These recommendations and guidelines for youth football
practice modification are a combination of evidence-based
data and expert opinion that allow athletes to safely and sufficiently acclimatize in the early season to improve the
safety profile for each player (72,74,92). Graduated and
repeated exposure to the heat stress, training intensity and
volume, and insulating properties of the football uniform,
combined with appropriate alterations of practice intensity
and duration, equipment cover, and between practice recovery
time, should allow physiological adaptation to occur
safely and effectively (19). Most high school and college
heat-related fatalities occur in the first 4 d of preseason
practice (with days 1 and 2 having the highest risk) and are
seemingly related to lack of acclimatization, associated with
too much activity in hot, humid conditions. Although exertional
heat stroke during football practice may not be totally
preventable, the incidence can be dramatically reduced with
more deliberate attention to progressive training and acclimatization,
utilizing appropriate practice modification that
reflects the environmental and physiological challenges facing
football players. Death from heat stroke can be averted
with prompt onsite recognition and appropriate cooling
treatment.