If you attend a football game on Friday night, undoubtedly you will be entertained at halftime — and perhaps pregame — by the home team’s marching band. Ditto if you are attending a college game on Saturday.

During the performance, you will probably give it little thought, but perhaps you should. How did they get to sound so good, keep in step, and hold that sophisticated formation that looks like letters, a state or a mascot?

It doesn’t happen overnight or with a wave of the conductor’s wand.

It takes hours of practice, working on the music and the marching steps.

All that repetition, however, will often lead to overuse injuries — just like in any sport.

Combine that with heavy uniforms, sometimes heavy instruments, twirling flagpoles and often having to perform in the heat and you have an activity that has significant dangers.

Consequently last month, the National Athletic Trainers’ Association issued a set of 16 guidelines that, if followed, will keep band members safer:

1. Prepare for activity with a preparticipation physical exam.

2. Put a written Emergency Action Plan into place for managing serious and/or potentially life-threatening injuries, including a contingency for off-site events.

3. Get ready to march by starting with 20-minute walks and gradually increasing distance/time over the course of four weeks before the season starts to prevent stress fractures and other overuse injuries.

4. Promote core strength and good posture.

5. Acclimatize to the heat over a seven to 14-day period.

6. Stay safe during lighting by following the NOAA guideline: “When thunder roars, go indoors.” Upon the first sight of lightning or sound of thunder, activities should stop and everyone should seek a safe indoor facility. After the final sound of thunder/flash of lightning, wait 30 minutes before going outdoors.

7. Wear lightweight shorts and t-shirts to avoid overheating during practice and be smart about footwear. Flip-flops should be avoided. Uniforms should be worn only for dress rehearsals and performances.

8. Band members should begin activity well hydrated and fluids should be readily available with appropriate breaks.

9. Students should report to an adult if they have hit their head. An appropriate medical professional should evaluate any band member experiencing any concussion symptoms such as headache, dizziness and/or loss of memory.

10. Cool down before and after practices and performances by standing in the shade during rest breaks or when only music is being practiced without a routine.

11. Fuel for success with healthy foods such as whole grains, dairy, fruits and vegetables and meat/poultry/fish.

12. Students should hold and manage sousaphones, drums, flutes, trumpets and other instruments correctly to avoid ergonomic injuries.

13. Stay fit in formation by moving fingers, knees and toes slightly to keep circulation flowing and joints flexible if standing stationary for an extended period.

14. Monitor band members for signs of heat illnesses and encourage them to look out for each other.

15. Inspect fields and routes for debris, water, rocks and other hazards. Small obstacles can lead to twisted ankles, bruised knees, scraped elbows or other more serious injuries.

16. Have a fully stocked first aid kit always available. Other than the normal gauze, adhesive bandages, and elastic wraps, it should also include an EpiPen if any members are at risk of anaphylactic shock and the spare inhalers of any members with asthma.

John Doherty is a licensed athletic trainer and physical therapist. This column reflects solely his opinion. Reach him at jdoherty@comhs.org. Follow him on Twitter @JDohertyATCPT.

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