The Inter-Association Task Force for Preventing Sudden Death in Collegiate Conditioning Sessions: Best Practices Recommendations

Maximizing strength and conditioning sessions has become fundamental to sport.

The right combination of strength, speed, cardiorespiratory fitness, and other components of athletic capacity can complement skill and enhance performance for all athletes. A sound and effective training program that relies on scientific principles of exercise physiology and biomechanics intended to produce outcomes that are sensitive and specific to the sport should be the goals. Unfortunately, the athlete’s development, health, and safety are sometimes overshadowed by a culture that values making athletes tough, instilling discipline, and focusing on success at all costs.

This ill-conceived philosophy has been a contributor to the alarming increase in collegiate athlete deaths and serious injuries during conditioning sessions. A total of 21 National Collegiate Athletic Association (NCAA) football players have died during conditioning workouts since 2000.(1) The 3 most common causes of the fatalities were (in order) exercise-related sudden death associated with sickle cell trait (SCT), exertional heat stroke, and cardiac conditions.(1) Seventy-five percent of the fatalities (n = 16) were Division I football players.

Also, the incidence of exertional rhabdomyolysis in collegiate athletes appears to be increasing. Excesses in strength training and conditioning—workouts that are too novel, too much, too soon, or too intense (or a combination of these)—have a strong connection to exertional rhabdomyolysis. Introducing full-intensity workouts too quickly is especially high risk: 11 of the 21 deaths occurred during day 1 or day 2 workouts.

Rule changes enacted in 2003 related to heat acclimatization procedures during August football practices have been extremely effective. In the NCAA Division I Football Bowl Subdivision, no player died from practicing or playing in a game between 2000 and 2011. However, conditioning workouts continue to be a catalyst for catastrophic outcomes. It is imperative that similar guidelines be implemented to improve the safety of conditioning sessions. This consensus statement provides specific conditioning recommendations with the intent of ending conditioning-related morbidity and deaths of collegiate athletes.