Heat Related Illnesses and the Athlete

By Brittney Lang, MS, ATC
Athletic Trainer

Summer is around the corner and with that comes hotter temperatures and humidity here in the south. Many high school and summer sports programs will be starting summer workouts and games soon. This is the time of year for athletic trainers to instruct their athletes on training in the heat and the potential environmental dangers and heat related illnesses that can arise. Athletes should be informed on what precautions they should take and what signs and symptoms to be aware of for the future. Proper information and guidelines can help to reduce heat related injuries and illnesses. 

Our bodies have a natural way of cooling itself through evaporation of our sweat. When there is an increase in heat and humidity, it can make it harder for the sweat to evaporate and decreasing the ability of the body to cool down efficiently causing more stress. Two main concerns when working out in the heat are dehydration and heat related illnesses.

Hydration is a major factor in maintaining a healthy athlete. It is especially important to promote proper hydration techniques for athletes during the heat and humidity. Because the body is producing more sweat it is imperative to replenish what is lost. It is necessary to inform your athletes that just drinking water during the workouts is not enough; they need to be hydrating well throughout the day, before and after training sessions. It is recommended to drink 17-20 oz. during the 2 hours before exercise, 7-10 oz. every 10-20 mins. during, and 16-24 oz. per pound of body weight lost after exercise. Most athletes can accomplish this task just by drinking fluids throughout the day regularly. They can also eat foods with high water and electrolyte content like fruits and vegetables. They can avoid fluids that contain alcohol or caffeine since these are diuretics and will add to the dehydration in the athlete.

If an athlete gets to the point of dehydration, there are signs and symptoms that they should be aware of and seek help when necessary.

Some signs and symptoms to look out for include:

  • Dizziness
  • Thirst
  • Headache
  • Muscle cramps
  • Less urine output/urine that is dark in color

If these symptoms are not given proper treatment, then they can lead to further heat related illnesses such as heat exhaustion and heat stroke.

When the body is stressed to the point it can no longer cool itself properly it leaves it defenseless and that is when the potential for heat related illnesses arise. It is important to teach our athletes what signs and symptoms to look out for so that they can seek treatment when needed.

Heat exhaustion a condition that is not necessarily life threatening but if not treated properly can be a step in the direction toward heat stroke.

Signs and symptoms of heat exhaustion:

  • Nausea
  • Vomiting
  • Confusion
  • Excessive sweating
  • Extreme fatigue
  • Weak and rapid pulse
  • Loss of coordination

If an athlete is experiencing any of these symptoms, they should seek medical attention. The athlete needs to be removed from direct contact with the sun and given fluids for rehydrating the body. If they are in sporting equipment or excessive clothing, it should be removed and the body should be cooled down with cool damp clothes or ice at the neck, groin and armpit areas. This will help to bring down the body temperature until a medical professional assesses them.

Heat Stroke is much more serious and is the point when the body can no longer cool itself properly causing the core body temperature to reach excessively high levels. The body core temperature can increase quite fast once to this point. If left untreated it can cause permanent damage to major organs and possibly lead to death. Heat stroke is a serious medical emergency that needs treatment immediately and quickly.

Though signs and symptoms of heat stroke include those of heat exhaustion, an athlete may not show signs of heat exhaustion prior.
Signs and symptoms to look out for:

  • Lack of consciousness
  • Significant confusion
  • Red Skin
  • Heavy sweating or cessation (loss) of sweat
  • Strong and fast pulse
  • Bizarre behavior
  • Core body temperature greater than 104 degrees (rectal temperature is best, more common methods –oral, armpit or forehead may not be accurate)

When an athlete is experiencing heat stroke, they need to be cooled rapidly. Getting the core body temperature lowered is the priority. Cold-water immersion is the best way if possible. If not able then placing them in an air-conditioned room, using fans and ice packs on the neck, armpit and groin areas will help. One can give fluids to the athlete if they are conscious as well. All is to be continuous until the athlete can transported to a medical facility for further treatment.

As athletic trainers, we do our best to eliminate the potential dangers by making sure athletes have plenty of access to water and ensure proper breaks are received during workouts. We monitor weather and have instruments to determine if it is safe for athletes to train. We make sure to have proper equipment like medical kits and cold tubs ready in case they are necessary. We also instruct coaches on the hazards of over training in the heat; and what to watch out for in their athletes. However, our most important goal is to inform the athletes how to train properly during the heat, the potential risks and symptoms of heat related illnesses, and when to seek medical treatment.