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Douglas J. Casa, PhD, ATC, FACSM, FNATA Director, Athletic Training Education Associate Professor, Department of Kinesio

ACSM/DOD Roundtable: EHS- Return to Play/Duty Issues EHS: CURRENT CIVILIAN & MILITARY GUIDELINES FOR RETURN TO PLAY/DUTY Session 7-Speaker Athletics Perspective . Douglas J. Casa, PhD, ATC, FACSM, FNATA Director, Athletic Training Education Associate Professor, Department of Kinesiology

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Douglas J. Casa, PhD, ATC, FACSM, FNATA Director, Athletic Training Education Associate Professor, Department of Kinesio

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  1. ACSM/DOD Roundtable: EHS- Return to Play/Duty Issues EHS: CURRENT CIVILIAN & MILITARY GUIDELINES FOR RETURN TO PLAY/DUTYSession 7-SpeakerAthletics Perspective Douglas J. Casa, PhD, ATC, FACSM, FNATA Director, Athletic Training Education Associate Professor, Department of Kinesiology Research Associate, Human Performance Laboratory University of Connecticut

  2. Basic Premise For Progress • Athletes and medical staff have long considered the recovery period to be the acute treatment phase in which the hyperthermia is resolved and life-threatening situations are abated. Once this was resolved they were sent back to activity within a day or two. • Need to treat EHS like any other athletic injury and institute a rehabilitation program that is well-supervised by a physician and athletic trainer. • Having seen it from the patient side, I can tell you I was not myself for a couple weeks and I was treated optimally with no long-term sequelae

  3. 3 Primal Considerations For Return To Play Following EHS • 1) What caused the EHS in the first place? • Lack of heat acclimatization, low fitness, overweight, etc. • The cause is likely still present when they return, consider how this can be modified prior to complete return

  4. 3 Primal Considerations For Return To Play Following EHS • 2) Do any transient impairments exist physiologically or psychologically still exist as a direct results from the EHS (i.e. heat tolerance still compromised)? • What is the timeframe for these issues and how are they modified with proper acute treatment?

  5. 3 Primal Considerations For Return To Play Following EHS • 3) Are the the teammates of the EHS victim now much more advanced with regards to heat acclimatization, fitness, skills, etc. (due to the timeframe that has passed since the EHS victim has been away)? • The EHS victim would have to work that much harder to keep upon return which may increase risk.

  6. Examples of the Current Recommendations Available for Sports Medicine Professionals • National Athletic Trainers’ Association Position Statement, 2000 • Inter-Association Task Force on Exertional Heat Illnesses Consensus Statement, 2003 • Casa, et al. Current Sports Medicine Reports, 2005 • American College of Sports Medicine Position Stand, 2007

  7. (18 Military, governmental, sports medicine, and athletics organizations) NATA News. June 2003: 24-29

  8. Inter-Association Task Force on Exertional Heat Illnesses Consensus Statement 2003

  9. Inter-Association Task Force on Exertional Heat Illnesses Consensus Statement 2003

  10. MSSE, 2007, 39(3):556-572

  11. Key Item 1 Key Item 2 Key Item 3

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