Heat-Related Illness in Young Athletes
It’s nearing the end of summer, which means high school sports will begin intensive practicing if they haven’t already. Unfortunately, the heat of the summer is still present and strenuous physical activity during this time can cause significant physical illness. This is particularly true in climates with combined heat and high humidity.
The human body actually does an amazing job of regulating internal temperatures to remain below dangerous levels. Where it runs into trouble with this is when there are external factors out of the body’s control or when natural cooling measures are impeded or ignored.
Definitions
Heat cramps: the most common and earliest form of heat-related illness in athletes. Dehydration and salt loss through sweat leads to severe muscle pains and spasms not associated with injury. Treated with rest, electrolyte solutions, and stretching.
Heat exhaustion: caused by significant loss of water and salt from the body. Athletes can have normal or raised body temperature. They will have pale, cool, clammy skin. Headaches, nausea and vomiting, and dizziness or fainting can be common. Treated by moving athlete to cool, shaded or indoor area, removing extra clothing and equipment, cold compresses and towels, and rehydration with electrolyte solutions. If not treated, this can lead to heat stroke.
Heat stroke: the most dangerous form of heat-related illness, than can lead to organ damage and death if not recognized and treated quickly. This is the leading cause of preventable death in youth sports. It is characterized by increased body temperature above 104F, and altered consciousness, seizures, and confusion. This is a medical emergency, and 911 must be called immediately upon recognition. While waiting for emergency services to arrive, remove any restrictive clothing or equipment and cool the athlete through immersion in cold water or use of ice bags.
Risk factors
Climate – hot, humid areas present a higher risk for heat-related illness.
Type of sport – outdoor, cardio-intensive sports pose a higher risk for heat-related illness.
Inadequate preparation – athletes who are out of cardiovascular shape, have poor sleep and rest between practices, or who have little recent exposure to the heat react more significantly to exercise in the heat.
Restrictive or non-breathable clothing – uniforms that are made of thick fabrics or protective gear that is heavy does not allow sweat to naturally cool the body effectively.
Intensive training – strenuous physical activity produces more heat
Age of athlete – younger athletes are less likely to recognize the need for consistent hydration or know when they are overheating and need a break.
Increased body mass index (BMI) – being overweight or obese puts extra strain on the body and its natural cooling mechanisms.
Medical conditions – fever, acute illness, or underlying chronic conditions (sickle cell trait, in particular) may affect the body’s ability to regulate internal temperature and/or increase the risk of heat-related illnesses. Athletes should NEVER exercise with a fever.
Prevention
Timing – avoid practice during the heat of the day. Earlier in the morning or in the late afternoon/evening times are best.
Hydration – this is key to avoiding head-related illness. Unlimited amounts of water and electrolyte drinks should be available to young athletes during practice and games, but parents should ensure hydration continues before and after activity as well.
Preparation – a slow, gradual introduction into the heat is important. An athlete who has been primarily indoors for months should not immediately be exercising outside during the heat of the day. Time to slowly acclimate to the heat will help to prevent illness.
Early recognition – quick realization of developing heat-related illness is essential to survival. Coaches and parents should monitor young athletes for signs of disorientation, dizziness, weakness, headaches, vomiting, or unusual behavior. Early intervention with cooling mechanisms and hydration can prevent development of full heat exhaustion and heat stroke
Final thoughts
Sadly, nearly every year I see an article about a young athlete who has died due to heat-related illness. More education is needed amongst athletes, parents, and coaches to prevent this from happening again and again. As discussed, there are easy ways to ensure the safety and health of our young athletes. Just as protective equipment and proper methods of sports play are used to protect players from injury, so should protective measures be implemented to prevent heat-related illness for those who practice and compete outside during the summer. No deaths from heat-related illness should ever be acceptable.
Resources
https://www.nata.org/sites/default/files/hydration_heat_illness_handout.pdf
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