Baseline Aerobic Fitness in High School and College Football Players: Critical for Prescribing Safe Exercise Regimens

Abstract

Background: Nontraumatic fatalities occur on a regular basis in high school (HS) and college football athletes, primarily in obese linemen performing high-intensity exercise. One contributing factor to these deaths may be a mismatch between baseline aerobic (cardiorespiratory) fitness and exercise regimens. Hypothesis: There is a wide range of aerobic fitness in HS and college football players. Body mass index (BMI) is a safe and simple method for estimating baseline aerobic fitness. Study Design: Retrospective cohort study. Level of Evidence: Level 3. Methods: A retrospective review was performed on 79 HS football athletes who had VO2Peak (mL·kg−1·min−1) measured during the offseason. Multivariate regression analysis was used to determine if BMI (obese, overweight, and normal; kg/m2), position played (linemen vs other), year in school (freshmen vs other), and/or race (African American vs White) were risk factors for poor aerobic fitness. A separate cohort of 135 (48 HS; 87 college) football athletes performed a 6-minute run test to determine speed (miles/min), extrapolate VO2Max, and calculate reference values for suggested upper threshold safe starting speeds (85% of maximum) for aerobic training based on BMI. The relationship between BMI and VO2Peak was assessed. The exercise regimens (speeds) of 2 collegiate football fatalities from the public domain were used to predict their VO2Max values. Results: Mean VO2Peak (mL·kg−1·min−1) was 38.5 ± 8.6 (range 19.1-60.6); when grouped by BMI, low scores (<40) were found in 87.5% of obese (32.4 ± 7.7), 47.8% of overweight (40.8 ± 7.6), and 45.2% of normal (41.4 ± 7.8) athletes. VO2Peak was significantly lower in linemen (32.8 ± 6.4; P = 0.007) compared with nonlineman (41.8 ± 7.9), and in obese players (by BMI; 32.4; P = 0.019) compared with nonobese players (41.4 ± 7.6), but did not differ by age, year in school, or race. Means for speed (min/mile) and extrapolated VO2Max (mL·kg−1·min−1) for the 6-minute run test by BMI groups were both significantly different ( P = 0.001) for normal (7.0 ± 0.6; 51.1 ± 2.6), overweight (7.6 ± 0.8; 46.5 ± 3.2), and obese (8.9 ± 1.5; 36.8 ± 5.9) athletes. There was a significant negative correlation ( r = −0.551; P = 0.001; R2 = 0.304) between VO2Peak and BMI. Safe starting speed recommendations for running 1 mile range from 7.3 to 12.1 min/mile for BMIs 20 to 40 kg/m2 for HS and college athletes. For the 2 fatalities (mean, BMI of 36.5 kg/m2) repetitive sprint speeds were 49 and 89% higher than our safe starting speeds for their BMI. Conclusion: A large spectrum of baseline aerobic fitness was noted in HS and college football players. Obese players and linemen had statistically lower baseline aerobic fitness, a major risk factor for possible heat illness. BMI is an acceptable surrogate for VO2Peak and can be employed to develop safe training regimens without the need for a maximum fitness test, which can place the athlete at risk for a medical event. Clinical Relevance: Knowledge of BMI provides an estimate of baseline aerobic fitness and a foundation for prescribing safe, individualized exercise regimens.

Epidemiology of sudden cardiac death and sudden cardiac arrest with resultant disability during high school organized sport in Japan

“…Moreover, the risk of cardiac event was highest among first-year student-athletes, who are generally less fit compared to upper-classmen. Suboptimal aerobic fitness has been identified as one of the key factors associated with sudden death in 17 While the study by Boden et al 17 did not report age as the risk factor, we must consider that Japanese high school organized sports typically conduct practice and training sessions in one team, with students of all ages and levels take part in the same session. In traditional US school organized sports, teams are divided by age and skill levels (e.g., freshman, junior varsity, varsity), which may help nullify the influence of age as a risk factor.…”

Relationship Between Pitch Counts and Shoulder Strength in Collegiate Baseball Players

“…In combination with baseline shoulder strength, sports performance specialists can prescribe appropriate training volumes by monitoring for changes in strength measures. In football players, BMI has been shown to be an adequate measure of aerobic conditioning and can be used to prescribe safe conditioning programs to prevent injury (6). This could provide a framework for evidence-based training schedules for baseball pitchers.…”

Getting Ready for Fall Sports

“…The best indicator of aerobic fitness is maximal aerobic capacity (VO 2 max). In a publication in this issue of Sports Health , Boden et al 2 report a wide range of VO 2 max in high school and college football players, with greater than a 3-fold difference between the best and worst aerobic performances on testing in high school athletes (19.1-60.6 mL kg -1 min -1 ) and a 2-fold difference in college players. These numbers demonstrate the need to individualize conditioning programs, as this range in aerobic fitness reveals how vastly different fitness profiles can be in the same sport at the same level of competition.…”

“…An excellent surrogate for aerobic fitness is body mass index (BMI), which is easily determined. 2 As Boden et al 2 report, BMI is a good measure for estimating aerobic fitness and developing progressive training modules while minimizing risks of a medical event. Boden’s 2 report demonstrates that most obese football players and approximately 50% of normal weight football players had poor aerobic fitness levels.…”

“…2 As Boden et al 2 report, BMI is a good measure for estimating aerobic fitness and developing progressive training modules while minimizing risks of a medical event. Boden’s 2 report demonstrates that most obese football players and approximately 50% of normal weight football players had poor aerobic fitness levels. Those in the lower levels of aerobic fitness will benefit from additional time and training to reach a fitness level appropriate for their sports.…”