Attached is information from the National Athletic Trainers’ Association and the American Football Coaches Association on the launch of an educational program called H.E.A.T., which stands for Helping Educate Athletes In Training. The program focuses on providing coaches, athletic trainers and other health-care professionals with important information to help minimize the dangers of grueling 2-a-day football practices and competitions in the heat.

Dear Coach:

As the summer heats up, it will soon be time for two-a-days sessions, which we know are some of the most intense workouts your athletes will undergo throughout the year. That’s why the American Football Coaches Association and the National Athletic Trainers’ Association have teamed up with the Gatorade Sports Science Institute to launch a new educational initiative, HEAT, Helping Educate Athletes in Training, designed to help you better prepare your athletes for the grueling conditions of two-a-day workouts.

Two-a-day practices are a part of most early season conditioning programs. They allow for accelerated physical conditioning, increased strength training and skill development and can even help develop bonds between teammates. But because these workouts usually occur in the hot summer months, heat-related stress becomes a serious concern. Studies have shown that football players can lose as much as 24 pounds of fluid in 24 hours during two-a-day workouts. Additionally, athletes who are not properly acclimatized to the heat are highly susceptible to injury.

Following are several sheets that provide valuable information to enable your athletes to avoid the pitfalls of two-a-day workouts. In addition to practical tips, the information also reinforces the NATA Fluid Replacement Position Statement that was released last year. On the back page, you’ll find a quick reference guide that can be copied and shared with your athletes so they’ll be able to stay at their best during these workouts.

Your athletes will work hard this summer to play at the top of their game. The HEAT program is designed to minimize the dangers of exhausting two-a-day practices and help your athletes get off on a great start to the season. You can also check out the Gatorade Sports Science Institute at for more information.

Best regards,

Executive DirectorAmerican Football Coaches Association
President National Athletic Trainers’ Association


Tips for Safer Two-A-Days

Injury rates increase during two-a-day workouts whether athletes are in peak physical condition or not. In fact, many athletes don’t even make their starting lineup because of injuries incurred during preseason training.

Here are some tips to help ensure athletes stay at their best and prevent heat-related injuries during two-a-days.

Encourage Athletes to Begin Conditioning Before Two-A-Days

  • Encourage athletes to begin conditioning in the heat two weeks before official practice begins. This allows athletes’ bodies to cool more efficiently by increasing sweat production sooner than when they are not acclimated to the heat.

Avoid Workouts During Unusually Hot Temperatures

  • Practice sessions during unusually hot and humid conditions should be limited to very moderate workouts, postponed until cooler times of the day or brought inside to avoid the heat.

Make Fluids Part of the Playbook

  • Before, during and after competition, be sure to consume adequate amounts of fluid. Athletes can make sure they are properly hydrated by checking their urine color: lighter urine color indicates athletes are better hydrated. The longer the workout session, the more frequently fluids need to be replaced. Research showsthat a sports drink containing a 6% carbohydrate solution, like Gatorade, can be absorbed as rapidly as water. But unlike water, a sports drink can provide energy, delay fatigue and improve performance.

Signs of Dehydration and Heat Illness

Dehydration can seriously compromise athletic performance and increase the risk of exertional heat injury. That’s why it’s important to recognize the warning signs.

  • Thirst
  • Irritability
  • Headache
  • Weakness
  • Dizziness
  • Cramps
  • Nausea
  • Decreased performance

Use the Shade

  • Before practice, warm up in the shade and be sure to rest in the shade during breaks. Even during rest, exposure to heat can raise the body temperature, increase fluid loss and decrease the blood available to the muscles during workouts.

Recommend Wearing Loose Fitting Clothing

  • Cotton blend, loose fitting clothing can help promote heat loss. The rule: the less clothing, the better.

Be Prepared for an Emergency

  • Always have a cell phone on hand and be familiar with emergency numbers. Also keep ice and ice towels on hand in case of heat-related emergencies.

Fluid Guidelines for Two-A-Days

  • Proper hydration is the best safeguard against heat illness. Remember to have athletes drink before, during and after training and competition.

Before Exercise

  • 2 to 3 hours before exercise drink at least 17 to 20 oz of water or a sports drink.
  • 10 to 20 minutes before exercise drink another 7 to 10 oz of water or a sports drink.

What to Drink During Exercise

  • Drink early-Even minimal dehydration compromises performance. In general, every 10 to 20 minutes drink at least 7 to 10 oz of water or a sports drink. To maintain hydration, remember to drink beyond thirst. Optimally, drink fluids based on amount of sweat and urine loss.
  • Athletes benefit in many situations from drinking a sports drink containing carbohydrate.
  • If exercise lasts more than 45 to 50 minutes or is intense, a sports drink should be provided during the session.
  • The carbohydrate concentration in the ideal fluid replacement solution should be in the range of 6% to 8% (14 to 18 g/8 oz).
  • During events when a high rate of fluid intake is necessary to sustain hydration, sports drinks with less than 7% carbohydrate should be used to optimize delivery.
  • Fluids with salt (sodium chloride) are beneficial to increasing thirst and voluntary fluid intake as well as offsetting the amount in lost sweat.
  • Cool beverages at temperatures of 50° to 59° F are recommended.

What Not to Drink During Exercise

  • Fruit juices, carbohydrate gels, sodas and those sports drinks that have carbohydrate levels greater than 8% are not recommended as the sole beverage.
  • Beverages containing caffeine, alcohol and carbonation are discouraged during exercise because they can dehydrate the body by stimulating excess urine production, or decrease voluntary fluid intake.

After Exercise

  • Immediately after training or competition is the key time to replace fluids. Weigh athletes before and after exercise. Research indicates that for every pound of weight lost, athletes should drink at least 20 oz of fluid to optimize rehydration. Sports beverages are an excellent choice.

Managing Two-A-Days

Stay Cool

  • Get in shape and acclimate
  • Know the warning signs of dehydration and heat illness
  • Don’t rely on thirst to drink
  • Drink on schedule
  • Favor sports drinks
  • Monitor body weight
  • Watch urine color and caffeine intake
  • Key in on meals as an opportunity to increase fluid intake
  • Stay cool when you can
  • From: Eichner, E.R. (1998). Treatment of Suspected Heat Illness. Int. J. Sports Med. 19:S150-153.

Stay Healthy

  • Minimize the stresses of life
  • Eat a well-balanced diet
  • Avoid overtraining
  • Sleep well
  • Avoid rapid weight loss
  • Avoid people with colds
  • Keep hands away from nose and mouth
  • Get a flu shot
  • Stay hydrated and ingest carbohydrates during exercise
  • From: Niemen, D.C. (1998). Immunity in Athletes: Current Issues. Sports Science Exchange 11(2): 1-6.

Stay Hydrated

  • Drink throughout the day
  • Drink at least 17 to 20 oz of fluid 2 to 3 hours before a practice or game
  • Drink an additional 7 to 10 oz of fluid 10 to 20 minutes before competition
  • Drink 28 to 40 oz of fluid per hour of play (at least 7 to 10 oz every 10 to 15 minutes) to replace sweat loss during exercise
  • Drink at least 20 oz per pound of weight loss within two hours of finishing training or competition
  • Optimal to have fluid intake match sweat and urine loss.
  • From: Casa, D. et al. Journal of Athletic Training 35(2): 212-224, 2000.