Health & Environment

Texas Football And Heat Stroke: A Deadly Duo

Texas A&M health instructor Michael Sandlin, a former paramedic, has seen the damage of heat stroke in athletes numerous times.
By Keith Randall, Texas A&M University Division of Marketing & Communications July 21, 2021

football players running on the field
Thousands of high school athletes are treated for heat stroke each year.

Getty Images


With thousands of Texas high school footballers reporting for fall workouts in the next few weeks, health experts say it’s time to be a wary of a silent killer — heat stroke.

Annually, at least three students die each year from heat stroke, but thousands are treated for the ailment that occurs as the result of high temperatures and loss of body fluids. Michael Sandlin, clinical associate professor in health and kinesiology at Texas A&M University, has seen the condition many times, both as a health instructor and a former paramedic.

Perhaps most frustrating is that the University Interscholastic League (UIL), the state agency that controls athletics in Texas, says that heat stroke is the most preventable death in high school athletics.

Texas is often ground zero for heat stroke because of the state’s sweltering temperatures, high humidity and intense sunshine. The Centers for Disease Control (CDC) reports that from 2004-2018, there was an average of 702 heat-related deaths that occurred in the U.S. annually.

“Heat illness during practice or competition is a leading cause of death and disability among high school athletes in the United States,” Sandlin said. “A recent survey of 100 schools sampled by a CDC study reported a total of 118 heat illnesses (among high school athletes) resulting in at least one day of time lost from athletic activity. The highest rate of loss among football players was at a rate 10 times higher than the average rate for other sports surveyed.”

The study also showed the month of August was most common to have heat- related emergencies which occurred more during practice, not game time.

In recent years, more efforts have been given to coaches regarding the possibility of heat stroke, especially the need for frequent water and rest breaks.

Not that long ago, it was believed that fewer water breaks and rest periods were a part of the “toughening” process of athletes. In the hit football film, Remember the Titans, a player asks his coach for a water break and the coach responds, “Water is for cowards.”

“I do believe most coaches are aware of the dangers of heat emergencies and the steps taken in recent years have been a big improvement in a positive direction to reduce the possibility of these occurring,” Sandlin said. “I would recommend discussing with all athletes the signs and symptoms of heat-related emergencies.”

Sandlin said that symptoms are things the athlete would have to tell the coach about how they are feeling and serve for early intervention for stopping the situation from progressing to a possible life-threatening heat stroke.

He said the signs to look for include sweating, thirst, fatigue, flulike symptoms (headache, body aches, and nausea), shortness of breath and rapid heart rate.

“I served as a paramedic for over 25 years and I have personally been involved in several cases of heat stroke in athletics,” Sandlin added.

“One very important consideration is the concept of gradual acclimation to heat weather. We all know it takes several weeks to acclimatize to high elevations (i.e. Colorado) for maximum performance and the same is true for heat. It does not have to be 100 degrees to suffer from heat stroke if we have not allowed our bodies time to acclimatize to the heat. It only takes a week or two to make this adjustment, which decreases our susceptibility to having a heat stroke.

“You have to remember that heat stroke is 100 percent preventable.”

Media contact: Justin Elizalde  at

Media contact: Dell Billings, Health and Kinesiology, 979-862-4425 or

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