Nineteen year-old Jordan McNair, a former University of Maryland College Park (UMD) offensive lineman, passed away June 13 of heatstroke two weeks after collapsing during football practice. McNair’s body temperature was found to be 106 degrees Fahrenheit at a local hospital and reportedly showed signs of heat exhaustion during practice.

This summer brought record-breaking temperatures in Maryland, even resulting in a heat advisory with a heat index of 105 degrees Fahrenheit in Baltimore, prompting the need for athletes to be extra cautious when playing and training outdoors due to the increased possibility of dehydration and heat-related injuries and conditions.

“The heat over the summer affected how I played soccer because it would drain my energy and just make me so tired and not want to play anymore,” senior varsity boys soccer player Jahir Williams said. “The heat affected my daily routine because I started to drink more and more water as the days got hotter.”

The Maryland Public Secondary Schools Athletics Association (MPSSAA) created a policy regarding fall practice heat guidelines to assist individual school systems in creating their own rules to ensure student-athlete safety. Montgomery County Public Schools (MCPS) has their own 14-day fall heat plan which is almost identical to most other school systems in Maryland. This plan includes guidelines and restrictions for fall sports such as limitations on what protective equipment can be worn in the beginning of the season and how long practices can last.

Part of the plan describes emergency procedures in the case of heat acclimation and heat-related emergencies which include guidelines for preparedness, treatment and pre-assignment of responsibilities. Under these rules, sports must have a plastic children’s pool on hand during physical activity in the event a player requires an emergency ice bath to reduce their body temperature if they are overheated and show signs of serious conditions such as heatstroke and dehydration.

This cold-water immersion treatment is a technique used commonly in sports and was used on two occasions at RHS over the summer for the football team. Both players were brought back to normal health conditions after the ice bath, drinking water and talking with the athletic trainer, Robert Kambies. In both cases, the players told varsity head coach Jason Lomax that they had not drank enough water that day, causing their bodies to break down.

“Usually it’s a dehydration issue where they just haven’t been drinking enough water,” Lomax said. “We encourage it, we teach it, we preach it, but at the end of the day, I can’t follow everyone home and force them to drink water.”

During McNair’s practice two weeks before his death at UMD, there was no reported ice bath, which could have prevented his death.

“It’s [the cold-water immersion treatment is] the magic elixir,” said Douglas Casa, chief executive officer of the University of Connecticut’s Korey Stringer Institute, in a Aug. 13 article in The Baltimore Sun. “That’s the thing that’s going to allow the person to survive.”

In the state of Maryland, practices for any high school sport cannot exceed more than five hours per day, with a maximum practice period of three hours. This prevents overworking student-athletes and allows for them to rest in between rigorous workouts. Rams football began their workouts during the winter, usually working out three to five days per week leading up to the current season. When temperatures started getting warmer, Rams football practiced and conditioned outside to get their bodies acclimated to the intense weather of the regular season.

The protective gear that football players wear can vary from 20 pounds to 60 pounds of additional weight that athletes play in. This makes it even more important for players to stay hydrated to counteract the amount of perspiration that exceeds fluid intake during aerobic exercise. Insufficient amounts of water intake may lead to heat exhaustion, which can be identified by its symptoms such as profuse sweating, weakness, nausea, vomiting, headache, light headedness and muscle cramps.

Whether someone plays professional sports or competes in high school sporting events, hydration is a crucial part of athletics and exercise to preserve health and prevent injuries and heat-related conditions, especially over the summer.

“Maintaining proper levels of hydration is key when demanding peak athletic performance. Hydration is a multiple day process that should always be part of your daily routine,” Kambies said. “The best way to prevent dehydration illnesses is to constantly maintain proper nutrition and hydration practices. Aside from personal care, practices should be held in cool temperatures if possible, with regular water breaks.”

Sports are meant to be fun and keep athletes in shape; however, the high possibly of heat-related injuries, and injuries in general, have the capability to sideline a player, possibly ending their season or their life. Athletes, specifically teenage athletes, need to know the importance of hydration and the effects of heat because otherwise, the consequences can be life-altering.

The awareness and prevention of concussions is being studied at a much higher rate as science catches up to injuries and the athletic community continues to study the harmful effects of head injuries. Montgomery County Public Schools (MCPS) coaches and athletes have joined the country and even world in working to educate teams about the dangers of concussions and how to identify them.  

Concussions are serious brain injuries sustained from a violent blow or shake to the head, according to the Centers for Disease Control and Prevention (CDC). Symptoms include headaches, blurred vision, nausea, sensitivity to light and poor memory. While there are many reasons for concussions, sports and physical activity are some of the most common, especially for high school student athletes.

In a 2017 report from the CDC on concussions among active high school students, a National Youth Risk Behavior cross-sectional study of sampled private and public high school students found that 15.1 percent of students surveyed had suffered at least one concussion from playing a sport or being physically active. Furthermore, the more sports a student played, the greater the chance of getting a concussion.

“A study of high school athletes found that among athletes with concussions, 40 percent reported that their coach was unaware of their symptoms,” the CDC said. “Students might not always recognize or remember that they have experienced a concussion, or they might not want to report having experienced a concussion.”

Not only can concussions end athletic careers or seasons, they can also have long term or even lifelong effects. In a 2005 study by Moser, Schatz and Jordan entitled “Prolonged Effects of Concussion in High School Athletes,” it was found that athletes with recent concussions performed worse on tests of concentration and attention than non-concussed athletes, and had lower grade-point averages (GPA). It was similarly found that athletes who had been symptom-free for years after suffering multiple concussions had similar scores and GPAs to the athletes with recent concussions.

In addressing this prevalent and debilitating injury, MCPS and the Maryland Public Secondary Schools Athletics Association (MPSSAA) have established state and countywide rules to aid in the training of coaches, trainers and athletes, in identifying concussions, as well as in preventing them. Each one of the 25 high schools in MCPS is assigned a certified athletic trainer who is specifically trained and certified to aid in injury care and prevention.

“Athletic trainers are responsible for submitting injury data into a systemwide database for various reports required by local, state, and national agencies,” MCPS athletics specialist Kathy Green said.

RHS’ athletic trainer, Robert Kambies, attends every single sporting event that takes place at RHS and aids in injury care of athletes.

“Through injury data software, MCPS can track injuries across the county,” Kambies said. “Concussions are primarily the most carefully tracked injuries when MCPS pulls data from the information that the athletic trainers have documented.”

In addition, coaches must attend athletic trainings and get certified or recertified every year, including attending a National Federation of High Schools (NFHS) concussion seminar every two years.

“MCPS utilizes the recommendations from state and national agencies when determining health and safety policy and protocol; such as, the Department of Health and Human Services Centers for Disease Control and Prevention (CDC), the National Federation of High Schools (NFHS), the Maryland Public Secondary Schools Athletics Association (MPSSAA), and the Maryland State Department of Education (MSDE),” Green said.

A 2008 study by Rechel, Yard and Comstock, published in the Journal of Athletic Training found that athletes are more likely to be injured in games than in practice, and football, unsurprisingly, had the highest incidence of injury rate. Similarly at RHS, football players experience injuries such as concussions on a regular basis.

“You’re going to get a few concussions here and there. We’ve had a couple this season and lot of times it’s teammates that just for unfortunate reasons, are running, trying to make the same tackle and a guy moves or something and they collide,” varsity football head coach Jason Lomax said. “Or, we found that the most [concussions] we get is actually when a head hits the ground, not so much of something else. It’s when you get like that whiplash effect and it goes back.”

Injuries such as these reinforce why another established rule in concussion identification is necessary: concussion baseline testing, which MCPS implemented six years ago. Every MCPS athlete is required to take a concussion baseline test every two years, which quizzes the athlete on basic memory and attention skills which would then be used in a comparison if the athlete had a suspected concussion.

Despite these efforts in preventing head injuries in sports, high school athletes will continue to struggle with serious injuries and coaches and trainers will work to support these athletes and educate them on the dangers of concussions. These tests and support systems continue to adapt and become more beneficial as the science catches up to the injuries.