When the Kansas City Chiefs were in town recently, Dick Vermeil reacted to questions about the death of Korey Stringer.  “I really think we have to be careful that we don’t over-react,” he said. “It was a unique thing that happened, and it was tragic.  But I don’t think it should totally overpower everything people have been doing for years.”

Over-react?!?

It is precisely because coaches haven’t reacted in any way to the deaths of young players that football needs to be sued ?  Big-time.  Stringer’s death may have been unique in the NFL, but more than 1,600 athletes have died in football, and many of those were preventable with an intelligent approach to training camp.

What is the over-reaction that Mr. Vermeil fears?  Is he suggesting we shouldn’t examine the tradition of long, hot two-a-day practices in the sun to see if we can do it in a safer way?  Are football coaches too arrogant to examine the facts?

Weeks after Stringer’s death, Mike Kelly, Viking attorney and Vice President, responded to questions about liability by saying, “We ran an exemplary camp.”  Wait a second.  You call it exemplary? ... as in, “good example?”  What if somebody believes you?  What if high school coaches read your statements, looking for justification to continue the dangerous tradition of long practices on the hottest days of the year?

Please! Defend yourself for past mistakes if you feel the need, but don’t advise others to copy your training camp after a player dies needlessly.

Athletes and parents should take time to examine the facts surrounding the deaths each year in football, mostly to high school athletes.

Note: Data on football deaths can be found at the website of the National Center for Catastrophic Sports Injury Research compiled by the University of North Carolina (http://www.unc.edu/depts/nccsi/FootballInjuryData.htm).

While 1,000 deaths were directly related to football contact, there have been another 617 that were not due to the inherent risks of the sport.   Most of these were high school athletes, 31 in the last three years. Every death by heatstroke was preventable.  “There is no excuse for heat stroke deaths,” according to Dr. Fred Mueller, head of the NCCSIR, and chairman of the Physical Education department at North Carolina. The number “should be zero.”

Consider the deaths of young football players last year alone.  If these cases sound redundant, they are.  It has been like this every year for the last seventy.   A 14-year-old died in practice on June 20 of a heart-related problem.  A 13-year-old collapsed in practice and died later from a coronary artery defect.  A 14-year-old collapsed in practice on August 15 and died later from an enlarged heart.  A 17-year-old collapsed at practice on August 19 and died later from a heart-related condition.  A middle school player collapsed on September 24 while running laps and died later.  A 16-year-old collapsed in practice on May 17 and died of unknown causes.

A 17- year-old died of heatstroke on August 1, the same day Korey Stringer died of heatstroke from conditions in Vikings’ practice.  A 15- year old died after practice on August 19 from a heart-related problem.  A 14-year-old collapsed at the start of practice on September12 and died of unknown causes.  A 22-year-old college player collapsed and died after conditioning drills on August 3. Cause of death was exercise-induced asthma.  An 18-year-old college player died from heatstroke during conditioning drills on July 25.  An 18- year-old player died after a morning practice on February 26.  Possible cause was listed as sickle-cell trait.

Coach Vermeil, is it really an over-reaction to examine the way we practice in football?

Certainly, some of these tragedies might not have been prevented; congenital heart conditions which were unknown, for example. However, if a healthy athlete becomes increasingly dehydrated in practice, the heart will have great difficulty maintaining blood pressure and homeostasis. So any pre-existing heart condition will be exacerbated. In the case of the Northwestern player it is reasonable to ask if the major cause of his death was asthma or an inappropriate conditioning workout that featured two dozen sprints with inadequate rest.

Some have suggested that Kelci Stringer’s $100 million lawsuit is just about the money; that this is part of the over-reaction.  On the contrary.  It may turn out that, by her actions, she has ultimately done more to make the game safe for football players than anyone in history.  She looks at the tragic list of needless deaths to young athletes and asks why coaches haven’t made changes to their training camp traditions.  It seems that nothing causes the football world to stop and think, until they are hit in the pocket book.

Consider changes that have already been made this year in football camps around the country, and you might agree Mrs. Stringer is right in her crusade.  The Vikings have added large umbrella tents for shade during water breaks, increased the number of water stations, sprayed players with water to cool them down, cancelled practices, replaced dark practice jerseys with light-colored ones to reflect some of the sun’s rays.  A physician is on-site at all practices now, and they were not last year.  Teams are actually planning for the prevention and treatment of heat-related injuries.

The Dallas Cowboys are conducting all practices inside where it is air-conditioned and out of the direct sunlight.  For voluntary pre-season practices, several colleges have made major changes. At the University of North Carolina, Florida State, North Carolina State, and Duke, there is more rest between anaerobic intervals, fewer repetitions for incoming freshmen, more trainers on the field, more water breaks, longer breaks in the shade, more discussions about dehydation, warnings taped to lockers, and ... “I have re-certified my CPR,” said Sonny Falcone, the strength coach at Duke University.

Why were these changes not made in past years?  Because football coaches don’t like being questioned about their ability to run a safe program.

Just hours after Korey died, Dennis Green answered a question that was asked by no one, but remains on everyone’s mind.  “We know how to run a football camp,” he said.

The changes that have already been made are good ones, but they are not enough to bring the number of preventable deaths to zero.

1) Practices for any sport in high school should be limited to a total of two to three hours per day, at most.  On hot, humid days this should be reduced, and much of the time should be spent in an air-conditioned facility.  At the very best, practicing after fatigue sets in accomplishes nothing more than repetition of slow, sloppy habits.  It’s amazing coaches don’t follow the lead of John Gagliardi, the most successful coach in the state.

2) Dehydration is an essential partner with heat in the etiology of heatstroke.  If we prevent dehydration, we will greatly reduce the chances of heatstroke in football. This can be accomplished by requiring athletes to weigh in before the season; then they are not allowed to start any practice during training camp in which their weight is below 99% of the standard.   If the team practices more than an hour in the heat, players should strip to their shorts and weigh in during a water break.  If their weight falls below 3% dehydration, they cannot continue practicing. If our high school league fails to act wisely here, perhaps the legislature should make this a law.

3) Large athletes cannot cool themselves as efficiently as smaller ones, even if they are in the same condition and have a similar physique.   It is not a matter of mental toughness, leadership, or conditioning level.  This is a fact of geometry.

The surface area does not increase in proportion to the weight (or volume) as similar geometric shapes get larger.  It is the surface area of the skin that determines how much heat is lost by the evaporation of sweat.  A player who weighs twice as much as a team-mate will do twice the physical work in the same practice drills.  This produces twice the internal heat.  But it is not possible to remove twice the heat, because he has only about 1.6 times the skin surface for evaporative cooling.

The surface area problem gets worse for a player who has a rounder shape than a thinner team-mate.  Furthermore, if he carries more body fat - - and he does, even if his percentage is the same as a smaller player - - he has a thicker layer of insulation, trapping the heat inside the body.

Football has encouraged its players to get bigger - - note the Viking offensive line is 100 pounds heavier than its counterpart of the 1970’s - - so, football must deal with these physical facts in an intelligent, safe way.  The big linemen need a reduced practice load on hot days, because no matter what condition they’re in, they cannot possibly cool themselves as efficiently as a Randy Moss.  The idea is ludicrous to require extra conditioning to work off extra pounds.  It is all water loss that is essential for survival.

Before and after training camp, overweight players should follow a healthy schedule of gradual weight loss, but never during two-a-day practices in the heat.

4) Most of the conditioning goals for training camps of the 1950’s are no longer valid.  Players today work out in the off-season and report in excellent shape. In fact, football has been a leader in getting its players to train consistently.  Then, it makes no sense to treat them on the first day of camp as if they’ve done nothing, as was the tradition years ago.  If there are players on the team who have not done their off-season work, they are the least capable of surviving extra drills in training camp.

5) Acclimatization to the heat is a poorly understood process, even by some “experts.” Immediately after Korey’s death a physician for an NFL team stated on national TV, “We play in these hot conditions, so we must practice in them.”  Although the comment sounds logical, there are several things wrong with it.  First, heat stroke deaths occur in training camp, not in games. Players know the real challenge to their survival is training camp, so they work out in the heat to prepare.  Unfortunately, the acclimatization does them no good if they are required to have their equipment on at all times during practice.

It is well known that athletes can exercise more safely in the heat once they’ve become acclimatized.

However, if their skin is covered and sweat is not allowed to evaporate and cool the blood beneath the skin, the acclimatization is of no benefit.  Research shows that with a football uniform on, core temperatures rise quickly to dangerous levels even in an air-conditioned environment - - even if the athlete has acclimatized previously.  During water breaks it is important for players to remove as much equipment and clothing as possible to allow sweat evaporation to cool them off.

6) No one questions the role of coaches to push athletes to higher comfort zones, sometimes past the point of pain or fatigue.  This is a necessity in football.  However, this can never be done when the outcome is unsafe or unknown, as is the case with heat injury.  Pro football players must often compete with bruises, muscle pulls, and even broken bones.  But, in those cases the evolving damage is visible.

With hyperthermia, the extent of injury is not always identified by obvious symptoms.  The athlete cannot always tell if his core temperature is dangerously high, or if he is dehydrated.

Scientific studies with college wrestlers have shown that cognitive abilities are impaired when athletes are dehydrated.  We cannot expect players to make good judgements, nor can we rely on their appraisal of a heat injury they may not even feel.  The debilitating effect of high core temperatures on the Central Nervous System may mean the hypothalamus does not thermoregulate normally.  Athletes may not even feel overly hot or thirsty, when in fact they are extremely close to death.

7) Coaches demand compliance to their decisions.  This requires unqualified trust in the coach that what he is demanding is both safe and productive.  Hot, five-hour practice regimens are neither.  If a coach willfully drives his athletes into dangerous or unknown territory, he has broken the trust and no longer deserves their unqualified effort.

This is no less true if the coach doesn’t know the important facts, because he has failed to do his homework.  It is the obligation of every coach to stay up-to-date on scientific research related to safety and conditioning.

If coaches continue to fail in this responsibility, we can be thankful there are people as determined as Kelci Stringer, who has shown the courage to raise her voice in dissent at a difficult time in her life.

“No player should ever die again,” she said recently.  “I want to make a right out of a wrong.”