As football teams practice diligently for the long season ahead, they must first plan ways to beat the heat of August.
Training camp for the National Football League is in full swing as all 32 teams have begun practice sessions. Starting this month, collegiate and high school athletes will each begin practicing for their upcoming seasons.
While this summer has featured cooler weather in much of the country, as well as extreme heat in the Northwest, those conditions are likely to change in August. In the Southwest, no significant change is forecast.
"A shift in the jet stream is forecast during the middle of August that will lead to longer-lasting warm weather over much of the eastern two-thirds of the nation and less extreme heat over the Northwest," AccuWeather.com Meteorologist Alex Sosnowski reported.
Heat stroke is a major issue for athletes, particularly in high school athletics where one third of schools do not have an athletic trainer on staff, Douglas Casa, chief operating officer at the Korey Stringer Institute at the University of Connecticut, previously told AccuWeather.com.
Korey Stringer was a Pro Bowl offensive lineman for the Minnesota Vikings, who passed away in training camp in 2001, after suffering exertional heat stroke.
According to a report from the National Center for Catastrophic Sport Injury Research released this past March, 52 football players have died from heat stroke since 1995, and 41 were high school football players. The report also states that 90 percent of the fatalities occurred during practice.
Casa added that heat stroke is 100 percent survivable if you get the affected person's temperature under 104 degrees within 30 minutes of collapse.
A number of steps are needed to prevent heat illness from occurring, starting with proper nutrition and hydration as well as becoming adjusted to the climate and practice work.
Christine Rosenbloom, professor emerita of nutrition at Georgia State University in Atlanta, has worked with college and high school football players throughout her career, but has also spent time with several pro players, including Geoff Schwartz, an offensive lineman for the New York Giants.
Rosenbloom said that while proper nutrition cannot directly combat heat illness, athletes that are in better shape will end up putting less strain on their bodies.
"The athletes [that] tend to get in trouble are the ones that tend to come in a little bit overweight," Rosenbloom said. "So then they're trying to lose weight during camp and extra weight can put a strain on your cardiovascular system and so can the heat."
Making sure an athlete is hydrated is critical, especially in the hot, humid environment of training camp. When a football player is practicing in those conditions with pads and a helmet, it is equivalent to a human sweat-box, Rosenbloom said.
Making sure that the athletes are very well hydrated by giving adequate fluids the whole time and then replenishing fluids after a workout can help them stay healthy, because it won't put so much strain on their heart and blood vessels, Rosenbloom said.
Acclimatizing athletes to the heat and humidity takes about 10 days to two weeks with a progressive approach to training, according to Scott Anderson, head athletic trainer at the University of Oklahoma and president of the College Athletics Trainers' Society.
"At the initial start, athletics may lack fitness and so you don't start hard, intense action," he said. "It's more an intensity problem than environmental."
High school athletes are susceptible because of varied fitness levels, particularly among linemen who tend to be overweight and out of shape, Casa said.
In 2013, the Pennsylvania Intercollegiate Athletic Association unveiled its first heat acclimatization rule for football.
The new rule gives an option to football coaches: They can either do a three-day acclimatization program with no contact drills before the official first day of practice on Aug. 11 or do the acclimatization program the first week of practice.
"There are some things we can't control in a contact sport like football but, with heat-illness deaths, we can take measures to prevent it from happening. It's necessary to keep kids safe," Associate Executive Director of the PIAA Melissa N. Mertz said.
Iowa and Georgia are couple of the other states who recently instituted heat safety rules, in 2013 and 2012, respectively.
Pennsylvania, however, is one of 40 states that does not follow national guidelines issued in 2009 by the National Athletic Trainers Association (NATA), said Certified Athletic Trainer Dave Csillan, who is the head athletic trainer at Ewing High School in Ewing, New Jersey, and one of the co-chairs of the task force that worked on the NATA guidelines.
"[Pennsylvania] doesn't have much substance," he said. "It has a three-day acclimatization; ours is a 14-day period which is evidence-based."
Still, coaches and other state association have the mentality of "It can't happen to us," Csillan said.
"Until we have 100-percent compliance with the guidelines, we're not doing okay," he said. "One death from catastrophic injury due to heat illness is too many."
On-field coaches need to be able to identify signs and symptoms of exertional heat stroke and seek immediate treatment of the affected athlete.
"[At Oklahoma], we have a cold tank at our practice facility which can be taken to the athlete to immerse them in cold water between 45 and 60 degrees," Anderson said.
Csillan said he uses a heat tracker to monitor air temperature, relative humidity and other factors and may modify the Ewing football practice schedule based on the information.
Athletes need rest breaks with shade, fluids and ice towels available to help with cooling. Fluids are also important for athletes during, before and after practices.
Coaches, however, should not think fluids provide immunity, an antidote, Anderson said.
In order to practice in a more favorable climate, several NFL teams move their training camp facilities to different parts of the country.
This year, the New Orleans Saints are holding part of their training camp at The Greenbriar Resort in White Sulphur Springs, West Virginia.
"We all understand the importance of training camp and ultimately, that's to get the team ready for the regular season," Saints head coach Sean Payton said in a press release. "As far as the time we will spend at The Greenbrier, it offers a tremendous opportunity to our team in a more moderate summer climate."
The Dallas Cowboys frequently eschew the Texas heat and hold their camp in Oxnard, California, where common summer temperatures are in the mid-70s. This is the third year in a row that the Cowboys will train in Oxnard.
"[The weather] allows you to get more work in and the players are more focused on what we're asking them to do instead of the Gatorade or the water jug behind them," Cowboys head coach Jason Garrett said in a 2012 dallasnews.com article.
Just last week, Cowboys safety Barry Church, told the website that practicing in Dallas versus Oxnard would be like playing in the "Mojave Desert."
"I mean, it's pretty bad out there. You can barely breathe," Church said.