Proposed changes for preseason football practice (fall camp) have come from a working group of the NCAA Football Oversight Committee. The working group studied student-athlete welfare issues related to out-of-season conditioning and involved input from student-athletes, coaches, medical personnel and administrators.

Recommendations in the model are an attempt to minimize the safety risks to student-athletes and are based on the best scientific information available regarding conditioning and practicing in a high-heat, high-humidity environment.

These recommendations evolved as the group evaluated the entire issue of student-athlete health and safety, as well as time commitment, from the end of the postseason to the compressed preseason time period. The group also was able to think outside the paradigms of the traditional "two-a-days" practice mentality.

While there will be changes in the non-mandatory summer conditioning period that will require pre-participation medical exams and increased medical supervision during these workouts, the most dramatic change will be in the preseason with the elimination of consecutive, multiple-practice days.

These recommendations, which are up for final review by the NCAA Management Council this month, call for the first five days of preseason practice to be limited to single practices, with gradual increase in equipment from shorts and helmets to half-pads to full gear. The practice format after that will allow for a 2-1-2-1 framework, eliminating consecutive days of multiple practices.

This sweeping change in the traditional approach to fall camp was derived from information gathered from many sources regarding conditioning, heat acclimatization, dehydration/re-hydration and recovery from high-level activity and fatigue.

The 2001-02 NCAA Injury Surveillance System (ISS) showed a four-times-higher risk of time-loss injuries in preseason than during the regular season. Additionally, in Divisions I and II that allow shoulder pads during the first three days of fall practice, a three- to four-times-greater risk of heat illness was reported than in Division III, which allows only helmets during this same time period. The five-day period to acclimate to equipment and exercise intensity at the start of formal practice is expected to minimize the risk for such illnesses.

Enhanced recovery during preseason practice, by modifying the schedule of double or multiple practices on consecutive days, further minimizes the risk for heat-related illnesses. In addition, daily hour limitations were incorporated into the model to reduce the likelihood of such illnesses.

Acclimation to the heat is a special problem for the football student-athlete. The addition of equipment to the equation exacerbates the potential for heat illness to occur by narrowing the range of environmental conditions in which the body can dissipate heat. Basically, the student-athlete goes from a hot-dry environment without pads to a hot-wet environment with pads.

The NCAA 2001-02 ISS showed that 91 percent of all fall heat illness was reported from football. Only 9 percent of all reported heat illness occurred in the other four sports monitored.

The inability of the student-athlete to properly re-hydrate and recover from the stresses of participating in consecutive, multiple practice days with pads, was also paramount to this model. The efficiency of the body to recover from high-intensity practice in high-heat/high-humidity conditions, and to heal from the physical contact inherent to the sport becomes impaired as the days add up.

The accumulative effects of dehydration, injury and physical exertion on the student-athlete probably are the reason for the four-fold increased injury rate during the football preseason as opposed to the regular season (2001-02 ISS data). These factors all were cited at the Gatorade Sports Science Institute 2002 summer conference. Guidelines and recommendations from that conference further strengthened the working group's stance on the implementation of the proposed changes.

Hopefully, the proposed changes to summer conditioning and preseason football practice will address many of the health and safety concerns that led to the creation of this working group. Obviously, there are many variables that can come into play. The student-athlete must take responsibility to see that he reports for preseason practice with a high level of base conditioning, and individual differences must be taken into consideration such as athlete size, medical conditions and medications.

Coaches must conduct and modify practice with consideration for the environmental conditions and time of day, and the medical staff must be prepared and trained to handle any issue related to re-hydration, nutrition, and heat illness as outlined in Guideline 2c of the NCAA Sports Medicine Handbook and the National Athletic Trainers' Association position paper HEAT. Just as importantly, educational efforts, such as the 2002 NCAA Out-of-Season Football Conditioning Educational Initiative, must continue to be emphasized with all parties concerned.

Future research and injury surveillance data will determine the efficacy of these proposed changes. This may still be a "work in progress," but good progress will have been made when these changes are adopted and implemented.