USA Football

• Audio
• Video
• Image

Ron Courson, who currently serves as the director of sports medicine at the University of Georgia, has been treating athletes for the past 25 years as an athletic trainer. After acquiring a degree in physical therapy at the Medicine College of Georgia, Courson worked as an athletic trainer at the University of Alabama, Samford University, the Healthsouth Sports Medicine and Rehabilitation Center and the 1988 U.S. Olympic team. With a career that has spanned three decades, Courson has trained athletes from various sports, including football. Courson shared his knowledge with USA Football Magazine on various topics including injury prevention, heat illness, and hydration.

Have an annual pre-participation physical exam to be conducted by a physician. The more information you have about someone, the more equipped you are to reduce an injury. When we do our physicals at Georgia, we have a list of follow-ups and we try to identify things before anything happens. Next, have a strength and conditioning program to help prepare them physically – get them out into the heat of summer on a progressive basis to help them climatize (get acclimated to the climate) and get ready for the heat. Also, emphasize proper technique, safety and practice.

Heat illness is most frequent, particularly in August. It can range from cramps, which are minor, to an emergency like a heat stroke. The biggest thing from a prevention standpoint is to climatize – it takes physiologically seven to 10 days to climatize so they’ve got to be out there in the weather. Have unlimited hydration during activities, allow them to respirate and monitor their environment – have a globo-thermometer around or check the weather service and base your practicing schedules and breaks around that. Another one I would say is concussions. To prevent them, make sure that their helmets fit properly. In youth and high school, many programs don’t have equipment managers and you want to make sure the helmets are fitted properly. A lot of the time people will drain the air out of the helmet to add comfort, but then they lose their protection. The most frequent thing that happens is muscular skeletal injuries, which range from strains to sprains. The biggest prevention there is to have an appropriate flexibility and strength and conditioning program, proper equipment and try to identify any kind of sprain or strain through a physical.

I think one of the myths with gaining weight in football is consuming a lot of protein – you want to have a balanced diet. You want to make sure you have your carbohydrates, wheats, grains, fresh vegetables and fruits. Your white meat is going to be leaner than your red meat – red meat has more fatty content, so you want to eat that in moderation. The other thing is over-training, particularly from a weight lifting standpoint. Alternate your muscle groups and don’t train the same body part multiple days in a row because it won’t have a chance to recover.

How important is hydration in football and what types of liquids are the best to consume?

Hydration is imperative when you’re exercising, especially in the heat. The other thing is that players are wearing heavy, protective equipment. Hydrate before, during and after practice. Fill up the tank before you go out there – we really recommend unlimited hydration where they can drink at anytime. In regards to the types of fluid you should consume, you want to drink water or an electrolyte drink. I’m not trying to advertise Gatorade or Powerade, but they’re better fluid-replacement drinks when exercising out in the heat. When you sweat, you’re losing electrolytes and that includes sodium, potassium, magnesium and calcium. Let’s say if you sweated out seven pounds, approximately every pound you lose is a gram of sodium. If you drink seven pounds of water back, you replace your fluids but you don’t replace your electrolytes, and that’s when you run into cramps and so forth. Particularly if you’re exercising in the heat and sweating heavily, electrolyte drinks are more efficient in replacing the electrolytes that you’ve lost. We emphasize weigh-ins before and after every practice because hydration problems can be awfully deceptive. Another thing we recommend is checking the color of your urine – your urine should be clear to light yellow in color. We teach our guys to do that because it’s a simple way to monitor hydration because thirst isn’t always the best indicator.

There’s a condition that you hear more and more about, and it’s called hyponatremia. Generally what happens with that is that you can over hydrate and over-drink with water and you can actually flush your system out with electrolytes. People with a history of cramps will try so hard to not cramp that they’ll drink a gallon of water before the next practice, but the thing is they’ll cramp up even worse. Since in football we practice with heavy equipment in the heat, we emphasize hydration with electrolyte drinks because you’ll replace the fluids and the electrolytes that you lost and you’ll get that balance.

Eat three balanced meals a day and hydrate appropriately. Supplements are something you need to exercise caution with and nutritional supplements aren’t regulated well—they’re not policed by the FDA like your food or prescription medication so whatever claims they might have on the bottle or medication that doesn’t necessarily tell you what’s in the supplement. In terms of vitamins, taking a one-a-day general vitamin works really well. We like to think of our bodies like a car—one of the first things you do before you go on a trip is you check the gas and tires to make sure it runs right, and the same goes for your body because you want to make sure you have a well-balanced diet.

If you’re trying to gain weight, one of the things you might want try to do is incorporate snacks or another meal. If you’re eating three meals a day, you might want to add a snack or meal at night—there are a variety of different ways you can do this. Some of the shakes, like the shakes made by Gatorade or MET-Rx, are good nutritional, balanced products. If you drink one shake with each meal and one at night, you’ll get 1,000 extra calories without experiencing some of the adverse side effects that you would get from taking creatine or protein powder. If you do decide to take creatine or protein-based products, you need to make sure you hydrate well because those products put an excessive demand on your kidneys.

One of our biggest focuses is on prevention – the more things we can prevent, the better we are and that encompasses pre-participation physical exams and screenings and so forth. We’re involved in the coverage of practices, games and conditioning sessions in the event if any injuries occur. If they do occur, we assess the injury or illness, determine the extent of it and determine if it’s something that you can manage there or should be referred to a physician. If we find out they need [a physician], we communicate with them, find out the diagnosis and get a plan of care and rehabilitation program to get that kid back as quickly and safely as we can.