Heat Illness

By Jennifer Stromberg, MD

 

As temperatures continue to rise this summer it’s important for our summer and fall athletes and coaches to be aware of the increased risk of heat illness. When we exercise body temperature rises, causing us to sweat, which is one of the ways the body works to prevent overheating. When we exercise in warmer climates it is harder for the body to cool itself naturally and this can lead to dangerously high body temperatures and heat illness. Symptoms of heat illness can range from mild to severe, as outlined below.

 

Mild Symptoms

• Swollen hands and feet

• Cramps, muscle tightness, muscle spasm

• Lightheadedness

• Severe Symptoms

• Mental status changes such as confusion, agitation, irritability and lack of coordination

• Rectal temperature >104° F (40.5° C)

• Excessive sweating or flushing (when very severe sweating may stop but skin remains hot)

• Fatigue

• Headaches

• Nausea and/or vomiting

• Chills or “goose bumps”

• Seizures

 

Who is at risk of developing heat illness?

Everyone! In hot and humid conditions anyone can develop heat illness, although the risk in higher in those who are unaccustomed to conditions or use heavy uniforms or equipment. Extremes of age, both older and younger, also make heat illness more likely.

 

How can I prevent heat illness?

When exercising in warm climates wear lightweight, light-colored clothing to protect yourself from the sun. Consider exercising early or late in the day when temperatures are usually cooler, or moving to a shaded area. Make sure that you have fluids available to hydrate before, during and after activities- use your thirst level to guide how much fluid to take in. Athletes competing in warm or humid environments should gradually become acclimated by practicing in similar conditions at least 10-14 days prior to competition.

 

What should I do if I start to develop symptoms?

If you start to develop early symptoms of heat illness try and rest in a cool, shaded area and take in plenty of fluids. For more severe symptoms athletes should be immersed in cold water as soon as possible. Athletes with mental status changes should be urgently evaluated by a medical professional. All athletes with heat illness should consult their physician before attempting to return to full physical activity.

 

Fluid Guidelines for Summer Workouts

Prior to workout: drink 20 oz of water or sports drink 1-2 hours before and may add another 10 oz 15 minutes prior to activity. Athletes who cramp often may need to augment electrolytes by adding an electrolyte packet.

Some athletes will also use “pickle juice mixtures, soy sauce, etc. which all have higher concentrations of sodium and other electrolytes. These are generally regarded as safe.

During workout: drink 10 oz every 15 minutes or so based on thirst. Athletes should be drinking beyond thirst as even minimal dehydration may affect performance. One caveat would be long endurance runs in which drinking too much fluid may decrease sodium levels to cause mental status changes. Sports drinks should contain less than 8% carbohydrate (18g per 8 oz) and should also be cooled to under 60 degrees if possible.

What not to drink during workouts:

Caffeinated beverages including sodas, alcohol, and fruit juices.

Post-Workout hydration: athletes should weigh themselves before and after activity if possible during summer workouts. It is recommended for every pound lost to drink 20 oz of water or sports drink. This may be done over many hours. Urine color is another good indicator of hydration. Darker urine color is indicative of dehydration.

AMSSM Member Authors
Jennifer Stromberg, MD