Beginning for many youth athletes in late July or early August, two-a-day practice sessions are a common part of early-season conditioning in football and other fall sports. These extra training sessions help to accelerate physical conditioning, skill development and team development; however, athletes experience increased amounts of physical, mental and other types of stress during these multi-session practice days as they manage high energy demands, limited recovery time and increased worry of making the team or earning a starting position. The heat and humidity of summer practices add additional stresses as well.
The high energy requirements and heat-related stress during this time are major concerns for coaches and medical staff. Energy intake and proper hydration are extremely important during this time in order to achieve adequate recovery and prevent injuries.
Many athletes will also experience an increased rate of injury and illnesses during two-a-days. Dehydration, physical exertion, poor nutrition, inadequate sleep and increased psychological stress suppress the immune system and increase the risks for viral and bacterial infections, as well as musculoskeletal injuries. Poor preseason conditioning and poor acclimatization also increase the risks of heat-related illnesses and injuries. Having an infection, a cold or diarrhea will also exacerbate the problem. Adequate rest and recovery are vital during this time of training. A good preseason conditioning program, as well as acclimatizing to the environmental conditions, is necessary to help reduce the risks of encountering injuries and illnesses.
Many athletes will experience fluctuating weight measurements during these intense trainings, but losing body weight during practice comes from fluids, not fat. A football player may lose over 12 pounds per day during two-a-day practice sessions. Dehydration, heat stress and physical activity can cause a player to go into a catabolic state that leads to loss of lean muscle tissue.
The American College of Sports Medicine’s (ACSM’s) position on “Exercise and Fluid Replacement” contains a summary of practical recommendations in regards to the health and safety of fluid replacement during exercise. A few of the recommendations found in the ACSM position stand are highlighted below.
“During exercise lasting less than one hour, there is little evidence of physiological or physical performance differences between consuming a carbohydrate-electrolyte drink and plain water.” However, recent research seems to indicate that carbohydrate ingestion may benefit performance during exercise less than one hour and during intermittent exercise such as high-intensity running, cycling and tennis
“During intense exercise lasting longer than one hour, it is recommended that carbohydrates be ingested at a rate of 30 to 60 grams/hour to maintain oxidation of carbohydrates and delay fatigue. This rate of carbohydrate intake can be achieved without compromising fluid delivery by drinking 600 to 1200 mL/hour of solutions containing 4% to 8% carbohydrates (grams per 100 mL). The carbohydrates can be sugars (glucose or sucrose) or starch (maltodextrin).”
Thirst is a poor indicator of dehydration. Your body is already 2% to 3% dehydrated when you begin to experience thirst. Drink at regular intervals throughout the day and during exercise to sufficiently replaced lost fluids.
Weight loss is a good indicator of fluid losses. Weigh yourself before and after exercise. Replace every pound lost with 600 to 720 mL (20 to 24 ounces) of fluids. Research indicates that ingestion of fluids that equal 150% or more of weight loss is required to achieve normal hydration within six hours following exercise. Decrease your next training session if you are unable to replace lost fluids within 24 hours.
The amount and color of your urine is a good indication of your hydration status. Urine should be clear, plentiful and frequent. Dark urine is a sign of dehydration.
Recognize the signs and symptoms of dehydration and heat illnesses. If any signs or symptoms occur, make sure all measures are taken to stop activity, rehydrate and cool down.
The following strategies may help athletes survive two-a-day practices:
Strategies to Maintain Fluid Hydration
Weigh athletes before and after each practice session.
Maintain weight within 4% before leaving the training room. (An athlete weighing 175 pounds should maintain a weight greater than 168 pounds.)
Weigh within 2% before starting the next practice session. (The same athlete weighing 175 pounds should weigh 171.5 pounds or greater.)
Replace fluids by drinking 150% of weight loss prior to the next session. (If the athlete weighing 175 pounds lost 4% of body weight, he would have seven-pound deficit, which equals 3.150 liters [105 ounces]. He should drink about 4.725 liters [158 ounces] within 24 hours.)
Drink fluids on a regular schedule before, during and after exercise (start drinking fluids immediately after practice). Avoid caffeinated drinks.
Watch urine color and volume to monitor hydration status.
Strategies to Maintain Adequate Energy Intake
Consume a daily carbohydrate intake of four to five grams of carbohydrates per pound of body weight (nine to 10 grams/kg).
Eat regularly scheduled meals (four to five nutritionally well-balanced meals).
Emphasize carbohydrates and limit fats in the athlete’s diet.
Strategies to Stay Healthy and Avoid Injuries and Illnesses
Get a proper amount of sleep and adequate nutritional intake for adequate rest and recovery.. Avoid overtraining.
Minimize suppression of your immune system by staying well hydrated and fueled with carbohydrates.
Avoid sick people and large crowds, wash your hands regularly and get a flu shot to help avoid infections.
Avoid heat illness by acclimating to the heat, staying cool and keeping well hydrated.
Know the warning signs of dehydration and heat illness.
Read More Articles by Dr. Smurawa regarding youth athletes:
Troy Smurawa, M.D.
Board-certified in both pediatrics and sports medicine, Dr. Troy Smurawa is the director of pediatric sports medicine at the Children’s Health Andrews Institute for Orthopaedics & Sports Medicine in Plano, Texas. Dr. Smurawa earned his medical degree from The University of Texas Health Science Center and did his residency in pediatrics at the University of Wisconsin. He completed a sports medicine fellowship at Children’s Hospital Medical Center in Akron, Ohio.