Three football players on three different levels of competition suffered heat-related deaths in a one-week period last summer, raising the total to 20 deaths since 1995.

When Mark Mangino’s first two-a-day, preseason camp opened last week in hot, humid conditions, Kansas University coaches had more to think about than just football.

Junior lineman Roy Teng cools off during a recent KU football practice.

“It doesn’t make me look at things any differently, but it’s opened the eyes of other coaches and that makes my job easier,” said head football athletic trainer Carol Jarosky. “They’re looking at things much more seriously. Coach Mangino has a 17-year-old son playing baseball this summer, and he’s worried about the heat.”

Last summer, University of Florida freshman Eraste Autin, Minnesota Vikings tackle Korey Stringer and Michigantown, Ind., high school player Travis Stowers suffered heat-related deaths in late July and early August.

Heat-related deaths nearly doubled to 15 in the 1990s compared to the previous decade. There have been seven in the last two years alone.

After last summer, teams on every level of football reviewed their heat precautions to protect players and to protect themselves from the kind of lawsuits the Vikings face from Stringer’s widow.

KU’s medical staff recently reviewed its procedures and decided it already was doing everything possible for its players.

“We aren’t changing anything,” Jarosky said. “Last year we didn’t have one athlete go into body cramps.”

Beating the heat

Practicing in the heat is necessary because the game is often played in it, especially early in the season. The Jayhawks open the season Aug. 31 at Iowa State before a duel in the desert against UNLV Sept. 7 at Las Vegas.

“It’s a balance of trying to make sure athletes get practice time they need and protecting their health,” said director of sports medicine and team physician Larry Magee. “On Aug. 31 it could very well be 100 degrees. If you don’t practice in the heat prior to then, you’re going to have problems. You can’t just bury your head in the sand and say, ‘We’re not going to practice because it’s too hot.’ If you don’t acclimate players to game-time conditions, they’re going to have a lot more problems than they would otherwise. You have to deal with the heat.”

During two-a-days, the risk of heat-related illness is greater than during the season because the athletes have less recovery time.

“We will error on the safe side,” Jarosky said. “An athlete’s health is primary. Coach Mangino has told me, ‘If we need more breaks, let me know.’ There’s a lot of communication about players who might be at risk.”

Players who are at risk are those who report to camp overweight or otherwise out of shape.

All players are weighed before and after each practice. The medical staff pushes fluids and salt tablets to minimize water-weight loss. Players who don’t replace weight lost during practice might be held out, or have their activity restricted, during the next practice.

Gatorade and water are available at every station on the practice field as well as in meeting rooms. Athletic trainers use wet sponges to cool down players during practice breaks.

Eight tubs filled with ice water are available for players to jump in after practice so that they can cool off.

For worse-case scenarios, emergency equipment such as defibrillators is available on the practice field. Four team physicians, including Magee, are on call during morning practices and in the training room following afternoon practices.

History lesson

The way medical staffs deal with heat has changed drastically.

“Thirty years ago, to be tough you didn’t drink water during football practice,” Magee said, “but they gave you salt tablets.”

That didn’t work, though, because taking salt without fluids actually accelerates dehydration.

In the late 1970s, the popular theory switched from no fluid and a lot of salt to no salt and lots of fluids. That didn’t work either because fluid without salt can cause muscle cramps and fatigue.

“It’s much better pushing fluid with salt,” said Magee, whose staff has been following that procedure for three years.

Electrolytes, sodium particularly, help blood pressure and muscle function.

“You can’t survive without salt,” Magee said.

Another factor contributing to the rise in heat-related deaths, believe it or not, is air conditioning. There was a time when not every home, school and office had the luxury of central air.

“When I was growing up, we didn’t have air conditioning,” Magee said. “We worked in the heat. We slept in the heat.”

No more. Americans today are not acclimated to the heat. When athletes aren’t in the heat and humidity of sun-baked practice fields, they’re often in cozy meeting rooms or apartments.

Pumping Up

Another perplexing problems is the increasing size of the players. Coaches, obviously, want big, strong players. But the bigger an athlete gets, the more at risk he becomes. A bigger body generates more heat, complicating its ability to maintain a normal temperature.

In 1972, the average KU offensive lineman weighed 225.8 pounds. The smallest Jayhawks on that line weighed in at 193 pounds, while the largest weighed 249.

This year, red-shirt freshman center Justin Henry a converted tight end is the smallest of KU’s offensive linemen at 260 pounds. There are four behemoths who weigh 300 pounds or more among the Jayhawks’ offensive linemen, whose average weight of 286 pounds is an increase of 29 pounds from just 10 years ago.

“There’s more expected out of players,” Magee said. “They go through conditioning all year long. There’s no down time. You might say, ‘If they condition all year long they should be in better shape.’ But the body needs time to recover.”

At Kansas, and every other school in the nation, there is no offseason. During the winter, the Jayhawks took part in a six-week program that included running sessions every Monday, Tuesday, Thursday and Friday and weight lifting on Mondays, Thursdays and Fridays.

During the spring, the team practiced on Mondays, Wednesdays and Fridays; lifted weights on Tuesdays and Thursdays; and scrimmaged on Saturdays.

During the summer, the Jayhawks resumed their winter exercise schedule for eight weeks.

Some college athletes up to 40 percent nationwide, according to one study turn to supplements to meet the standards set by their coaches, teammates and, of course, themselves.

That has proven dangerous. Researchers claim some over-the-counter supplements, such as creatine, hinder the body’s ability to remain hydrated during strenuous activity.

KU’s training staff and the strength staff educate players about which supplements are against NCAA rules.

“If guys want to go out on their own and take creatine or some kind of protein supplement, we don’t supply it to them,” said head strength and conditioning coach Mark Smith said. “That’s up to them.

“Going into two-a-days, I always tell our guys, ‘If you’re taking anything, just get off it. You shouldn’t be on any type of supplement because when you’re going twice a day you’re going to lose a lot of water. You have to hydrate yourself well.'”

Senior linebacker Leo Etienne said that shouldn’t be an issue in KU’s camp.

“Most of our guys don’t deal with supplements,” he said. “We try to get bigger by eating good food and putting good things in our bodies. We realize what happened last year. You have to do everything you can to stay hydrated.”