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Researching Heatstroke In Athletes


In June, a 19-year-old freshman on the University of Maryland football team died in a hospital of heatstroke. Jordan McNair had collapsed two weeks earlier after running long sprints during training. His body temperature when he arrived at the hospital was 106 degrees. The university has opened an investigation, and head coach D.J. Durkin has been put on administrative leave. Many blame an abusive, toxic coaching culture at the university for McNair's death. And it's not just Maryland. According to the National Center for Catastrophic Sport Injury Research, a dozen college football players in addition to Jordan McNair have died just from heatstroke since 1995. That figure is higher if you include things like sudden cardiac arrest and asthma attacks. Douglas Casa studies heat illness and sudden death in sport at the Korey Stringer Institute at the University of Connecticut. And he joins me now. Mr. Casa, welcome to the program.

DOUGLAS CASA: Yeah. Thank you very much for having me.

BLOCK: And what do you make of the case of Jordan McNair? This was an offseason practice. This was not during a game.

CASA: Yeah. That is correct. It is during a collegiate conditioning session, which is really the place where we're having the most problems right now dealing with sudden death in sport.

BLOCK: According to reports that have come out, when Jordan McNair had trouble standing after these long sprints, one of the trainers reportedly yelled, drag his ass across the field. Is that - does that speak to a culture that you find very common in college football?

CASA: Thank God that's not common. But, you know, did that potentially delay the appropriate care? It may have. And we know in the world of exertional heatstroke that when you cool somebody down to under 104 degrees within 30 minutes, survivability is 100 percent in all the people that have ever been studied. So it's a complete shame when you don't have the correct, you know, treatment being done for the person on the field at that time.

BLOCK: The institute where you work is named for Korey Stringer. He's the NFL lineman. He died of heatstroke in 2001 in a workout. And since then, as I understand it, there has been no NFL player that's died of heatstroke. So what is the NFL doing that college football apparently isn't?

CASA: There's probably a few things to consider that I would say are things to consider to model. One is the NFL, after the death of Korey Stringer, thankfully, made sure that the best practices were being utilized by all 32 teams with the prevention, recognition and treatment of exertional heatstroke. So that's obviously helpful. Second, the players, in conjunction with the NFL, have developed appropriate policies to make sure that they stay safe. So in a sense, the players have rights in the NFL. And the players have no voice and no rights in college football. College conditioning coaches and college football coaches can literally do anything they want, you know, during a conditioning session. But in pro football, the players and the teams, you know, work together in unison, I think, a lot better.

BLOCK: I've seen the term used in terms of how these workouts are conducted at the college level - this term irrational intensity workouts - in other words, pushing people well past the point of anything being helpful or useful in their training.

CASA: That's correct. Back in 2012, we convened a task force. And all the top sports medicine organizations in the country attended and endorsed the document that was called "Preventing Sudden Death In Collegiate Conditioning Sessions." But the NCAA did not endorse that document. If they had endorsed it, I'm sure we would not be having this conversation right now. And we wouldn't have had a lot of those deaths that we've had in the last six years. But they have not done enough to make collegiate conditioning sessions of more a controlled environment. Right now, it's the Wild West.

BLOCK: I'm thinking about a column that Sally Jenkins wrote in The Washington Post in which she essentially accused college coaches of working these kids to death on the field. Do you agree?

CASA: Yeah. In lot of cases, that's true because you're doing workouts that are not intuitive for what you need at that time. I'll give you a great example. In 2013, the University of Iowa - in the first day back in January when they were doing a workout, they had the football team do 100 squats. And they had 13 people hospitalized within a day. Those players could have done 100 squats if they had trained for it properly over a few weeks but not on the first day back. So that happens across the country all the time. But the NCAA needs to make the big steps to make some big policy changes so that we can protect all of these college athletes in football and in every sport.

BLOCK: That's Douglas Casa. He's CEO of the Korey Stringer Institute at the University of Connecticut. Thanks so much for speaking with us.

CASA: Thank you - pleasure to be on.

(SOUNDBITE OF MATEO MESSINA'S "UP THE SPOUT") Transcript provided by NPR, Copyright NPR.

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