SPORTS MEDICINE
EDUCATIONAL PLAN
Hillsborough County Public Schools
Committee Members:
Lauren Otero, APA, Leto High School
Evanitta Omensetter, APSA, Leto High School
William Sargable, Wrestling Coach, Riverview High School
Jayson Roberts, Football Coach, Tampa Bay Tech High School
Joel Kennedy, ATC, Plant High School
HYDRATION
HYDRATE TO ELEVATE
Are you hydrated?
Dehydrated?
If you are thirsty,
you are already dehydrated.
What are you drinking?
HYDRATE TO ELEVATE
HYDRATED: HAVING ADEQUATE
FLUIDS THAT ALLOW THE BODY TO
FUNCTION AT MAXIMUM CAPACITY
Dehydrated: is a deficiency of body
water, with an accompanying
disruption of metabolic processes,
performance and may lead to heatrelated illnesses
HYDRATE TO ELEVATE
WHAT EFFECTS HYDRATION LEVEL?
Stool, urination, breathing
and most significantly……
SWEATING
HYDRATE TO ELEVATE
WHAT EFFECTS ONE’S SWEAT RATE?
Ambient temperature
 Humidity
 Genetics
 Gender
 Body weight
 Fitness level
 Intensity

HYDRATE TO ELEVATE
SIGNS & SYMPTOMS OF DEHYDRATION
Headache, Fatigue, Confusion, Nausea,
Cramps, Dizziness
Decrease of Stamina, Speed, Energy, and
Muscular Strength
HYDRATE TO ELEVATE
MONITOR YOUR HYDRATION
Check your urine color
Measure your water
weight loss
GAME
PRACTICE
BEFORE
HYDRATE TO ELEVATE
AFTER
DECREASE IN ATHLETIC
PERFORMANCE
2-4% weight loss - reduced
muscular endurance time
 4-6% weight loss - reduced
muscular strength &
endurance, heat cramps
 6% weight loss - severe heat
cramps, heat exhaustion,
heat stroke, coma,
DEATH

HYDRATE TO ELEVATE
HOW TO GET AND STAY HYDRATED…
Drink plenty of water
EVERYDAY
AVOID or LIMIT sugary
and caffeinated drinks
HYDRATE TO ELEVATE
GAME DAY
GENERAL RULE OF THUMB

NOTE:
Room temperature fluids
absorb more quickly.
Pre-Game
16 oz. 4 hours BEFORE game time
&
8 oz. 2 hours BEFORE game time

During Game:
7-10 oz. every 15 minutes
throughout the game

Post Game:
16 oz. bottle of sports drink (Gatorade)
to replace carbs & sodium
HYDRATE TO ELEVATE
HYDRATE TO ELEVATE
YOUR PERFORMANCE
THINK TO DRINK
PROPOSED ACTION STEPS
Chart containing timeline of hydration for pregame, during game, and post-game measures.
 Emphasis to players of how hydration is directly
tied to athletic performance.
 Explanation to athletes of what not to drink and
limitations on caffeine.

HYDRATE TO ELEVATE
HEAT ILLNESS
Cool first, treat second!
HOW HEAT EFFECTS YOUR BODY
 Places
extra stress on the body
 Increases core body temperature
 Increases heart rate
Cool first, treat second!
HEAT INDEX
Cool first, treat second!
HEAT RELATED ILLNESS
 Body
temperatures can rise to dangerous
levels.
 Types
of Illnesses Across a Spectrum:
Heat Rash
 Heat Cramps
 Heat Exhaustion
 Heat Stroke

Cool first, treat second!
HEAT RELATED ILLNESS: HEAT RASH


Occurs when pores are
blocked and
perspiration is trapped
under skin

Methods of Treatment:

Symptoms usually go
away on their own when
skin is cooled.
Symptoms include:
Superficial blisters, itchy
or prickly in feeling
 Mainly found on neck,
shoulders and chest.
 Usually develops where
clothing causes friction.

Cool first, treat second!
HEAT RELATED ILLNESS: HEAT CRAMPS

Symptoms

Painful, involuntary
muscle spasms.
 Most likely to occur in
arm, calf, abdomen
and back.
 Affected muscles firm
to touch.
 Body temperature
may be normal

Method of Treatment:
Rest briefly and cool
down.
 Drink clear juice or
electrolyte-containing
drink
 Gently stretch and
massage affected area
 Contact medical
personnel if cramps do
not subside within an
hour

Cool first, treat second!
HEAT RELATED ILLNESS: HEAT EXHAUSTION

Definition:
 Body Temperatures
rise as high as 104°
 Causes stem from
exposure to high
temperatures,
particularly when
combined with high
humidity, and
strenuous physical
activity
 Can lead to heat
stroke if left
untreated

Symptoms:









Often begin suddenly
Resemble those of shock
Cool, moist skin with
goose bumps when in the
heat
Heavy sweating
Faintness/Dizziness
Nausea
Low blood pressure upon
standing
Muscle cramps
Dark-colored urine
Cool first, treat second!
HEAT ILLNESS: HEAT EXHAUSTION

Treatment:







Stop all activity and rest in a cool place
Drink cool water or sports drink
Apply cool water to your skin
Submerge in ice bath
Loosen/Remove excess clothing
Contact doctor if signs/symptoms do not improve or
worsen within one hour.
Seek immediate attention if body temperature reaches
104° or higher. Brain damage occurs when body
temperature reaches 106°. Death can occur when body
temperature reaches 108°.
Cool first, treat second!
RISK FACTORS OF HEAT EXHAUSTION

Certain Factors Increase Sensitivity to Heat:





Young or old age
Certain medications
Obesity
Sudden temperature changes
High heat index
Cool first, treat second!
HEAT ILLNESS: HEAT STROKE
Results from untreated heat exhaustion
 Life-threatening condition that occurs when a
person’s body temperature reaches 104° or higher
 Skin may be hot, but body may stop sweating to
help cool itself
 Person may develop confusion and irritability
 Seek immediate medical attention to prevent
brain damage, organ failure, or even death.

Cool first, treat second!
PREVENTING HEAT RELATED ILLNESS
Wear loose fitting,
lightweight, lightcolored clothing
 Avoid sunburn
 Seek shelter/cooler
places
 Drink plenty of fluids
 Take extra
precautions with
medications

Avoid hot spots
 Allow your body to
acclimate to the heat
 Know your fitness
level
 Avoid mid-day sun
(10am-4pm)
 Wear sunscreen
 Have a back up plan

Cool first, treat second!
COOLING PROTOCOLS







Move victim to a cool spot
Lay the victim down
Elevate their feet
Loosen/remove excess
clothing
Give cool (NOT ice) water
Cool victim until body
temperature is between
100°-102° degrees
Call 911 to transport
Cool first, treat second!
PROPOSED ACTION STEPS
Purchase of thermometers for use at practices
and games
 Expanded use of cooling methods
 “Dipping” into ice baths to be routine at practice
 Coolers at practice filled with iced towels
 Display of signs and symptoms posters to be
hung in restroom stalls and above urinals
 Examples of proper clothing to combat heat
illness

Cool first, treat second!
SICKLE CELL
DISEASE
WHAT IS SICKLE CELL DISEASE?



Sickle Cell Disease is an inherited genetic disorder that
affects the red blood cells.
Red blood cells in a person with sickle cell disease have an
abnormal version of a protein called hemoglobin.
This abnormal protein causes the blood cell to have a crescent
or sickle shape instead of the normal round shape that red
blood cells should have.
WHO GETS SICKLE CELL DISEASE?


Sickle cell disease affects almost only people of African,
South American, Caribbean, or Mediterranean countries
decent.
A person can only have sickle cell disease from genetic
inheritance from parents.
SICKLE CELL TRAIT VS SICKLE CELL DISEASE
Sickle Cell Trait
Child inherits a recessive sickle cell gene from one
parent and a dominant normal cell gene from the other.

Sickle Cell Disease
Child inherits a recessive sickle cell genes from both
parents.

SICKLING IN SICKLE CELL TRAIT CARRIERS


Under normal non-stressful conditions, people
with sickle cell trait have virtually no health
issues from the trait.
Sickle cell trait carriers can have issues when
dehydrated, under heavy physical demand, or
at high altitudes due to cells starting to sickle.
THE PROBLEM WITH SICKLE CELL TRAIT



Many athletes have no idea that they are sickle
cell trait carriers.
If an athlete does know they are sickle cell trait
carriers, many are under the impression that
they have no risk of sickle cell crisis.
In either scenario the athlete is at risk of
physical overexertion, leading to sickling of red
blood cells.
EFFECTS AND COMPLICATIONS FROM
SICKLE CELL

The sickled red blood
cells become
problematic due to
their shape causing
the cells to become
blocked and stuck in
blood vessels. The
sickled shaped
renders them unable
to carry adequate
oxygen as well.
EFFECTS AND COMPLICATIONS FROM
SICKLE CELL
 Sickle
cell disease can affect the body in 2
ways:
1. Anemia – reduced amounts of oxygen that can
be carried by the sickled shaped cells, causing the
following:
1. Fatigue
2. Paleness
3. Shortness of breath
4. Rapid heart rate
5. Yellowing of Skin
EFFECTS AND COMPLICATIONS FROM
SICKLE CELL
2. Sickle Cell Crisis – blockage of blood vessels
taking blood to the limbs and organs due to the sickle
shaped cells causing :
1. Pain in extremities and lungs
2. Small strokes (lack of
oxygen causing interruption
of blood flow)in brain
3. Ulcers on lower legs
4. Enlarged Spleen
SICKLE CELL CRISIS VS HEAT ILLNESS


Sickle cell crisis in a person with the trait and heat illness
can appear very similar in their symptoms.
However there are a few key difference in symptoms that
allow you to differentiate between the two.
Heat Illness


Person has heat cramps.
They hobble to the ground
and cry out in pain
Muscles are locked and
rock hard
Sickle Cell Crisis
vs.


Person falls to the ground
immediately from
weakness and doesn’t cry
out in pain
Muscles look and feel
normal
RECOMMENDATIONS FOR MANAGING
ATHLETES WITH SICKLE CELL TRAIT
 If
coaches are aware that they have an athlete
with sickle cell trait there are some
recommendation on how to manage them to
reduce chances of a crisis
•
•
•
•
Do not allow the athlete to condition heavily
Monitor the athlete’s body temperature on warm humid
days
Be aware of the altitude that the athlete is
participating at
Allow the athlete to drink water whenever they feel the
need
PROPOSED ACTION STEPS
Collaborating with FHSAA to add doctor’s sign
off on EL2 physical form
 Signs and symptoms poster to be hung in locker
rooms
 Addition of lines to medical release card for
parent(s) to write in “medical conditions” and
allergies
 Adjustment of practice and drills

CONCUSSIONS
When in doubt, sit them out.
WHAT IS A CONCUSSION?
A Traumatic Brain Injury (TBI)
 Your brain jarring against your skull
 No grades of concussions. No mild or severe.
 Use to be called “Dinged” or “Bell rung”
 Treatment: REST!

A concussion is an interruption of the
brain’s ability to work properly.
When in doubt, sit them out.
SIGNS AND SYMPTOMS
Headache
 Dizziness
 Nausea
 Balance problems
 Sensitivity to light and sound
 Amnesia
 Difficulty concentrating

Every concussion has different signs and symptoms,
it does not determine the severity.
When in doubt, sit them out.
STATISTICS

2013: 11.2 concussions/10,000 games & practice in high
school football

2008-2009: 400,000 TBI in high school athletics

2/3 of concussions occur in events, 1/3 at practice



2011: 15% of injuries reported in high schools with a
certified athletic trainer (ATC) were concussions
15.8% of athletes who suffered Loss of Consciousness
(LOC) returned to play the same day!!
Three times more likely to suffer a 2nd concussion
in the same season.
When in doubt, sit them out.
2ND IMPACT SYNDROME (SIS)




What is it? Experiencing a second concussion
before the original signs and symptoms are gone
from the first concussion.
Adolescents are particularly susceptible to SIS
Athletes who suffer multiple TBI within a short
period of time(days or weeks) may suffer
catastrophic or fatal reactions
In a 13 year study, out of 92 high school athletes
with SIS, 71% had a previous concussion in the
same year and 39% were playing with symptoms
When in doubt, sit them out.
PROPER PROTOCOLS—RETURN TO
LEARNING
Limit visual stimulants, such
as texting and computer use
 Allow extra time for
tests/assignments
 Break assignments into smaller
chunks
 Provide alternative methods to
learning
 Set reasonable expectations

When in doubt, sit them out.
PROPER PROTOCOLS—RETURN TO PLAY


Athlete must be seen & evaluated by medical doctor
If athlete has no symptoms and is cleared by physician,
then FHSAA’s AT18 form is initiated and a step-by-step
process can begin for athlete to return.
Aerobic activity: bike, jog, etc.
 Increase activity to include sport-specific exercise
 Non-contact practice
 Full practice




Athlete must get steps signed off on by an ATC, coach or
Athletic Director on the AT18
Athlete then returns to physician, is re-examined and
AT 18 is signed off to return to play (RTP)
AT18 is filed in student’s athletic packet
When in doubt, sit them out.
PROPOSED ACTION STEPS




SCAT cards to all
coaches (tests to
determine if an athlete
has a concussion)
Handouts to
parents/coaches on signs
& symptoms of
concussions
In-service by medical
doctor on concussions
(pre-season or summer)
Review/discuss Return
to Play (RTP) protocols
(per FHSAA) with
coaches/parents.




Must see a medical
doctor (preferably one
with experience in
diagnosing concussions).
Complete 5-step process
with coach or ATC
Follow up with medical
doctor to RTP. Must be
cleared by medical
personnel on FHSAA’s
AT18
A neuro/cognitive
computer baseline test
(example: ImPact) on
athletes
When in doubt, sit them out.
IN CONCLUSION:
•
Hydrate to Elevate
•
Cool First, Treat Second
•
Be aware. Understand. Monitor. Prevent.
•
When in doubt, sit them out.