hydration and nutrition] a little more powerful this year," Siedlecki said.

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