DEAR DR. DONOHUE: This will be my first year as an assistant football coach at the high-school level. The head coach has given me the task of preparing for heat-related injuries. It stays hot here way into October. I’d appreciate any tips you can give me. — G.O.

ANSWER: The best prevention for heat injuries is calling off practice on hot, humid days. What exactly is a hot, humid day? If your school has a wet-bulb globe thermometer, on days when it registers 82 or higher, either call off practice or limit the work done. This reading incorporates heat and humidity.

It takes two weeks for the body to acclimatize to heat. In the first few days, drills should not be demanding. Once acclimatized, the body sweats earlier and the sodium content of sweat lessens. Encourage players to stay hydrated. They should drink 16 to 20 ounces of water or a sports drink two hours before and again half an hour before practice. Players should continue to drink 8 ounces every 20 minutes. Sports drinks provide sodium.

Heat cramps are the first sign of trouble. Muscles of the arms, legs or abdomen cramp. Cramping players should be taken out of practice, sit in a cool, shaded place and drink sodium-containing fluids. Heat fainting is a more serious sign of heat trouble. Such a player should be taken to an air-conditioned room, hydrated and carefully watched. This player ought not to practice the following day. Heat exhaustion is the next and is a quite serious sign of heat injury. The player sweats heavily, might be nauseated, breathes rapidly and has a fast pulse and low blood pressure. He’s apt to be confused. The player is dehydrated and sodium-depleted. He must be quickly taken to an air-conditioned room, have his clothes removed and his legs elevated. Cold fluids containing sodium are essential. If he’s not responding to this treatment shortly, he ought to be taken to a hospital emergency department.

Heatstroke is the most serious heat injury. All the signs mentioned above are present, but the skin can be dry. The player is groggy or unresponsive. He needs to be taken to an emergency room by ambulance. Clothes are removed. During transport, ice-water-soaked towels are placed under his arms, in his groin and around his neck. Immersion in an ice-water bath will be accomplished at the hospital.

DEAR DR. DONOHUE: When is the best time to do cardio and weight training? I have been under the impression that doing cardio first is better. Your muscles will be warm when you weight train. Lately I have heard that weight training first is better. If this is true, should you warm up a little first?

I am 70. Last year I lost 10 pounds but still have a protruding abdomen. I do crunches and leg raises. Are there better abdominal exercises? — L.M.

ANSWER: I belong to the school that says cardio training is better first for the same reason you gave — warming up the muscles. I don’t know if it makes all that much difference. Warming up before weight training is recommended.

Your abdominal exercises are fine for abdominal muscle strengthening. Strong abdominal muscles act like a girdle and hold the internal organs where they should be. Look to your back. I bet you have a pronounced forward curve in the lower back. That makes the abdomen protrude. Make an effort to straighten out that curve and adopt that posture for your normal posture.

DEAR DR. DONOHUE: I played college and semi-pro basketball. I have a grandson who has excellent ability and the desire to become an outstanding player. He just turned 13 and is 4 feet 11 inches tall. Just about everyone in our family is 6 feet to 6 feet 6 inches tall. We assume that his growth spurt is yet to come. Is it appropriate to start him on a jump-rope routine? I don’t want to impact his growth plates. — D.T.

ANSWER: His bones won’t be adversely affected by jumping rope. Like anything else, it’s not wise to overdo rope jumping. But it is an excellent way for him to exercise and develop his lung capacity. It’s very tough work, tougher than running.

If the boy doesn’t show a growth spurt soon, the family doctor ought to give his opinion.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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