High-tech equipment, vigilant medical care and perhaps even the time-worn comfort of chicken soup will be on tap to combat Arctic conditions for Sunday's NFL playoff game in Green Bay, Wisconsin, between the Packers and San Francisco 49ers
So says Dr. Matthew J. Matava, head team doctor for the St. Louis Rams and president of the National Football League Physicians Society.
With temperatures expected to drop below zero Fahrenheit (-18 C) accompanied by icy winds during the game, hand and finger fractures, hamstrings and quadriceps, frostbite and dehydration are of particular concern, according to Matava.
Players will wear the latest in fabrics that retain body heat, use chemical heat products in their shoes and gloves and apply petroleum-based products to their faces to protect their skin, the orthopedic surgeon told Reuters in a telephone interview.
More than two dozen medical personnel, including trainers, doctors and chiropracters, will patrol the sidelines to massage and treat players and watch out for possible frostbite.
"One thing we tend to forget about is hydration (on a frigid day)," Matava said.
"You lose a lot of water just through respiration. Your body metabolism is geared up so much in order to maintain your body heat that part of the waste that you expel through your lungs contains water.
"A lot of sidelines will have warm chicken broth available. It tastes good, it's going to be warm and help warm them internally. It contains electrolytes and the sodium chloride (salt) helps replenish electrolytes you lose in sweat."
Bitter cold makes the football harder, putting players that have to handle the ball at greater risk.
"I would be concerned about fractures of the digits," said Matava. "Especially those that catch the ball and run with the ball like receivers, defensive backs and running backs."
Matava said some players put on surgical gloves under their playing gloves to retain warmth.
A frozen playing surface could increase the threat of concussions.
"That makes common sense from sheer physics," acknowledged Matava, although he was not aware of studies on that factor.
"Colder structures tend to be harder and when there is contact there is going to be more risk at transferring that force to whatever body part is struck," he said about hitting one's head against a frozen playing surface.
Joints tend not to react as quickly in cold weather as they do in warm weather and muscles need to stay warm and flexible, he warned.
"It's environments like this that we tend to see tears of the hamstring and strains of the quadriceps muscle, the muscles of the lower extremities for running," said Matava, who said special teams players were at high risk.
"You're taking a warm muscle, it's getting cold again and then jump into duty immediately to run down the field to cover a punt. That's when we see muscle tears and the like."
Fingers, toes, nose and ears are targets of frostbite and players' coloring should be observed, the doctor said, saying skin losing its rosiness is an early sign of possible frostbite.
Players that have asthma need to protect against a possible broncho spasm that could lead to an asthmatic attack and should keep an inhaler available on the sidelines, he added.
Medical staff on hand will include orthopedists, internists, a neurosurgeon on each sideline, primary care doctors, trainers and emergency medical technicians.
"The chiropracters might be very busy because players get muscle cramps because they're running and when the muscles cool down they're more prone to muscle spasms," Matava said.
Matava even had some advice for people attending the game at Lambeau Field.
"The biggest concern we have for fans is keeping your clothes on and watching the amount of alcohol you drink," he said.
"Taking shirts off is great for TV but not advised from a medical standpoint.
"And when you drink, you tend to feel warm at first but your blood vessels are just dilating. When you dilate, you tend to lose heat instead of retain heat. Even though you might get a warm glow, you're actually losing heat in the process."
(Reporting by Larry Fine, Editing by Gene Cherry)