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Player Health and Safety  

American College of Sports Medicine: Fluid Replacement

 September 12, 2006

 The primary objective for replacing body water loss during exercise is to maintain normal hydration. To minimize risk of heat injury and impairment of exercise performance during exercise, water intake should attempt to equal fluid loss. At equal exercise intensity, the requirement for fluid replacement becomes greater with increased sweating during environmental heat stress.

To minimize the potential for thermal injury, it is advocated that water losses due to sweating during exercise be replaced at a rate equal to the sweat rate. Inadequate water intake can lead to premature exhaustion. During exercise, humans do not typically drink as much water as they sweat and, at best, voluntary drinking only replaces about two-thirds of the body water lost as sweat.

 ACSM concludes it would be premature to recommend drinking something other than water during exercise lasting less than 1 hour. However, during intense exercise lasting longer than 1 hour, a sports drink containing carbohydrates can delay the onset of fatigue.

In addition, ACSM concludes that there is little physiological basis for the presence of sodium in an oral rehydration solution (for example, sports drink) for enhancing intestinal water absorption as long as sodium is sufficiently available in the gut from the previous meal.

A primary rationale for electrolyte supplements in sports drinks is to replace electrolytes lost from sweating during exercise greater than 4-5 h in duration.

However, if the presence of sodium enhances palatability, then ACSM find that its presence in a replacement solution may be justified because drinking can be maximized by improving taste qualities of the ingested fluid.

The American Academy of Pediatrics also found that children might be more likely to drink a flavored sports drink over water. Even though most children wouldn’t need the sports drink for their intended purpose, electrolyte replacement, sports drinks may encourage young athletes to increase fluid intake and stay hydrated.

Link to USA Football

Ice or Heat?

When to apply ice to an injury and when to apply heat is confusing for some people. Since the application of heat in the early stages of injury can actually cause more swelling, it is important to know the appropriate time to use heat and ice to help recover.


  • Causes blood vessels to constrict, reducing swelling in an acute injury thus decreasing pain and speeding up the healing process.
  • Reduces the sensation of pain.
  • Reduces muscle spasm.
  • Application of ice directly to the skin can be uncomfortable at first.
  • After about 7 minutes the area becomes numb and pain is reduced.
  • Apply directly to the skin or over a wet towel if too cold.
  •  Elevate the injured body part above the heart.
  • Leave in place for 20 minutes.
  • Repeat application of ice every one and a half to two hours for the first couple of days following injury or as long as swelling, redness or heat/warmth are present around the injured area  
Do not use ice for people with sensitive skin or those with known skin allergies.
When using frozen gel packs, place over a wet elastic wrap or wet towel. Never apply directly to the skin which may be damaged due to the extremely low temperature of the packs.


  •  Can be used on chronic injuries when there is no swelling present.

  • May aid healing process in chronic injuries by increasing the amount of blood to the area.

  • Causes blood vessels to enlarge, increasing swelling in an acute injury thus increasing pain and lengthening the healing process

  • Best treatment for injuries without swelling, redness, warmth, and acute pain.

  • This could be as long as a few days to several weeks after injury, depending on injury severity.

  • Reduces muscle spasm.

  • Heat should be left in place for only 15-20 minutes.

  • Apply injured area with a heating pad, including cover or liquid heated pad with cover. 

USA Football Health and Safety articles

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 All there is to know about Blisters
Blisters are usually formed by friction, such as the shoe rubbing on an area of the foot. The friction causes the outer skin layers to separate and fluid accumulates between the two skin layers.
Blister Treatment:
  • Treatment is based on whether or not the skin is broken, creating an open wound.
  • If the outer skin is intact, the body will eventually absorb the fluid if the blister is treated properly.
  • Puncturing this outer skin to drain the fluid will not aid in healing, but rather creates an open wound susceptible to infection.
  • If required, only a physician should drain the blister.  
If outer skin is intact: 
  • Clean with antiseptic soap
  • Over the blister, place a foam pad having a hole cut in the center of the pad larger than the blister. 
  • A Band-Aid type bandage may be used if such a pad is not available.
  • Apply an antibiotic ointment on the surface of the blister.
  • Cover with sterile gauze pad.
  • Secure in place with athletic tape.
  • Change bandage daily
If outer skin is not intact:
  • Treat it like an open wound.
  • If the skin covering of the blister is intact, leave the skin in place for several days.  This will act as a protective covering over the blister.
  • Clean the area with antiseptic soap.
  • Apply an antibiotic ointment to the blister under the skin.
  • Apply a donut pad for protection.
  • Cover the blister with a sterile gauze pad.
  • Secure with athletic tape.
  • Change the bandage daily.
  • Monitor for signs of infection.  




What is a concussion?

A concussion is a brain injury. Concussions are caused by a bump, blow, or jolt to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even a “ding” or a bump on the head can be serious.

What are the Signs and symptoms of concussion?

You can’t see a concussion.  Signs and symptoms of concussion can show up right after the injury or can take days or weeks to appear. If your teen reports any symptoms of concussion, or if you notice the symptoms yourself, seek medical attention right away. 

Appears dazed or stunned             Headache
Is confused about assignment   Nausea
Forgets plays   Balance problems or dizziness
Is unsure of game, score, or opponent   Double or fuzzy vision
Moves clumsily   Sensitivity to light or noise
Answers questions slowly   Feeling sluggish
Loses consciousness   Feeling foggy or groggy
Shows behavior or personality changes   Concentration or memory problems
Can’t recall events prior to hit   Confusion
Can’t recall events after hit  

 What should you do if you think your teenage athlete has a concussion?

  1. Seek medical attention right away.  A health care professional will be able to decide how serious the concussion is and when it is safe for your teen to return to sports.

  2. Keep your teen out of play.  Concussions take time to heal. Don’t let your teen return to play until a health care professional says it’s OK.  Athletes who return to play too soon—while the brain is still healing—risk a greater chance of having a second concussion.  Second or later concussions can be very serious. They can cause permanent brain damage, affecting your teen for a lifetime.

  3. Tell all of your teen’s coaches about any recent concussion.  Coaches should know if your teen had a recent concussion in ANY sport. Your teen’s coaches may not know about a concussion your teen received in another sport or activity unless you tell them. Knowing about the concussion will allow the coach to keep your teen from activities that could result in another concussion.

  4. Remind your teen: It’s better to miss one game than the whole season.