Concussions, practicing in heat, both under the microscope in Harford high school sports

Twenty-five years ago, if you were toiling in 95-degree August heat during the second half of a two-a-day, full-pad, pre-season high school football practice and you complained that your mouth was dry, you might be told by a coach to finish the drill you were performing before hitting the water cooler.

Likewise, if you took a nasty, helmet-to-helmet collision during the end-of-practice scrimmage and came up seeing stars, you might hear, "come on, get up and walk it off, you're OK."

Those days, though relatively recent in the history of high school athletics, are long gone, and legislation passed last year by the Maryland General Assembly will make most of the practices of the past seem prehistoric.

The two issues covered in the legislation are hydration and the treatment and prevention of sports-related concussions. As a result, high school sports officials have been required to address both in with a number of new policies and practice procedures.

"Basically, all of this is going toward keeping our athletes safer," Ken Zorbach, supervisor of physical education and athletics for Harford County Public Schools, said of the changes. "There's an inherent risk in all sports, but if we can eliminate some of the things that are in our control, we'll make it safer for all the kids taking part."

Heat and hydration

The Maryland Public Secondary School Athletic Association's website,, has a page dedicated to the heat and hydration. The first paragraph states: "It has become a major concern in that heat-related deaths among young athletes over the last 15 years has remained constant.

In an attempt to halt injuries and fatalities that the MPSSAA calls "almost entirely preventable," the Maryland General Assembly came up with legislation that seeks to buck a dangerous trend through education and an overhaul of practice regulations.

Assembled by members of the Maryland State Department of Education, the Department of Health and Mental Hygiene, the MPSSAA, the Maryland Athletic Trainers Association, local school systems and a group of physicians, a document titled "Model Policy for Preseason Practice Heat Acclimatization Guidelines for Student Athletes," was put forth after the General Assembly's 2011 session.

Prominent in the document are guidelines aimed at sports that require extensive use of body padding, namely football, and the need for coaches to provide their team members with longer portions of practice in which pads are not required. These periods are identified as "walk-throughs" in the document, and they are defined as "teaching opportunities" when an athlete is not wearing protective equipment, including helmets and shoulder pads.

"The walk-through periods are just bodies on the field, no equipment," Zorbach explained. "That means no helmets, no balls, no sticks."

According to the guidelines set forth prior to the fall 2012 season, high school football teams have not been permitted to work out in full padding until the sixth day of practice.

They also haven't been allowed to practice more than once a day, or more than three hours at a time, not including a one-hour walk-through, until the fifth day of practice.

Football teams were allowed to run two-a-day practices on the sixth day, but the total practice time for both sessions was limited to five hours or less and had to be followed up by a one-day practice.

"Basically, the main thing the guidelines did away with were two-a-day practices," Zorbach said. "I sent out an e-mail to all of the athletic directors with the guidelines and they e-mailed it to their coaches, who then sent their practice schedules to me."

"Some people misinterpreted it and we had to tell them where they were off, but everyone was fine in implementing the new schedules," he continued. "With the new rules in place, you can only practice once a day for three hours for the first five days, then, if you want, you can have a one-hour walk-through after a three hour break. As far as I know, nobody did the walk-throughs. The coaches were more of the mind, 'we'll work hard for three hours, then call it a day.'"

In the document's suggested guidelines, the players are advised to drink eight to 16 ounces of fluid before each physical activity, to keep up a four to eight-ounce intake of fluids every 15 during physical activity and to consume 16 ounces of fluid two hours before practice begins.


Also available on the MPSSAA's website is a document entitled "Policies and Programs on Concussions for Public Schools and Youth Sports Programs," which details at length the signs, symptoms and proper care for athletes who have suffered head trauma.

Following the passage of the General Assembly's legislation in 2011, Harford County Public Schools started a database with the help of Medstar, a Baltimore-based nonprofit healthcare organization, which required all Harford County Public Schools athletes to undergo an impact test to establish a baseline in case the athlete suffered a head injury in the future.

"Last spring, we started testing every athlete to establish a baseline for them," Zorbach said. "This year, we've got most of the athletes out of the way, and we just have to test the students who haven't played sports prior to this year. By establishing a baseline for each kid, doctors can test them based on that in case of a future head injury."

"With the old system, which was mainly just questions about how the athlete felt, they could lie to the doctor and get back on the field," he continued. "If the doctor asked, 'are you sick?' the athlete could just say, 'nope, I feel fine,' and put themselves in harm's way."

Zorbach said the database and pre-testing approach should help cut down on the possibility of an athlete suffering a chronic disability or death as a result of a high school sports-related head injury.

"Now, we've got a much better way of telling if they're suffering from a concussion," he said. "There's no test that's 100 perfect accurate, but this is a much better system for keeping the kids safe."

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