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Maximizing Player PerformanceTemperature Rising!by: AFM Editorial Staff © More from this issue It’s the summer of 2003, and the Oklahoma Sooners football team doesn’t have much to complain about. The squad is ranked No. 1 in the Associated Press and the ESPN/USA Today Coaches’ Preseason Poll, and the Sooners are enjoying the return to national prominence brought upon by coach Bob Stoops and his dominating defense. The team is preparing for a season that would see it lose the National Championship in the Sugar Bowl in New Orleans. But while players work to get their bodies in peak shape for another grueling season at the top, the second year of an unusual science experiment is being performed with ramifications that will impact athletes, not just football players, across the world. “There’s a lot of tradition with football,” said Scott Anderson, the head athletic trainer at Oklahoma, “but not a lot of science.” That was about to change. How it started It his eight years at OU, Anderson had often wondered why the same players would always seem to cramp up during intense workouts. Regardless of size, physical condition or outside environmental conditions, practice seemed to have the same effect – cramping – on the same players. “We saw that we were consistently seeing the same guys, regardless of what we did to try to help them,” Anderson said. Anderson wondered why. He went looking for answers. Anderson had heard that the Gatorade Sports Science Institute was studying the same topic – heat-related illnesses, cramping and dehydration – with select NFL teams. He thought Oklahoma might be a good place to conduct those experiments. First, Anderson had to convince coach Bob Stoops to allow that access. When you run a major football program, distractions are always an issue. Still, Stoops allowed GSSI scientists to come to practice. “That Coach Stoops gave the support is great,” Anderson said. “He has a great awareness for athlete welfare, unlike any coach I’ve been with before. “It was unique to give that kind of access to anyone. But the response was overwhelmingly positive. We made an offer to them to come in and give them comprehensive access to the program. It was mutually beneficial to us.” GSSI scientists agreed to come to campus, starting during the 2002 football season. Sweaty Sooner Study Anderson, OU team physician Dr. Randy Eichner and GSSI scientists had a theory – that certain players sweated more salt out of their bodies than others. This is especially important when considering the causes of cramping. Cramping has three roots, according to Eichner – muscle fatigue, dehydration and depletion in amount of sodium in the body. “We went into it with a suspicion that we’d find those crampers had sweat more and lost a lot of salt,” Anderson said. “They sweat heavy, and they were losing more sodium than the players who didn’t cramp.” The “Sweaty Sooner” study measured sweat and electrolyte loss in those players with a history of whole-body muscle cramping against those players who never cramped up. Scientists matched five “crampers” with five “non-crampers” along the lines of age, race, position and weight, and put them through practices that lasted two-and-a-half hours. While they practiced, scientists measured the sweat loss, fluid intake, sweat sodium and potassium levels in each player. The GSSI team, in conjunction with OU representatives, found that crampers lost more sodium than non-crampers, were more dehydrated and sweated more. They also tended to sweat earlier during a workout than “non-crampers.” The key finding, according to Eichner, was that crampers lost more salt than non-crampers. The average cramper tested lost 5 tsp. of sodium during a workout. One cramper even lost 9 tsp. of sodium. The adult body contains 200 to 250 grams of salt, so some athletes can lose between 10 to 25 percent of their body’s total salt content in one day. “Crampers dehydrate slightly more than non-crampers, and lose twice the salt,” Eichner said. The conclusion was what the scientists, trainers and medical staff had suspected – crampers tended to seize up because they lost more sodium than their teammates. Radio Pill Study Intrigued by their findings, the GSSI scientists returned to Norman, Okla., in the summer of 2003, armed with a new question – How quickly do athletes heat up? The scientists wanted to find out whether there was a relationship between a player’s core body temperature and the risk of heat-related illness. This time, the scientists used a more high-tech method of tracking body temperature. Players were given a “radio pill” that allowed researchers to track the temperature. Players were asked to swallow the pill, made by NASA and costing $40 apiece, the night before practice. The pill lasted from 24-36 hours before passing through the system. When the players went to practice the next morning, the low-frequency radio wave given off by the pill was read by scientists using a receiver about the size of a deck of cards. The players participating in the study did field and agility drills for 30 minutes, followed by half-hour sessions in a weight room and doing sprints on the field. All the while, scientists measured the players’ changes in core body temperature every 10 minutes. “The thing we noticed with the core temperature study was how quickly it escalated two to three degrees in 10 minutes, and then it maintained a high plateau throughout the workout,” Anderson said. “As they completed the weight lifting and went back to the indoor field to change shoes, the temperature dropped a bit and then spiked and reached its aggregate high during sprinting.” What scientists learned was that, regardless of the player, the intensity of the practice was the most important factor in determining a body’s core temperature. “We’ve focused on environment and uniform before,” Anderson said. “Those aren’t inappropriate, but the key thing in this study is that it took place at 6:30 a.m. in an indoor facility. We didn’t have those ambient environmental factors. “Even without uniform and environmental factors, there’s still an opportunity to have a rapid escalation of core temperature and metabolic heat temperature. Intensity is the key.” Advice for Coaches Armed with knowledge acquired from the two studies, Anderson, Eichner and officials from schools nationwide now have a better idea of how to treat and prevent cramping and heat-related illnesses. “What you need to stay cramp-free is what you lose in sweat – water and salt,” Eichner said. “Not potassium, calcium, magnesium, phosphate, amino acids, mustard, or vinegar.” Although a sports drink such as Gatorade offers the ingredients above, OU officials recommend drinking Gatorade strictly for the sodium, in terms of cramp prevention. The flavor of Gatorade encourages players to keep drinking, and the sodium players acquire can prevent them from cramping during the next practice. In part because of that, Anderson has instituted a drinking schedule for his players. In the case of chronic crampers and salty sweaters, a sports drink such as Gatorade is necessary to ensure that those players are receiving as much salt as possible. “Probably one of the most successful things that we have done is scheduled drinking, especially for those high-risk individuals,” Anderson said. “Studies indicate that drinking on thirst in that they’re drinking only half of what they need. We give them a schedule such that they’re drinking on a routine basis, not just relying on thirst. We’ll schedule that according to their weight loss, so they’re not under-consuming or over-consuming.” “A good rule of thumb,” Anderson said, “is that players should drink what they lose during practice. If a player is putting on weight between practices – Anderson weighs each player before and after practice – odds are he or she is drinking too much.” Drinking too much water could lead to hyponatremia, a rare medical condition known as “water intoxication” that could lead to death when the body receives too much water and not enough sodium. Drinking a sodium-rich sports drink such as Gatorade could prevent such a condition. “Players should also salt their food whenever possible and try to eat sodium-rich foods,” said Anderson and Eichner, to ensure that sodium enters their system. In extreme cases, Oklahoma uses GatorLytes, which are sodium pills created by the makers of Gatorade. GatorLytes can be added to a 20-ounce bottle of Gatorade to add almost four times more sodium to a player’s diet. In cases where players can’t keep food or drink down, OU administers salt intravenously. “Of course, no amount of prevention is fool-proof if practice intensity isn’t closely monitored,” Anderson said. “In the case of the radio pill experiment, scientists found that the intensity of practice - more than environment, uniform and other factors – is the main contributor that raises or lowers a player’s core body temperature.” During two-a-day practices, coaches should give their players ample time for water breaks and schedule high-intensity drills intermittently during practice to give players’ body temperatures time to cool off during less-intense sessions. Also, players who might have recently received more repetitions than they’re used to – a backup moved into a starter’s role, for instance – might not be used to such an intense workout quite yet. Coaches should keep that in mind. “It’s common sense,” Anderson said. A Brighter Future There’s little doubt that Oklahoma learned a great deal about cramping and heat-related illness during the two GSSI studies; there’s also no question GSSI scientists learned a lot from OU’s players and the access granted by Sooner coaches. “I think we’ve had a reduction in both numbers and severity of cramping,” Anderson said. “It’s becoming an awareness for coaching staffs and athletic trainers as well. When the coaches reaffirm the messages we’re giving, that helps, too. “You get into a contest and you want your best players on the field. Prevention is a huge part of what we do. If we can prevent a syndrome from occurring, that’s what we want to do. It’s preventable.” Of course, having a greater chance of keeping players healthy on Saturdays helps, too. “We want them to individually achieve their best. That’s going to contribute to the team. That’s what we’re all about.”
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