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Hydrating Athletes Then and Now

October 1, 2018

The Evolution of Hydration in Athletic Training

By Jane Steger, First Aider Staff

“As a student athletic trainer, during high school football pre-season practice I was instructed to take a knee at the water fountain and give each player a salt tablet. They could wash it down with a small gulp of water. That was the science then. Thankfully, we didn’t kill anyone.”

“We had salt pills in the locker room and gave them away like candy. We didn’t know then that the pills just sat in the player’s gut and it was more like feeding them BB’s than candy.”

“If the team had a bad practice, water was restricted at the half. Coaches believed water was bad for players and it slowed them down. They knew that a lot of marathon runners who finished first or up in front were very dehydrated, so they thought it must be better to be dehydrated. How crazy is that! It’s amazing we didn’t kill people.”

Yes, these are actual quotes from three long-time athletic trainers with extensive experience in the southern heat. When interviewing them for this article, they were all quick to illustrate how far we’ve come in understanding the science and importance of hydration. Thankfully.

Salt tablet usage was popularized by the military. Ironically, it was research conducted by the military as well as others that debunked their value and started the shift toward electrolyte drinks.

According to athletic trainer John Purdy ATC, back in the late 1950’s Louisiana State University’s head athletic trainer Dr. Martin J. Broussard developed the first electrolyte replacement drink, Bengal Punch. “Marty knew his players were losing salt because he could see salt on their uniforms. Believing that salt tablets were too hard and soft drinks weren’t adequately replacing electrolytes, he made a mixture of electrolytes, salt and a sweetener. Bengal Punch was developed in 1958, the year LSU won the national championship, so there was always this connection between the drink and the championship,” Purdy said. “Afterward, the drink was renamed Quickick and I was introduced to it at a Cramer three-day student athletic trainer course.”

(Left) Student Trainer Dean Kleinschmidt was featured in The First Aider back in 1963.

“I first heard about the shift from salt tablets to sports drinks at an NATA Conference in the early ‘70’s,” said Dean Kleinschmidt, ATC. “The speakers were instructing on not using salt tablets and supporting their recommendations with research.”

“In 1967, I was introduced to Gatorade when I was at Troy University,” said John “Doc” Anderson, ATC. “Florida was on the winning end of an upset and they were using Gatorade. Before you knew it, Gatorade was everywhere. To be honest with you, Troy University couldn’t afford electrolyte drinks back then so we just gave players water. But we hydrated the snot out of them.”

“When we did start using electrolyte drinks, we choose Quickick because it used saccharin, not sugar," continued Anderson. “At breaks, players would be given Quickick, water and sometimes watermelon and popsicles. Quickick was obviously very popular in Louisiana."

Better education and more interest in the topic of hydration drove the improvements the profession has experienced over the past several decades. Kleinschmidt noted, “I remain an outspoken, raving fan of hydration, having worked 31 years with the New Orleans Saints, usually in high heat and high humidity. We always made it a priority to hydrate and that is still the stance across the NFL today.”

Purdy added, “Sports medicine in general started getting better during the 1980’s and we realized you really need to give unlimited fluids. And we started using things like a psychrometer. So instead of just saying ‘wow, it’s pretty hot today so let’s be careful,’ we used the dry bulb temperature system to determine how much humidity was in the air. Generally if the humidity is greater than 88%, perspiration starts dripping off the noses of the athletes and it’s not being evaporated off the skin. That is an indicator that there is too much water in the air and you’re setting yourself up for a lot of humidity problems. That’s when things like ice tubs started to show up on the sidelines."

“We used Cramer Weight charts to track player’s weight change. Based on research that had been done, we were advised that a player should be within 2% of his normal body weight before starting practice. I don’t know how tightly anyone adhered to that, but a player was given a jug of electrolyte drink to replenish before the next practice or until they were back to their normal weight,” Anderson said.

“Back in 1990 or ‘91, I think it was someone at Texas A&M who came up with a way to pump water on the field; called it a water caddie. That was a godsend. But before then, I got on my knees and Coca-Cola came thru with free cups and the chow-hall loaned me four of their big stainless steel thermoses. The athletic training students would fill up the cups with ice and water as fast as they could and set them on a table. Then the players would come up to the table in a pre-assigned order to get their first cup of water. Once they had their first cup of water, they could get back in line for another cup,” Anderson said. “We had to put this specific process in place because the first time we did this, the players broke out in a slug fest.”

In the mid 1990’s, Cramer introduced their first hydration system. Today, the Cramer Powerflo hydration systems help keep athletes hydrated on the field.“Our portable units can be maneuvered from the training room to the field and run off a lithium battery,” said Chad Stephens, Marketing Manager, Cramer Products. “This has become a vital piece of equipment when it comes to hydration management of athletes.”

“At my last few years at LSU, I would be embarrassed if any of my players cramped. I think most athletic trainers feel the same way because hydration is such a science now. When I started at LSU, a lineman weighed 220 pounds, now they weigh in at 330 lbs. It’s a completely different athlete,” Purdy said. “You have to teach your players about checking their urine, getting enough fluids and eating proper meals. If they loose six to 10 pounds in practice, they need to make that up in fluids before they leave the practice facility.”

Anderson added, “Back in the day, kids coming into the program were lighter—even 220 lbs. was considered fat—and they were acclimatized. They actually looked forward to football practice in August because they had been working in steel mills and on the farm all summer. Now we have Rolls Royce bodies on Volkswagen engines. And the players are not acclimatized. The locker rooms are air-conditioned as well as the dining halls, classrooms and dorms.”

“In addition to hydration, athletic trainers also understand the value of rest and recovery,” stated Kleinschmidt. “It used to be ‘push, push, push,’ but research has shown that giving players breaks and not practicing 12 hours a day can enhance their performance. As such, teams are now building recovery rooms into their facilities.”

“We also know the importance of eating right,” added Anderson. “Eating three square meals a day is the best way to get sodium.”

As the science has evolved, numerous athletic lives have likely been saved thanks to a primary role of athletic trainers in athletic hydration. As you can see, Cramer has been there with athletic trainers over the years, to supply anything they need; and also there to change with the science and the practice of athletic training…from salt tablets to QuickKick Electrolyte drink to Cramer Weight Charts and Hydration Units, Cramer has been there every step of the way in hydration.

Sidebar - We couldn’t resist asking these three legends what they’d say to a group of new or soon to be graduating athletic trainers. Here is what they shared.

John Purdy: I want new AT’s to appreciate what it’s been like in the past and why we are so specific about it today; why it is so important to hydrate your athletes in an unlimited fashion. And here’s another thing. Coaches are so much better educated now then they were. Like I said, using salt tablets and restricting water because you had a lousy first half is what coaches experienced as players, so that’s what coaches did in my early days. Now coaches are educated on fluids and concussions and CPR trained; the whole science of managing the health of athletes is so much better.

Dean Kleinschmidt: You come out of school feeling so prepared you’re almost cocky, and then something happens. You look into an athlete’s eyes and you know they trust you to do the right thing. You can never stop learning, never stop preparing. Every summer, we did emergency action plans long before they were mandatory in the NFL. And we practiced everything, such as strapping each other onto a spine board. You need to practice these things to keep up just like you keep up with your CPR and NATA certifications. You have to stay sharp.

John “Doc” Anderson:1. Surround yourself with people smarter than you, 2) Know what you don’t know, and 3) Ask the question before the question.

Bios ….

John H. Anderson, MEd, ATC – Anderson has enjoyed a career spanning nearly five decades. Except for a 10-year stint at Louisiana State University, he has held various roles at Troy University since 1967, including head athletic trainer, professor and program director and serves as a professor emeritus lecturer. He was a member of the Mexican Track and Field coaching staff for the 1984, 1988 and 1992 Olympic Games and served as an athletic trainer for the 1996 U.S. Olympic team. Anderson is the founder of Iota Tau Alpha, a national athletic training honor society. Since its inception in 2005, the organization has expanded to more than 100 chapters with more than 4000 inductees.

Dean Kleinschmidt, ATC, LAT – Kleinschmidt has acquired over four decades of experience in the athletic medicine field, most of which occurred on the NFL level. In 1971, Kleinschmidt was named the head athletic trainer for the New Orleans Saints, becoming the NFL’s youngest ever head athletic trainer at the age of 24. His work has been well-recognized throughout his career, and he is an inductee in the Senior Bowl Hall of Fame (2008), Southeastern Athletic Trainers Association Hall of Fame (2007), New Orleans Saints Hall of Fame (2002), National Athletic Trainers Association Hall of Fame (1994) and the Louisiana Athletic Trainers Association Hall of Fame (1990). In addition to his duties over the years, Kleinschmidt has coordinated all sports medicine efforts at the Senior Bowl All-Star Game in Mobile, AL, since 1971. He has also served on the board of directors and as president of the Professional Football Athletic Trainers Society.

John Purdy, MS, ATC, CSCS-CPT – Following 22 years in the Army as an airborne ranger, which included two Vietnam combat tours, Purdy’s 40+ year athletic training career started in 1975 at Robert E. Lee High School in Baton Rouge, LA. Between 1978 and 1998, he held AT positions at Louisiana State University, and from 1999 thru 2018, he rehabilitated patients and athletes at Vanderbilt Sports Medicine. He worked with NLF players in nine pre-season training camps for the Dallas Cowboys and Seattle Seahawks and supported Olympic athletes for their quest for gold during the 1994 Winter Games in Norway (luge/bobsled) and at the 2004 Summer Paralympics in Athens, Greece (Seated Men’s Volleyball). Purdy is currently a free agent.

Editor’s note – When I was asked to write an article on hydration, I thought, “Really? How interesting could this topic be?” That was before I spoke to Purdy, Dean and Doc, real legends in the athletic training field. Thank you all for taking the time to share your insights, experiences and so many wonderful stories. And thank you for your gratitude for the impact Cramer made on your careers. Jane Steger

Posted in: Hydration