By Elizabeth Watts
Understanding Heat Related Illnesses
Heat related illness are common and can affect any athlete, young or old, at some point in their athletic career. A basic education on how to recognize, treat, and prevent heat related illnesses could help current and future athletes. Understanding how easy it is to prevent heat illnesses it is crucial to be aware of the risks of participating in physical activity during extreme heat. The severity of the heat will change the presenting symptoms of anyone stricken with a heat related illness. Knowing the signs and symptoms could potentially save someone’s life. Treatment depends upon severity, but a common factor is the hydration level of the affected athlete. Heat related illnesses can dramatically affect the performance of the participating athletes.
Types of Heat Related Illnesses
The signs and symptoms of heat related illnesses can differ depending on the severity. One of the least severe heat illnesses is heat edema, also known as heat rash. This condition can appear in an individual with a normal body temperature. So, there it is not necessarily associated with their body overheating. The typical skin rash is caused by a blockage of eccrine sweat glands from wet athletic equipment or clothing. This results in leakage from sweat glands that develops into an irritating, prickling, itching sensation. The condition is easily treatable with cold, dry towels, anti-inflammatory cream, and dry clothing.
Another type of heat related illness is heat syncope. This condition may also occur with an individual with a normal body temperature. It usually occurs with quick postural change or extreme exertion demanding enhanced blood flow from the body core to the extremities. This may create a sudden loss of balance leading to potential injury if the athlete is unable to support themself. According to a 2016 study, treatment for this condition includes immediately putting the individual in the supine position (on their back) and elevating the legs. When an athlete is determined and highly motivated during maximal exercise, efferent neural activity relaying heat sensory information to the body’s central command may be neglected or overlooked. If the athlete is unaware that they are experiencing heat related illness symptoms, it is crucial for the coaching staff to recognize the signs and remove the individual from the activity immediately.
Beyond heat rash and heat syncope, there are several levels of greater severity with heat related illnesses. The least severe, and most commonly seen level is heat cramps. The symptoms are generally mild, including slight dizziness, thirst, and accompanying muscle cramps. Usually heat cramps are readily treated by drinking some water and moving into the shade out of direct sunlight. If left untreated, heat cramps often progress to heat exhaustion. This condition is also less severe and may be characterized from mild to moderate. This, too, can rapidly progress if not treated immediately.
Some of the associated symptoms include dehydration, headache, profuse sweating or pale skin, loss of coordination, nausea, muscle cramps, and stomach cramps. If medical attention is not taken these symptoms can worsen, perhaps becoming life-threatening. Therefore, with the first sign of symptoms the individual should be treated immediately.
Symptoms of heat cramps and heat exhaustion are commonly confused because of the of their similar symptoms. If heat exhaustion is left untreated, the condition may quickly become more serious. Heat stoke is much more severe, can lead to hospitalization, and may be life threatening. Symptoms heat stroke include potential loss of consciousness, central nervous system dysfunction (seizures), hot and dry skin without sweating, increased heartrate, and rapid breathing.
With heat exhaustion the individual may feel awful but will be able to coherently explain their condition. With heat stroke the individual will not be able to verbally explain their condition due to the loss of cognitive function. Both cases should be brought to the attention of the coaching staff immediately to be resolved regardless of severity.
Risk Factors and Prevention Strategies
When considering the effects of heat illness, there are many risk factors that arise in competition, according to a 2004 study. Some of these factors include dehydration, hot and humid climate, obesity, low physical fitness, lack of acclimation, previous history of heat stroke, sleep deprivation, medications (especially diuretics or antidepressants), sweat gland dysfunction, and upper respiratory or gastrointestinal illness.
One of the most common risk factors for athletes is dehydration, especially when exercising in the heat. Therefore, it is vital that every athlete is hydrated with water and other sports drinks containing electrolytes. Knowing the causes and effects of heat related illnesses is important to help prevent their onset.
To prevent heat illness from occurring or worsening, make sure medical care is available. Should an individual suffer from heat illness, they can be properly treated. To help prevent heat illnesses, have the athlete medically screened by a medical professional. They can determine if they are predisposed to heat illnesses and if they have other underlying health issues. Athletes should be exposed to any extreme heat conditions slowly. Consider warming up with morning or schedule night practice to help acclimate the athletes. It is the coach’s responsibility to appropriately schedule practices.
They should check environmental conditions and adjust training schedules for the safety of their players. Consider shorter practice times. slowly adding more time as their bodies adjust to working in the heat. A 2002 study found that the most important consideration is staying hydrated before, during, and after physical activity. Match fluid intake with sweat and urine loss as a baseline to maintain adequate hydration. Without proper hydration it is difficult for the body to function properly.
Treatment Methods for Heat Illnesses
Despite the different levels of severity, there are different methods to treat each illness. Heat exhaustion is most easily recognized by the body’s temperature. If the individual is experiencing heat exhaustion, remove any excess clothing to cool the body. This also allows better access to apply ice towels and use fans. If this treatment does not work, they should be given emergency care for intravenous fluids to minimize the risk of developing heat stroke.
For heat stroke, the first step should be to seek emergency medical attention. A 2021 paper suggested proactively cooling the individual with cold packs or wet towels until medical attention can arrive. A 2016 paper advised the victim should not participate in physical activities until they are fully recovered.
“Most important aspect in monitoring athletes competing in the heat is the proper diagnosis of symptoms being experienced by the athlete, this can allow for proper procedures and protocols to be followed in order to maintain the safety and health of the individual.”.
While heat illness may be serious, it can also be preventable with proper knowledge on hydration, equipment, and climate. The individuals’ presenting symptoms should determine the course of treatment. Athletes showing symptoms of heat cramps should immediately stop activity. They should begin consuming fluids with a high sodium content and begin massaging and stretching the affected area. For heat syncope, move the athlete to a shaded area, monitor their vital signs, rehydrate, and elevate their legs above head level to create better blood flow.
For heat stroke, a 2002 paper suggested that, if medical attention is not available, cool the athlete as soon as possible. If a pool or tub of cold water is available, their lower body should be immersed to cool body temperature. Once they are cooled, they should be removed from the cold water and be monitored to prevent over-cooling. If medical attention is available, it needs to be determined if immediate transport to a medical facility is necessary. Any activity after a heat related illness should be closely monitored for the safety of the player.
Conclusion and Final Recommendations
The effects of heat stress on the youth are more extreme in the months where the heat index is the highest. A 2022 study reported “At least 50 high school football players in the U.S. have died from heat stroke after falling ill on the field in the past 25 years.”. Considering heat illnesses are preventable and precautions that could be put in place, this statistic is shocking.
Typically, the months used by coaches to practice is during the summer. Unfortunately, they are the hottest months of the year. Perhaps regulating practice times, increasing the number of water breaks, and revising athletic heat policies, could assist in the recognition, prevention, and treatment of many heat related illnesses.
