The Inter-Association Task Force for Preventing Sudden Death in Collegiate Conditioning Sessions

Abstract

In January 2012, the National Athletic Trainers' Association, along with the National Strength and Conditioning Association, convened a meeting in Colorado Springs, Colorado. Its purpose was to hold an interdisciplinary forum and gather input to address sudden death in collegiate conditioning sessions. Based on these discussions, a writing group drafted the following recommendations. To date, these best practices have been endorsed by the American College of Emergency Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, American Osteopathic Academy of Sports Medicine, Canadian Athletic Therapists' Association, Collegiate Strength and Conditioning Coaches association, Gatorade Sports Science Institute, Korey Stringer Institute, National Academy of Sports Medicine, National Athletic Trainers' Association, and National Strength and Conditioning Association. Other reviewers and meeting participants are listed with the professional organizations they represent at the end of this article. Maximizing strength and conditioning sessions has become fundamental to sport. The right combination of strength, speed, cardiorespiratory fitness, and other components of athletic capacity can complement skill and enhance performance for all athletes. A sound and effective training program that relies on scientific principles of exercise physiology and biomechanics intended to produce outcomes that are sensitive and specific to the sport should be the goals. Unfortunately, the athlete's development, health, and safety are sometimes overshadowed by a culture that values making athletes tough, instilling discipline, and focusing on success at all costs. This ill-conceived philosophy has been a contributor to the alarming increase in collegiate athlete deaths and serious injuries during conditioning sessions. A total of 21 National Collegiate Athletic Association (NCAA) football players have died during conditioning workouts since 2000.1 The 3 most common causes of the fatalities were (in order) exercise-related sudden death associated with sickle cell trait (SCT), exertional heat stroke, and cardiac conditions.1 Seventy-five percent of the fatalities (n = 16) were Division I football players. Also, the incidence of exertional rhabdomyolysis in collegiate athletes appears to be increasing. Excesses in strength training and conditioning—workouts that are too novel, too much, too soon, or too intense (or a combination of these)—have a strong connection to exertional rhabdomyolysis. Introducing full-intensity workouts too quickly is especially high risk: 11 of the 21 deaths occurred during day 1 or day 2 workouts. Rule changes enacted in 2003 related to heat acclimatization procedures during August football practices have been extremely effective. In the NCAA Division I Football Bowl Subdivision, no player died from practicing or playing in a game between 2000 and 2011. However, conditioning workouts continue to be a catalyst for catastrophic outcomes. It is imperative that similar guidelines be implemented to improve the safety of conditioning sessions. This consensus statement provides specific conditioning recommendations with the intent of ending conditioning-related morbidity and deaths of collegiate athletes.