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Heat stress and athletic participation

By Times staff writer

© St. Petersburg Times,
published August 3, 2001

The ailments

HEAT CRAMPS: Painful cramps involving abdominal muscles and extremities caused by intense, prolonged exercise in heat and depletion of salt and water due to profuse sweating.

HEAT SYNCOPE: Weakness, fatigue and fainting due to loss of salt and water in sweat and exercise in the heat. Predisposes to heatstroke.

HEAT EXHAUSTION (Water depletion): Excessive weight loss, reduced sweating, elevated skin and core body temperature, excessive thirst, weakness, headache and sometimes unconsciousness.

HEAT EXHAUSTION (Salt depletion): Exhaustion, nausea, vomiting, muscle cramps and dizziness due to profuse sweating and inadequate replacement of body salts.

HEATSTROKE: An acute medical emergency related to thermoregulatory failure. Associated with nausea, seizures, disorientation and possible unconsciousness or coma. Might occur suddenly without being preceded by any other clinical signs. Victims can have high body temperature and hot, dry skin, or might be sweating profusely.

The precautions

1. Athletes should have a physical exam with a medical history when first entering a sport. History of previous heat illnesses and type of training activities should be included.

2. Coaches should know the physical condition of their athletes and set practice schedules accordingly.

3. Acclimatization, the process of becoming adjusted to heat, should be provided. A graduated physical conditioning program is suggested, with 80 percent acclimatization expected after the first seven to 10 days. Final stages of acclimatization to heat are marked by increased sweating and reduced salt concentration in the sweat.

4. Water must be on the field, in unlimited quantities, and readily available at all times. Ten minutes are recommended for water breaks for every half-hour of heavy exercise in heat. Drinking ample water before practice and games has also been found to aid performance in heat. Cold water is preferable.

5. Salt should be replaced daily, modest salting of foods after practices or games is enough. Salt tablets are not recommended.

6. Know both the temperature and humidity. The greater the humidity, the more difficult it is for the body to cool itself.

7. In extremely hot and humid weather, reduce amount of clothing covering the body as much as possible.

8. Athletes should be weighed each day before and after practice and weight charts should be maintained. Generally a 3 percent weight loss through sweating is safe. More than 3 percent is in the danger zone and the athlete should not be allowed to practice in hot and humid conditions. Athletes should not be allowed to return until replacing that weight.

9. Observe athletes carefully for signs of trouble, particularly those who lose significant weight and the eager athlete who constantly competes at his/her capacity. Some trouble signs are nausea, incoherence, fatigue, weakness, vomiting, cramps, weak rapid pulse, visual disturbance and unsteadiness.

10. Know what to do in case of emergency and have emergency plans written with copies to all staff. Be familiar with immediate first aid practice and prearranged procedures for obtaining medical care.

In the event of heatstroke, immediately cool body while waiting for transfer to a hospital. Remove clothing and place ice bags on the neck, in the axilla (armpit) and on the groin area. Apply cool water to the victim's skin and vigorously fan the body.

In the event of heat exhaustion, cool body as you would for heat stroke while waiting for transfer to hospital. Give fluids if athlete is able to swallow and is conscious.

- SOURCE: National Federation of State High School Associations

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