Football players are supposed to be tough.

Weekend warriors of the gridiron who can take a crushing hit and pop right back up to show their opponent they barely felt it — even if they did.

Throughout the state of Maine football players and other fall sports athletes alike have eagerly tried to prove themselves on the practice field since training camp began Monday.

In every huddle, however, toughness needs to stand should-to-shoulder with intelligence.

As technology advances and information becomes more readily available, the more we learn as a society about the dangers that exist in athletics today.

More importantly, we learn about the steps that can be taken to prevent potentially catastrophic injuries from happening. When it comes to potentially-fatal, heat-related ailments, Dr. William Heinz has a firm belief on whether or not they can be prevented.

“It’s 100 percent a preventable problem,” said Heinz, a medical orthopedist who is the current chair of the Sports Medicine Advisory Committee for the National Federation of State High School Associations. “There’s absolutely no reason that any kid dies on a field because of heat illness, so in my mind it’s complete liability on that part of the school, the coaches and whoever the idiot was that made that kid do that.”

According to the March 2014 Annual Survey of Football Injury Research conducted by the National Center for Catastrophic Sport Injury Research, there have been 138 heat stroke fatalities in football between 1931 and 2013 — 52 of which have happened since 1995. The survey also reports that 90 percent of those deaths occurred during practices.

Now, heat related illnesses are far from being an epidemic nationwide. In a release issued by the NFHS on Thursday, the organization estimated nearly 1.1 million student-athletes participated in high school in 2013, with the NCCSIR reporting zero fatalities due to heat stroke.

That being said, it has happened and the Maine Principals Association is not taking the issue lightly — particularly considering it is one that is “100 percent preventable,” as Heinz notes.

“Fortunately in Maine (the heat) is not a huge issue. There’s not a lot of heat that we have to worry about,” said Heinz, who is also an advisor on the MPA Sports Medicine Committee. “I still think they need to be smart about it, and that’s why we’ve put into place these regulations as far as the first week of practice in what they can wear and what they can do.”

In the first two days, teams were limited to helmets and cleats only, no contact and no use of heavy bags, sleds or weighted items. Practices were limited to 2 hours and 15 minutes, with a mandatory three hours of rest in between double sessions.

As the week progressed, practice time increased and more contact was introduced, all with the idea of gradually getting athletes used to the weather and practicing again. It’s something the MPA, according to Heinz, has really pushed in the past few years.

“There really has been a big change in the thinking of coaches and administrators as far as heat illness is concerned and they really have gotten on board with it,” Heinz said. “Basically it was a matter of educating them and teaching them that the kids are going to be better if they’re acclimatized to the heat if you’re careful with how you practice with them in the heat.

“That doesn’t mean that you can’t go out and practice when its 90 degrees out, you just have to be careful.”

Under MPA guidelines, all head coaches must be certified in both CPR/AED and first aid, as well as view two videos on the NFHS website — ‘Concussion in Sport — What You Need to Know’ and ‘A Guide to Heat Acclimatization and Heat Illness Prevention.’

The increase in coaching education is something Oak Hill High School athletic director Jim Palmer has seen firsthand in his nearly 20 years of experience in high school athletics. Palmer said in addition to the MPA mandates, he addresses the matter of heat safety personally with his coaches as well.

“We do the heat acclimatization course but when we have our coaches meeting, we just talk about being smart,” Palmer said. “If you see a kid that is winded and might need to step out, let him know you don’t have to be a hero. If you need that break, take that break because you never know.”

According to the Center for Disease Control and Prevention, “muscle cramping might be the first sign of heat-related illness, and may lead to heat exhaustion or heat stroke.” Symptoms of heat exhaustion — the less life-threatening of the two, yet still serious condition — include heavy sweating, weakness, nausea or vomiting, fainting, a fast, weak pulse and cold, pale and clammy skin. Heat stroke signs include high body temperature (above 103 degrees Fahrenheit), rapid and strong pulse, possible unconsciousness and hot, red, dry or moist skin.

Gardiner AD Steve Ouellette said he takes similar steps to Palmer with his staff, but also noted that the increased prevalence of athletic trainers at both games and practices has helped.

“That’s changed from way back when we first started,” Ouelette said. “We have medical professionals that are on hand that schools have been appropriately adding to their staff to make sure that we’re aware of all these situations. I’ve been fortunate to work to some great athletic trainers.”

One of those trainers out on the fields is Steve Tosi, who has been employed at MaineGeneral Sports Medicine since 1992 and provides services to Lawrence High and Junior High Schools in Fairfield. From stretching calves to taping ankles, Tosi is one of nine athletic trainers employed by MaineGeneral that are stationed at area high schools.

Part of Tosi’s work entails doing what he can to prevent situations, like heat-related emergencies, from happening.

“We try to have parent meetings and things like that,” he said. “We try to warn them about the heat and encourage them to drink water. We talk to the coaches and we talk to the kids. Usually when the practices start we like to get around to the teams and get the word out in regards to that, or the coaches are getting the word out and encouraging them to drink.”

It sounds like a simple concept, but anyone who has ever dealt with teenagers can tell you how even the simplest things sometimes get overlooked.

“I think everybody has that mindset that they need to drink and get that word to the kids, but that doesn’t mean the kids are doing that and that’s the problem,” Tosi said. “They’ve got other things on their minds.

“They’ve got video games to play, they’re going to see their girlfriend or boyfriend and they kind of forget and so three, four hours later they haven’t drank anything. Then it’s time for bed and now they haven’t had anything from 4-o’clock in the evening until 8-o’clock in the morning.”

At least at the practices, athletes seem to be getting the message.

“(Coaches) tell us to hydrate throughout the day,” Mitchell Caron, a senior on the Cony football team, said. “They give us probably six to seven water breaks a practice. After every drill they give us a water break, come right back, do another drill, another water break. It’s do whatever they need to do to keep us hydrated.”

Of course, staying hydrated and beating the heat are not problems only football players face.

“Really it’s any of the sports,” said Jill Haskell, also an athletic trainer at MaineGeneral who works at Hall-Dale and Monmouth. “Most think of football because they’re in full pads, but really soccer and field hockey and cross country and anyone that’s exercising out in the heat is at risk for it if they’re not prepared or properly hydrated.”

Ian Wilson is entering his eighth season as the head coach of the Waterville girls soccer team, and also served as the Purple Panthers track coach for 18 seasons before accepting a position with the Colby track team this summer. Wilson provides similar instruction to his girls soccer team.

“We had a talk (Friday) about making sure they’re staying really well hydrated,” Wilson said. “When you get thirsty you’re already dehydrated. You’re already way down in the amount of fluid your drinking. You’re not feeling thirsty until you’ve lost several pounds. We’re really conscious of talking to the girls about drinking a lot.”

Wilson has also noticed the increase in the amount of information that has become more readily available, as the first introduction he had to heat exhaustion was when he was attending Bates College in the late 1980s.

“I went for a really long bike ride, and I just didn’t drink very much water,” Wilson said. “For the last 10 miles I remember being woozy and sick to my stomach and sort of cold with tingly, clammy feeling skin. I felt really nauseous. I didn’t know what the heck it was and I learned after what had happened to me. I think probably for a lot of people before there was a lot of information that was kind of the (learning) experience.”

Fortunately for Wilson’s team and those starting the fall sports season this past week the weather has been very mild, even by Maine standards. Next week may be a different story with temperatures potentially reaching the mid- to high-80s in some areas, but it is something area schools are planning for and expecting.

“We have to pay close attention to that, it doesn’t matter what state you’re in,” Ouellette said. “It does get warm in Maine.”

Evan Crawley — 621-5640

[email protected]

Twitter: Evan_Crawley

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