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ARTICLES - Click Here to go Back to Articles Main PageHeat:
A Silent Opponent; Considerations
for Athletes July 19, 2003 (Originally Posted) In my experience, most people are simply do not recognize the signs and symptoms of heat disorders. Understanding the risk factors, signs, symptoms and the seriousness of heat illness is of utmost importance. Heat disorders can occur in both active and sedentary individuals. The three main disorders we will discuss are heat stroke, heat exhaustion, and heat cramps. Heat can victimize us all, even if we are not engaging in physical activity. In the United States, “According to the National Centers for Health Statistics (NCHS), 7046 deaths were attributed to excessive heat exposure from 1979-1997, or an average of 371 deaths occurred per year.” 1 The elderly, young, and even pets are extra susceptible to the dangers of the heat. Young individuals tend to ignore the warning signs, and participate in vigorous activity during times of high temperature. I am sure we all know someone (maybe we are that person), who fits into this category, such as the stubborn, hard headed, or extremely dedicated individual that insists on completing their scheduled workout or training session. Exercise Induced Heat Stroke “is the second most common cause of death among high school athletes, surpassed only by spinal cord injury.”1 If your gut instinct tells you that maybe you should not exercise, than you probably should not. It is much better to be safe and workout the rest of your life, than to push that one workout, risking permanent injury or death. Heat Stroke: Severity and Danger – High Perhaps the most serious of the heat disorders is Heat Stroke. This is the most serious because it can result in death. Heatstroke results from the body's cooling mechanisms failing. The medical community defines heatstroke as body temperatures above 106º Fahrenheit, or 41º Celsius. Neurological dysfunction follows these dramatic body temperature increases. The result is often failure of the circulatory system, and if left untreated, death. Heatstroke can strike suddenly and without any significant warning signs or symptoms. Body temperature rise up to 105º or 106º Fahrenheit (hyperthermia), in a matter of 15 minutes or less is not uncommon. Heat Stroke can occur suddenly and without warning, or can be associated with a variety of symptoms, such as:
So what should you do if you feel you, a friend or a loved one is potentially suffering from heat stroke? Seek medical attention immediately! Heat stroke is not something to self-diagnose or self-treat. This is as much of a medical emergency as a heart attack or head injury. The initial goal of treatment should be to reduce core body temperature. If possible, start this process yourself with anything available while waiting for emergency medical personnel. Ice packs, frozen vegetables or other cold items can be place around the groin and armpits. Fan the individual if possible. If outside, move the individual to a shaded area, but only if they are safe to move. If the person is unconscious, do not move them, as they may be injured. You do not want to risk causing a permanent injury if you are not completely certain of the problem. Try removing any layers of clothing while you wait for help. This will allow for better heat dissipation. Cold-water immersion is currently the most common of all the cooling methods used by medical facilities. A word of caution: In some cases, victims can experience convulsions and seizures. In such cases, do not give fluids under any circumstances. Do your best to keep the persons airway clear, and keep them from injuring themselves, such as placing your hands under the back of their head if lying on a hard surface. Heat Exhaustion: Severity and Danger – Moderate to High The second most serious of the heat disorders, and perhaps more common, is heat exhaustion. Heat Exhaustion has many similar symptoms that were indicated for possible symptoms of Heat Stroke. If left untreated, Heat Exhaustion can progress and increase in severity until it becomes heat stroke. While medical attentions is not always required for heat exhaustion, it is recommended. If medical treatment is not sought at onset, it should definitely be sought if symptoms worsen or if they continue in duration longer than one hour. Medical treatment should always be sought if the victim has pre-existing medical problems, such as heart conditions, blood pressure related conditions, or severe problems with any organs or body systems, such as liver, kidneys or renal problems. The loss of water through excessive perspiration can lead to decreased total blood volume, and increased salt concentration. The result can be a variety of problems from headache and dizziness to rapid, weak heart beat. Lets review some of the common symptoms of heat exhaustion: They are:
Treatment of heat exhaustion is similar to that of heat stroke, though not as severe. Seek medical advice if possible, and follow the physician’s recommendations. Keep the victim cool, and move to a shaded or air conditioned environment if possible. If approved by the physician, give cool fluids that do not contain alcohol. If excessive sweating has occurred, consider re-hydrating the individual with a salty beverage such as sports drinks, or adding a small amount of salt to tap water. Consider helping the victim take a cool bath or shower to further facilitate the cooling process. Heat Cramps: Severity and Danger: Mild to Moderate The third and arguable most common heat related disorder we shall discuss is heat cramps. Heat cramps normally affect individuals who are involved in strenuous activities. Loss of fluids and electrolytes as a result of sweating during strenuous activities can result in severe cramping most common in the abdomen, arms and legs. It is important to note that these cramps or muscle spasms can also be a symptom of heat exhaustion or heat stroke, so be cognizant of other possible symptoms. If you suffer from heat cramps, consult your physician immediately if you are on any type of modified diet, such as reduced salt intake. Sit or lay down in a cool place. Drink water or a sports beverage to replace fluids. Rest for a while. Under most circumstances it is not recommended that you return to activity. Sometimes when only mild cramps occur, and there are no other medical conditions or symptoms present, an individual can return to activity after a few hours rest. Always consult your physician for his recommendations.
Prevention Right now, I’m sure many of you are thinking about ways to avoid problems during the hot days of summer. Prevention is always the best approach. Here are a few suggestions:
Considerations for Athletes: All athletes can be susceptible to illness from heat. However, younger athletes, such as high school and college athletes can be especially susceptible. The dedication and desire of many younger athletes often drives them past conservative training, and puts them at higher risk of injury, over training, and heat illness. Even more common in the younger athletes is failure to allow their body to get acclimated to the environment. These athletes often travel straight from a cool environment such as car air conditioning to blazing hot conditions. Their body cannot properly adjust and they are at increased risk of excessive heat build up. As the fall approaches, many high school and college team sports start their vigorous practice for the upcoming season. Football comes to mind, not only because of the strenuous nature of the sport, but also the amount of equipment and padding that must be worn. This padding covers a large portion of the bodies’ surface and drastically interferes with heat dissipation and effective cooling. Football coaches and players should be especially aware. It is normally recommended that “double sessions” or “two-a-days” as they are called, start with limited padding. Some states even have laws in this regard. Pads can gradually be added over the days as the body becomes accustomed to the heat and the additional pads, which hinder heat dissipation. Coaches should ease into these sessions and keep a close eye on their athletes, allowing them plenty of water and frequent breaks when warranted. “The majority of the … heat stroke deaths occurred during the first two days of practice”. 7 Most athletes think that heat stroke can only occur in very hot environments. However, even milder temperatures can be an environment for heat illness in athletes. Several recent studies have shown the serious accumulation of heat in much lower temperatures, as low as 41° Fahrenheit.5 Exercise Induced Heat Stroke “is the second most common cause of death among high school athletes, surpassed only by spinal cord injury.”1 That statement says volumes. Young, intense, motivated, athletes combined with peer pressure can become a potentially dangerous situation. Athletes with excess body fat should also use caution and be very aware of their physiological responses to their activities. Higher body fat levels result in lower total body water volume, making proper hydration even more crucial. This also makes individuals such as football linemen are especially predisposed to heat illness. Conclusion: The heat is often enjoyed by many and thought of in a positive light. Many people enjoy the sensation on the skin, the sunlight, and the perspiration during physical activity, making them feel like they are working hard. However, heat can be dangerous and should be taken seriously. Do not underestimate the danger and serious problems heat can cause. Stay aware of your environment, whether training, working or relaxing. Prevention is always better than treatment. Remember that heat dissipation through perspiration and evaporation is the bodies main cooling mechanism, so dress appropriately. Prevent the problem before it occurs. When heat exhaustion or heat stroke symptoms are suspected, do not try and “tough them out”. Heed the warning you are being given, and take a break. Ignoring the warning signs, is not a sign of toughness, it is foolish and dangerous. Many athletes are highly motivated and dedicated, making them more likely to try and push through a potential dangerous situation. If you are a parent or coach, monitor your children or athletes closely. Heat need not be feared; only respected. Train, work and live smart!
Bibliography: 1. “HEATSTROKE”
eMedicine. Robert S. Helman, MD 11/18/2002 2. United
States. Center for Disease Control: CDC.gov “Extreme Heat”, National
Center for Environmental Health. 3. “Understanding
Heat Related Illness” WebMD Health. July 1, 2002. 4. Williams, M. H.. Nutrition for fitness and sport, 5th ed. New York: McGraw-Hill, 1997 5. Armstrong, Lawrence E. 1992: ENVIRONMENTAL CONSIDERATIONS: Heatstroke during exercise. National Strength & Conditioning Association Journal: Vol. 14, No. 4, pp. 82–82. 6. Payen, J.F., Bourdon, L., Reitenauer, H., Melin, B.B., Le Bas, J.F., Steiglitz, P., & M. Cure. 1992: Exertional Heatstroke and muscle metabolism: an in vivo 31 P-MRS study. Med. Sci. Sports Exerc. 24: 420-425. 7. Fleck, Steven J., Dudley, Gary A. 1983: Heat Stroke: A life-threatening situation. National Strength & Conditioning Association Journal: Vol. 5, No. 6, pp. 22–25. 8. Halder, Lanny J. 1985: Dynamics of Adaptation: Keeping cool when the heat is on. National Strength & Conditioning Association Journal: Vol. 7, No. 6, pp. 32–33. |
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