Preventing Heat Related Illnesses.
Heat related illnesses (heat cramps, heat exhaustion, and heat stroke) are the result of extreme fluid loss over a period of a few hours or fluid loss which is never completely replaced causing the fluid debt to grow over a period of several days. Athletes become susceptible to heat related illnesses as a result of: 1) a hot, humid environment, 2) over exposure to direct sunlight, 3) not allowing adequate time to be accustomed to the environment, 4) wearing heavy, dark colored clothing, and, 5) too heavy a workload, all coupled with an inadequate fluid intake. Due to the equipment and uniform requirements of football, extreme care must be taken to help players avoid heat related illnesses. However, any athlete, in any sport can suffer from heat related illnesses.

Children and adolescents are more susceptible to heat related illnesses than adults. Extreme caution should be used when younger athletes are exercising in the heat and humidity.

According to the American Academy of Pediatrics Committee on Sports Medicine, all heat related illnesses are preventable. The following precautions are recommended to help prevent heat related illnesses from occurring.

1. GET USED TO THE HEAT - If athletes do not work outside during the summer, and has not been working out in the heat, they need to gradually become acclimatized to working in the heat. One must gradually increase activity in the heat for approximately 7-10 days to be prepared for the heat and humidity that may occur during two-a-day fall practices.

2. DRINK PLENTY OF FLUIDS

Coaches must insist their athletes drink fluids, even when they are not thirsty! UNLIMITED amounts of water, or sports drinks, should be available during all practices. Drinking plenty of fluids is the single, most important thing athletes can do to prevent heat related illnesses.

One indicator athletes can use to tell if they are drinking an adequate amount of fluids is the color of their urine. Clear, or pale, urine means an athlete is drinking an adequate amount of fluids. Yellow urine indicates a need to drink more fluids. Expect yellow urine after a practice session, but it should be clear before the next practice session.

Sports drinks are recommended during hot, humid, two-a-day practices held in the late summer. The use of sports drinks:

1) encourages student-athletes to drink more fluids because of the added flavor,

2) decreases urine output which allows more fluid to cool the body,

3) helps maintain the thirst drive which encourages athletes to drink more,

4) helps restore electrolytes lost through sweat, and,

5) helps replenish energy stores used to fuel athletic performance.

Many people believe the need for fluid is decreased when one becomes accustomed to the heat. That is not true! As one becomes accustomed to the heat the need for fluids increases because the body sweats more, which helps cool the athlete.

3. WEIGH IN BEFORE AND AFTER EVERY PRACTICE - Coaches should require athletes to weigh themselves BEFORE AND AFTER EVERY PRACTICE during two-a-day practices. Coaches are encouraged to monitor the weight of their athletes during the first seven to ten days of any season. For every pound of weight lost during a practice, or contest, an athlete should drink at least 24 ounces (3 cups) of water before the next exercise session. Athletes losing 5%, or more, of their body weight over a period of several days should be watched very carefully for heat related illnesses. During two-a-day practices, some medical professionals advise athletes not be allowed to participate in the second practice of the day if they have not gained back at least 90% of the weight lost in the first practice session.

4. TAKE BREAKS DURING PRACTICE - A ten minute fluid break every 30 minutes when the temperature is above 80 degrees should be seriously considered. The higher the temperature and/or humidity, the more frequently breaks should be scheduled. When wearing football equipment, have the athletes remove their helmets and shoulder pads during breaks. If the temperature and humidity are extremely high, the possibility of practicing without football equipment, or postponing practice until the outside temperature is cooler, should be strongly considered.

5. EAT THE RIGHT FOODS - The proper foods can help you stay hydrated and maintain your energy level. Especially during two-a-day practices, athletes should be encouraged to eat more apples, oranges, bananas, vegetables, breads, grains, cereals, pasta, and noodles. They should avoid fatty, greasy foods and those high in protein. Such foods produce more heat during digestion, contributing to dehydration. DO NOT USE SALT TABLETS, as they contribute to further dehydration. Lightly salting food while getting used to the heat will adequately replace any sodium lost.

6. MONITOR TEMPERATURE AND HUMIDITY - Coaches should closely monitor the temperature and humidity during practices. Coaches and administrators should use discretion in modifying practice when the temperature and humidity are high. The National Weather Service recommends the following precautions during extremely hot, humid weather:

"On particularly hot and humid days, strenuous activity should be rescheduled for the mornings or evenings to avoid peak heat of the afternoon. A good benchmark for determining ‘hot and humid days' is a predicted heat index of 100 degrees or higher, or a temperature above 95 degrees."

In summary, heat illness is preventable if one follows a few basic guidelines. Those guidelines are 1) insist that athletes drink an adequate amount of fluids before, during, and after practices or games, 2) allow athletes sufficient time to become acclimated to the environment, 3) monitor an athlete's weight before and after practice, 4) take regularly scheduled water breaks during practice, especially in hot, humid conditions and, 5) modify practices if temperature and humidity warrant it. Even with these precautions the Athletic Association suggests that you have an emergency plan ready in the case of any accident or injury.

HEAT RELATED ILLNESSES ARE PREVENTABLE!

The following suggestions for preventing heat related illnesses are extremely important, especially in hot, humid weather:

1. ACCLIMATIZATION - Allow a minimum of 7 - 10 days to get used to the heat. During these days, more frequent water breaks and shorter practice sessions are suggested.

2. PROPER CLOTHING - Wear loose-fitting, light-weight clothing. In football, removal of equipment, especially shoulder pads and helmet, at breaks is recommended.

3. PROPER DIET - Eat at least 6-8 servings of apples, oranges, bananas, and green leafy vegetables every day. Reduce the consumption of foods high in protein. DO NOT USE SALT TABLETS!!

4. ADEQUATE FLUID INTAKE - Drink ample amounts of fluids every day, all day. Sports drinks and water are the best fluids to use in preventing heat illness.

A. Drink a minimum of 8 - 10, eight ounce glasses of fluids every day.

B. Drink 2 - 3, eight ounce glasses of caffeine-free fluids 1 - 2 hours before exercise.

C. Do not wait until thirsty to begin drinking fluids.

D. Drink 1, eight ounce glass of fluids every fifteen minutes during exercise. Do not drink carbonated beverages during exercise.

E. After exercise, drink 3, eight ounce glasses of fluids for every pound of weight lost during exercise.

F. Clear, or light colored urine, means adequate hydration.

5. MONITOR WEIGHT LOSS - Use weight charts to monitor weight lost during practice. Weight lost during a practice session should be replaced before the next session, (see #4, E)