Joanne Atkins-Ingram remembers every detail as she watched her 19-year-old son, Braeden Bradforth, walk through Newark Liberty International Airport last August, heading off to play football for a community college in rural Kansas.

The Neptune, N.J., mother stood on her tiptoes to kiss her 6-foot-4, 305-pound “baby” goodbye. He wore his Adidas slides and his dreadlocks cascaded down his back. He really looked like a man, she said.

Two days later, Bradforth died from exertional heat stroke after a grueling football practice at Garden City Community College, an autopsy found. It happened on a hot, humid night after a session that included more than three dozen 50-yard sprints to be completed in less than 8 seconds, with restrictions on water breaks, according to reports at the time.

He hadn’t even unpacked.

The anniversary of Bradforth’s death — and the beginning of fall sports season — comes as researchers report that over-conditioning kills more football players than traumatic injuries. The report was presented at the American Orthopaedic Society for Sports Medicine’s annual meeting last month, when researchers said August is the deadliest month for the game.

From Pop Warner up to the National Football League, more than four million players participate in football in the United States, according to the National Center for Catastrophic Sport Injury Research.

While traumatic fatalities during games have declined since the 1960s, nontraumatic fatalities have not, said lead author Barry Boden at the Centers for Advanced Orthopaedics in Maryland.

Between 1998 and 2018, there were 187 fatalities that occurred during conditioning sessions. More than half were related to cardiac issues, about 24% were heat related, and 5% were from asthma, according to the study.

There were some commonalities in the fatalities, said Boden. The workouts were often run by coaches who used irrationally intense drills. There was no distinguishing for a player’s size, fitness level, or position when it came to the workouts. And a player who began having problems did not receive adequate medical attention, he said.

Overweight players, such as linemen, are particularly vulnerable to heat issues. Many of the players who died had a body mass index of 33, Boden said. (A BMI of 30 or higher is considered obese, though some dispute the usefulness of BMI as a health measure for such athletes.)

These deaths are preventable, said Boden.

Bradforth’s death shares some traits with that of University of Maryland offensive lineman Jordan McNair, who died two weeks after he suffered heatstroke and had a seizure during a 2018 spring football practice.

There are guidelines at both the collegiate and high school levels to help prevent this type of tragedy. But they are not mandated.

NCAA guidelines recommend that all schools have an emergency action plan for heat-related illness. Players should participate in at least six to eight weeks of preseason conditioning and be given 10 to 14 days to acclimate to playing in the heat to minimize the risk of exertional heat illness.

The Pennsylvania Interscholastic Athletic Association (PIAA) requires coaches to take a class on the fundamentals of coaching and a first aid class that includes how to handle concussions, sudden cardiac arrest, and heat-related illness.

Safety precautions used on most high school football fields are also present in other fall sports, such as field hockey and soccer.

“Our state has done a good job of being ahead of the curve,” said Matt Ortega, head football coach at Coatesville Area Senior High School in Chester County. Completing all the requirements can be time consuming but necessary.

“We are not going to play around; we are always going to do right by the student-athlete,” Ortega said.

At Conwell-Egan Catholic High School in Fairless Hills, Bucks County, fall football practice is punctuated by the drum beat of coaches reminding players to drink fluids.

“Make sure you hydrate,” head coach Jack Techtmann said to a group of linemen headed to the locker room to suit up for field drills last week.

Techtmann has been coaching for more than 40 years. Years ago, water was restricted and intense practices were held in the heat.

“We’ve moved into the 21st century,” Techtmann said. “You don’t do those things now.”

During a recent practice, there were two mandated water breaks for the team between sled and bag drills. The coaching staff eases the team into summer practices and makes sure all players pass a physical before competing, he said.

When one player forgot his medical clearance form, Techtmann said he could watch practice, but not participate.

Bryce Vorters, Conwell-Egan’s team trainer, carries with him a WetBulb Globe Temperature monitor, a device that combines the measurements of temperature, relative humidity, radiant heat from the sun, and wind speed. It is used to determine how long players can safely remain on the field in hot days.

Players weigh in before and after each practice to help monitor their fluid loss, said Vorters, who is employed at the school through NovaCare. A golf cart that carries first aid equipment, including an AED, and ice is on the field when any team practices, he said.

Although some of these precautions were allegedly in place at Bradforth’s practice in Kansas, the coaches and trainers did not respond to his symptoms, according to reports.

Atkins-Ingram places the responsibility for her son’s death on the coaches and staff at Garden City Community College.

Former head coach Jeff Sims has said Bradforth’s death was an act of God. He left after the 2018 season for a job as head coach at Missouri Southern State University.

Bradforth, who had been accepted at the Kansas school five days before he boarded the plane, had not been doing any preconditioning workouts, and the 2,800-foot altitude was far different from Neptune’s sea-level fields, Atkins-Ingram said.

“They never gave him time to acclimate,” she said.

The night he died, teammates reported that the coach yelled at Bradforth when he began to feel ill. As the team left the field for a meeting, Bradforth showed signs of delirium and headed back to his dorm alone, she said.

Bradforth was found by teammates collapsed in a small alley near his dorm. When emergency medical technicians arrived, Bradford had begun to vomit something that looked like a dark motor oil, presumably blood, multiple sources said. According to reports, he was taken to a nearby hospital, where he was declared dead about 90 minutes after the practice ended.

“Now I know he suffered at the end,” Atkins-Ingram said.