Two-a-days are ramping up across the country under a higher than average forecast, and two of the sport's biggest medical and governance bodies say the coaching approach regarding linemen needs to change.
The National Athletic Trainers Association and the National Federation of State High School Associations are urging coaches to treat linemen differently in the preseason, according to a new ESPN article.
The reasoning? Linemen account for 90% of heatstroke deaths at the high school and college levels.
The recommendations are very specific. Expert trainers are asking that linemen be held out of things like mile runs, serial sprints and other preseason performance testing during the first few weeks of the season.
They're also recommending that coaches stop using conditioning as punishment. Exertion drills used as discipline were cited as a factor in 37% of football heatstroke deaths.
That last point should land differently for any coach who has ever run a kid for a busted assignment or used it as a course of discipline for misbehaving during school hours.
The most recent numbers outline the urgency. Scott Anderson, director of special projects for the College Athletic Trainers Society and the former head athletic trainer at Oklahoma, shared with ESPN that fatalities have actually crept up marginally over the last two-plus decades. "If we look from about 2000 to present, they've gone from about 2.1 per year to 2.6 per year," Anderson said. "So the bottom line is, we're not preventing fatalities."
The problem is the same characteristics that make lineman successful are the same things that put them at higher risk of heat stroke. NATA points to larger body mass, lower aerobic fitness, greater metabolic heat production and reduced cooling efficiency as the factors that stack against linemen specifically.
The NFHS told its state associations in June that the old standbys, lighter and cooler clothing, more hydration and longer acclimatization windows, still matter but do not go far enough because they do not fully account for a lineman's unique risk. NATA's guidance is set to publish in the medical journal Sports Health.
Anderson's coaching-friendly takeaway is that linemen should be trained for what the game actually asks of them. "They stand at the line of scrimmage and in a sense have a wrestling match," he shared with ESPN. "There's some movement, but they're not out there sprinting up and down the field like a receiver or running back or defensive back."
He also went as far as to suggest giving linemen access to air-conditioned space during the year's hottest practices.
Within just the past two months, two 14-year-old high school linemen, in Arkansas and Louisiana, were hospitalized after heat-related incidents. Earlier this summer, Mississippi's Rankin County School District settled a lawsuit brought by the parents of Trey Laster, a senior who died of heatstroke in 2022. That suit specifically pointed to his elevated risk as a lineman.
The overall culture piece is the part coaches control. Rebecca Stearns, chief operating officer of the Korey Stringer Institute and the NATA task force chair, framed it as a competitive advantage, not a concession. "If you can avoid preseason injuries and outcomes that take away weeks or maybe years of an athlete's participation, then we've strengthened the team," she said. "We don't need linemen who can run a mile in eight minutes."
Plenty of programs are already there. Alabama High School Athletic Association assistant director Brendt Bedsole, who oversees football at more than 750 middle and high schools, told ESPN that many staffs, especially at the top levels, already tailor workouts for their linemen.
Still, there will be plenty of pushback.
Back in August, we shared news of a groundbreaking wearable technology set to hit the market to help monitor individual athletes in hot environments that seems relevant to this latest push.
Stay tuned to The Scoop for more.