OPINION: How to raise a gladiator: When the heat becomes the opponent
Every August, football fields across America come alive with hope. Young athletes report for practice dreaming of Friday night lights, college scholarships, and perhaps one day hearing their names called in the NFL Draft. Parents cheer from the sidelines. Coaches push them to improve. Entire communities rally behind them.
I recently had the privilege of speaking at the National Medical Association about one of the most preventable causes of death in youth sports, exertional heat illness. It is a subject that deserves far greater public attention because the consequences can be devastating, and in many cases, entirely preventable.
Exertional heat stroke remains the leading preventable cause of death among high school athletes. Since the early 1990s, nearly 60 high school football players have died from exertional heat stroke in the United States. Experts in sports medicine believe many of these deaths could have been prevented through proper heat acclimatization, hydration, and environmental monitoring.
As temperatures continue to rise, practicing and competing in extreme heat has become one of the greatest threats facing young athletes. Heat exhaustion, heat stroke, permanent disability, and death can occur within minutes.
Picture a typical August afternoon in Mississippi, Alabama, or Louisiana. The air temperature may reach 104 degrees. Add high humidity, direct sunlight, artificial turf, and the weight of football helmets and shoulder pads, and the body can quickly lose its ability to cool itself. At temperatures this extreme, strenuous outdoor exercise should be postponed or significantly modified.
That is why athletic programs should never rely on air temperature alone. They should monitor the Wet Bulb Globe Temperature, commonly known as WBGT. This internationally recognized standard measures not only temperature, but also humidity, wind speed, and radiant heat from the sun. It provides a much more accurate picture of the stress placed on an athlete’s body and should guide decisions about modifying, delaying, or canceling practices.
Heat is not the only invisible danger. Sickle cell trait is another important risk that deserves far more attention. About 8 to 10 percent of African Americans carry the sickle cell trait. Most never experience health problems. However, intense physical exertion combined with heat, dehydration, or high humidity can trigger exertional collapse associated with the sickle cell trait. Without immediate recognition and treatment, the condition can become fatal. The NCAA requires Division I athletes to know their sickle cell trait status, but awareness should begin long before college. Parents, coaches, athletic trainers, school officials, and physicians should know an athlete’s status and take appropriate precautions during conditioning and competition.
We admire athletes who demonstrate courage, discipline, and perseverance. Young people watch stars like Jalen Hurts and dream of one day reaching the highest levels of competition. Mississippi, Alabama, Louisiana, and other Southern states continue to produce some of the finest athletes in America. Every year college recruiters and professional scouts travel throughout our region searching for exceptional talent.
No scholarship, championship, Name, Image, and Likeness opportunity, or professional contract is worth the life of a child.
Too often young athletes remain silent because they do not want to appear weak. Parents hesitate to question coaches because they fear their child may lose playing time. Coaches face enormous pressure to win. Everyone wants success. Success, however, should never come at the expense of safety.
Children are not miniature professional athletes. Their bodies are still growing, and their minds are still developing. Before adolescence, many children benefit from participating in multiple sports instead of specializing too early. Cross-training develops different muscle groups, reduces overuse injuries, and often uncovers talents that might otherwise remain hidden.
Great athletes are not created by simply demanding more. They are developed through thoughtful coaching, gradual conditioning, proper nutrition, hydration, adequate sleep, recovery, and careful attention to both physical and mental health. One of the greatest lessons a coach can teach is that knowing when to rest is just as important as knowing when to compete.
Preparing athletes for extreme heat requires planning, not wishful thinking. Heat acclimatization should occur gradually during the first two weeks of practice. Athletic programs should monitor WBGT and modify, shorten, or postpone practices when conditions become dangerous. Unlimited access to water, scheduled cooling breaks, trained medical personnel, cold water immersion tubs, and well-rehearsed emergency action plans should be standard practice.
When an athlete develops exertional heat stroke, every minute matters. Sports medicine experts have simple rules. Cool first. Transport second. Immediate cold-water immersion before transport to a hospital can mean the difference between complete recovery and permanent disability or death.
Protecting young athletes is not solely the responsibility of coaches. Physicians must educate families. Athletic trainers must be empowered to make independent medical decisions without interference. School administrators and school boards must adopt evidence-based heat safety policies. Legislators should support laws that protect student athletes. Parents, pastors, and community leaders all have a role in creating a culture where health always comes before winning.
Our responsibility is to help young people become healthy adults who will one day serve as parents, teachers, physicians, military leaders, business owners, and community leaders. Athletics should build character, confidence, resilience, and lifelong health.
Years from now, I hope we will not be remembered only for the championships we celebrated, but also for the lives we saved because we chose preparation over complacency, science over tradition, and courage over convenience.
Selika Sweet, M.D., FAAFP
Diplomate, American Board of Family Medicine
Climate and Health Equity Fellow, 2025
