IN THE GRIPS of a polar vortex in Kansas City last winter, Matthew Maddux received an offer the lifelong Chiefs fan couldn’t refuse: one free ticket to join his buddy for the wild-card game against the Miami Dolphins. The forecast called for dangerously cold weather, so Maddux did everything he could to prepare. He put on ski gear, layers of sweatshirts, boots, a scarf, hat and a pair of thick gloves. He even bought electric hand warmers online. Maddux sat in the upper bowl, vacillating between elation and misery.

Wind chills reached minus 27, and the air temperature dipped to 4 below zero as the Kansas City Chiefs won 26-7. On the ride home, Maddux noticed something wasn’t right. He peeled off his gloves and his right hand was ice cold. He took a long, hot bath when he got home, but could not warm up his hand. As the night progressed, it swelled and throbbed with so much pain he couldn’t sleep. The next morning, it started blistering, so he went to urgent care and was sent to the University of Kansas Health System’s burn unit, where he underwent a rigorous treatment to save his fingers from frostbite.

“It feels like you’re getting burned from the inside out,” Maddux said.

Maddux, 32, was one of dozens of people around the Kansas City area who felt the aftereffects of Jan. 13, 2024, the night of the fourth-coldest game in NFL history. Dolphins offensive tackle Terron Armstead called the conditions “borderline inhumane.” An army officer who had undergone special forces training for cold weather attended the game and said it seemed “irresponsible” for the NFL to allow it to be played. League officials said they did their due diligence in the days leading up to the game. But as the playoffs head into the divisional round this weekend with games scheduled for cold-weather outdoor stadiums in Kansas City, Buffalo and Philadelphia, fans and players might benefit from the experiences of that night one year ago.

Fifteen people who attended the game were taken to a hospital because of the cold weather, according to the Kansas City Fire Department. Nearly two months after the game, reports surfaced that some fans who attended the game faced amputations. The story went viral.

The NFL has no minimum or maximum temperature at which games will be canceled. NFL chief administrative officer Dawn Aponte said the league’s medical experts weighed whether the game could be played safely, and discussions with local authorities in Kansas City led to the final decision. The league said it was not aware of any severe injuries related to attendance at the game, according to NFL spokesman Brian McCarthy, and heard nothing to substantiate reports of potential amputations. McCarthy said another consideration leading up to the game was that Kansas City fans live and play in extreme temperatures, “so they’re accustomed to cold-weather games and cold-weather activities.”

Maddux, for his part, doesn’t question the NFL’s decision to play that night. He figures the league had to adhere to a strict schedule, and the people in the stands were aware of the risks. He had no idea he’d be forced to spend five days in the hospital or a long winter rehabbing. But he knows that with Mother Nature, things can still go wrong even when you try to do everything right.

“It’s a playoff game,” Maddux said. “I guess you could say we all love a good challenge out there, and just being part of the Arrowhead experience. I mean, it’s a one-of-a-kind place to go see a football game, much less a playoff game like that.

“You want to be out there to support the team. I just wanted to go do it, simply put.”

REGULARS CALLED IT “Amateur Night” because some people in the stands didn’t seem to know how to dress for a January football game.

“I saw a kid in cowboy boots,” longtime season-ticket holder Catherine Baskett-Cook said. “He didn’t have anything between that concrete and his feet. So those are the people where you’re looking at going, ‘All right, you sacrificed some extremities for this game.'”

For the average fan who doesn’t often get to see a game in person, much less a playoff game, it was a unique opportunity. In the days leading up to the game, ticket prices dipped as low as $30 (the cheapest for Saturday’s divisional round is $158). Closer to kickoff, some of those wild-card seats were free.

It was like no other game in Arrowhead Stadium history. Tailgates were scaled down, or scrapped, to avoid being outside too long. Unless you were Taylor Swift or someone else in the luxury suites, there were few places to seek refuge from the elements.

Beers sprouted from aluminum bottles like frozen fountains. Hot chocolates froze in the time it took to get from the concession stand to the seats.

Season-ticket holder Annette Keeter retreated to the bathroom to run warm water on her hands. But the water was stuck on cold.

“People were trying to go to the warming stations,” Keeter said. “The problem with those was that when you went to the warming station, it was so cold that they literally were not putting out any heat themselves.”

But Keeter and Baskett-Cook were pros at this. They layered up and brought cardboard to slide under their feet to protect them from the cold ground. They wore ski goggles and tried to cover every inch of skin. Keeter’s husband, Jason Johnson, forgot his goggles, which caused his eyelashes to frost. When he touched them, she said, the eyelashes fell off.

They stayed, despite their discomfort, despite millions of pixels that make modern-day home viewing feel as if you’re in the huddle with Travis Kelce. They couldn’t leave.

“Any given Sunday, anything can happen,” Keeter said. “I just always feel like I have to be there to root on my team. When that clock hits zero, that’s when the game’s over.”

Josh Stazen traveled 1,300 miles from his home in Key West, Florida, that Saturday, buoyed by cheap tickets and the love of his team. A native of the Kansas City area, Stazen prides himself on handling the cold. He dressed in duck-hunting gear and said he felt “comfortable” throughout the game. But in the fourth quarter, after a long spell without a Chiefs touchdown, Stazen wanted to rally the team. So he let out a yell.

“Tarps off, boys!”

Stazen and his friends ripped off their coats and their shirts. About a half dozen of them stood bare-chested. Stazen estimated they were shirtless for maybe two minutes.

One of his friends, Shawn Larson, looked at the timestamps on photos and said it was actually five minutes. Stazen, who said he didn’t drink much that night because he wanted to remember the game, felt a pins-and-needles sensation on his exposed skin; Larson, who was drinking, said he felt numb.

“When you get really cold and kind of get numb when you warm back up, if it just goes back to normal, nothing happened,” said Dr. James Miner, head of emergency medicine at the University of Minnesota Medical School and a physician at Hennepin County Medical Center. “As you warm back up, if it kind of really, really starts to hurt as it warms up, and it’ll turn purple for a second and then it turns red and aches and it can hurt for a little while — usually not more than a half hour, hour — that we call frostnip.”

Miner described frostbite as when “your skin and tissue below it just freeze. Most of your body’s made of water — like 60% water.”

The announced attendance was 71,492, but near the end of the game, the stadium appeared half-full. Isiah Pacheco‘s 3-yard touchdown run with just over 11 minutes left in the game gave many Chiefs fans the confidence to leave with a 26-7 lead.

Battalion chief Michael Hopkins said the Kansas City Fire Department had 69 patient contacts at Arrowhead Stadium, with 15 taken to the hospital. Seven people had hypothermia symptoms, he said, and three had frostbite symptoms.

Weeks after the game, a Kansas City TV station reported that 70% of the patients at the Grossman Burn Center at Research Medical Center who were referred for frostbite injuries during the January cold snap were being advised to schedule amputations. The station reported the majority of those patients attended the Dolphins-Chiefs game.

The story went viral, with headlines that said many Chiefs fans needed amputations. In correspondence recently shared with ESPN by the Associated Press, a spokesperson for the hospital told the AP that information in the local TV report wasn’t accurate. It included a statement from Dr. Megan Garcia, medical director at the Grossman Burn Center, saying the center treated nearly 30 patients and several others in their outpatient clinic during the 11-day cold spell. “To date,” the statement to the AP read, “12 patients have undergone amputation(s) surgeries primarily impacting fingers and toes. Some of these patients attended the Kansas City Chiefs vs. Miami Dolphins game on Jan. 13.”

ESPN made multiple requests to Research Medical to speak with Garcia and for updates on those numbers. A spokesperson for the hospital said in an email that Garcia was “not available or interested in discussing this topic further, as it was widely covered last year.”

DURING A BREAK in the action that night in January, Dolphins defensive lineman Zach Sieler, waging a “mental battle” by not wearing long sleeves, approached umpire Ramon George and asked how many layers he was wearing.

“Six,” George said. “Two wet suits.”

Sieler recently told ESPN he thinks he had frostbite for a couple of days, but he said battling the elements was one of the things he loved about football while growing up.

“What you love and hate is you play through everything,” Sieler said.

Even before kickoff, it was apparent this wasn’t just another cold game day.

“During warmups, your sweat would start to freeze on your hair,” Chiefs cornerback Trent McDuffie said. “I’ve never had ice in my hair before.”

McDuffie said he thought the conditions were dangerous, “but you know nothing is going to change, so you can’t allow yourself to think that way. But you were definitely wondering, ‘What are we doing out here?'”

Chiefs cornerback Joshua Williams said he wore surgical gloves under his usual gloves. He also applied Vaseline to exposed areas “to try to block out some of the wind and keep it from piercing my skin.” Williams, who said some of his teammates got frostnip during the game, added that if he had to do it again, he might don a wetsuit under his uniform.

“That day in Kansas City was the worst conditions I ever stepped foot in. It was different. It was borderline inhumane.”

Terron Armstead

The NFL made additional accommodations for the game, including heated benches and other heating equipment, heavy jackets and parkas, gloves, hand warmers and fluids to help avoid dehydration. Additionally, the field was heated and tarped to prevent the turf from freezing.

But even all that couldn’t totally mitigate such frigid temperatures.

“It was literally the worst that you could even imagine,” Armstead said. “And I’m from Illinois. I’ve been playing in snow my whole life growing up. I love the cold games. I do. To me, December, January, that’s football to me. I love those games. But that day in Kansas City was the worst conditions I ever stepped foot in.

“It was different. It was borderline inhumane.”

Former Seattle Seahawks Pro Bowl safety Kam Chancellor can sympathize. Chancellor played in the third-coldest game in NFL history when the Seahawks faced the Minnesota Vikings in a 2016 wild-card game at the University of Minnesota during construction of U.S. Bank Stadium. The temp was minus 6 with a wind chill of minus 25.

A few days after the Seahawks’ victory, Chancellor noticed black marks on his fingertips and fingernails. He notified his team’s training staff members, who looped in the team’s doctors to take a closer look. The diagnosis: frostbite.

“I had never had frostbite,” Chancellor told ESPN in a recent interview. “I was like, ‘Wait, are y’all going to cut my fingers off?'”

Such a drastic option was not out of the question, doctors told him. But after assessing the sensation in Chancellor’s fingers, doctors determined he had enough good remaining tissue and his fingers could be saved. But healing was quite the process. Chancellor said it took two months before his original color returned and nearly three months before he regained all of his sensation. He also had extensive peeling of his skin, and one of his fingernails fell off.

Chancellor wondered how he had sustained the injury even while wearing gloves. But doctors explained to him that sweat inside his gloves likely froze on his fingertips, resulting in frostbite.

“You’re out there playing in that cold weather and you’re out there sweating,” he said. “And then once you take a timeout, you’re standing or sitting down, now all that sweat is on you and it’s cold as hell. So, sweat makes it worse.”

NFL OFFICIALS MONITOR weather patterns at least a week to 10 days in advance of scheduled games. According to Aponte, each week, two to three stadiums are reserved as alternate facilities in the event that games need to be moved because of weather or other circumstances.

And after last season’s experiences with the Dolphins-Chiefs game and the Steelers-Bills matchup that had to be postponed because of dangerous travel conditions in snowy western New York, Aponte said in mid-December that league officials planned to initiate conversations about weather contingencies for this postseason even earlier than usual.

The NFL lengthened the season in 2021 by adding a 17th game, and commissioner Roger Goodell has broached the idea of adding another week. Under that scenario, the Super Bowl could be played as late as President’s Day weekend, he said last year.

Extending the length of the NFL season might exacerbate the frequency of games played in extreme temperatures, said Mark Anderson, professor emeritus in the University of Nebraska’s department of earth and atmospheric sciences..

“They’re dragging more into January, which is going to give you colder temperatures,” he said.

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Last season’s wild-card game in Buffalo was postponed not because of temperatures but, rather, because New York Gov. Kathy Hochul and the NFL reached an agreement that the forecast of 2 feet of snow would make it risky for the thousands of fans commuting to the game.

Jazzlyn Johnson, a spokesperson for Kansas City, Missouri, mayor Quinton Lucas, confirmed the city worked with the NFL ahead of the Chiefs playoff game to ensure there were resources such as ample first responders at the game. She emphasized that “weather extremes are not rare for Kansas City in connection with outdoor events.”

Meanwhile, teams are always evaluating their individual approaches. The Green Bay Packers, for example, have been known to issue guidance to fans that explicitly mentions the potential for frostbite. The team has offered free cider, hot chocolate and hand warmers during particularly cold games. There are also multiple climate-controlled locations throughout Lambeau Field that fans can access if they wish to warm up.

Still, that won’t guarantee that fans will avail themselves of resources or follow advice.

Not all fans are going to be like Craig Keith, a U.S. Army officer who was stationed at nearby Fort Leavenworth at the time of the game. He and a friend, Drew Thomas, were drawn to the idea of attending the game because of the plummeting ticket prices. When prime lower-bowl tickets fell below $100, they pounced. The seats were great. Swift’s suite was just a few rows behind them.

But before buying the tickets, Keith and Thomas had to decide if they were equipped to attend the game. Keith was qualified to determine this. He had undergone special-forces cold-weather survival training years ago and cited that training as the reason he felt comfortable going. He had been taught the dangers of prolonged exposure to such extreme temperatures and knew how to protect himself.

He explained his attire in detail. His base layer was a moisture-wicking top and socks. A thick, “continuous” undergarment was also a must, he said. Then he had multiple layers — including pants — on top of that, ensuring that each layer overlapped to keep the wind out. The surplus Patagonia winter gear he had kept from his army training came in handy.

Finally, Keith donned heavy-duty gloves and used a heated hand muff, covered his head and face with a gaiter and utilized a “shemagh” headdress he picked up while deployed in Afghanistan.

Keith added a key point: Much of his outfit could not be put on until arriving at the game because of the risk of sweating underneath during the commute. The perspiration would have left him freezing once he stepped into the cold temperatures.

Ultimately, the approach worked. He used one of the warming stations at some point to warm his feet. But overall, Keith said, he was mostly fine.

“I was pretty comfortable,” he said.

He could not say the same for everyone.

“I think the whole spectrum of preparedness was on display,” Keith said.

He added, “It seemed irresponsible, in our opinion, for the NFL to even do this, especially when we saw Miami fans walking up. There was no way these folks are ready if they flew in for the game.”

Afterward, Keith wrestled with mixed emotions. On one hand, the lifelong Detroit Lions fan thoroughly enjoyed his first NFL playoff game experience. But he wondered if there might be a cost for some others.

“I wouldn’t trade my good time for others getting hurt,” he said.

THE URGENT CARE clinic was down the street from Maddux’s home, so he went there the day after the Chiefs game. His night of pain had dragged on slowly, but on Sunday, time moved quickly. A doctor examined him and called the University of Kansas Health System, which had a hospital bed available for Maddux in its burn unit.

Within hours, he was administered a treatment called tPA, a clot-busting drug that helps resume blood flow to tissues before they are irrevocably damaged. Frostbite cases are treated with an extreme sense of urgency, said Dr. Richard Korentager, clinical service chief and chair of the department of plastic, burn and wound surgery at the Health System.

“Different tissues have different abilities to survive after having suffered a cold injury,” Korentager said. “Muscle, as an example, is extremely sensitive. So it’s different if you just have, say, a finger versus if you have an arm or if you have a lower leg.

“If you don’t treat those muscles, if you aren’t able to get blood supply and get them warmed sufficiently quickly, you know, within — generally it’s going to be less than an hour — before there’s going to start to be a degree of long-term damage.”

For three days, Maddux had to sit in an upright position in the hospital as the TPA drugs coursed through his system. He didn’t know whether he’d lose his fingers, or if he’d still do the things he loved — such as golfing and playing softball. Roughly five days after the playoff game, Maddux’s radiology tests showed promising results with the blood flow in his hand. His fingers would be OK.

Dr. Julia Slater, the medical director at the burn center who oversaw Maddux’s treatment, said the reason Maddux only suffered frostbite on his right hand may have had something to do with the watch he was wearing because metal freezes faster than skin and conducts cold from the metal to the skin it’s touching.

“This would make the hand wearing the metal watch colder,” Slater said in an email. “Also, the watch was circumferential, and applying increased cold all the way around the wrist may have led to vasoconstriction (narrowing) of the blood vessels at the wrist. This would result in less blood flow to the hand, making it more susceptible to frostbite.

“This is why we recommend removing any metal jewelry if you are going to be exposed to very cold temperatures.”

A Health System spokesperson said the hospital had 73 encounters with frostbite/frostnip patients in January 2024, with 36 ER patients and 17 in the burn unit. None of their patients who attended the Chiefs-Dolphins game required amputations.

This past summer, Maddux played softball and golfed. He has had a few manicures to shape his once-gnarled fingernails. And in the fall, he returned to Arrowhead Stadium to watch the Chiefs. For early-season games.

“Yeah … I don’t really want to go back out to the cold games too much,” he said. “At least not for a while.”

Marcel Louis-Jacques and Adam Teicher contributed to this report.