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Heat Illness and Injury

The athletic world was shocked and saddened by the death of Minnesota Vikings offensive linesman Korey Stringer due to heat stroke.  His death has focused much attention on the dangers of excessive exercise in the heat.

Heat illness is the most common and preventable sports injury.  Since 1995, there have been reported 19 deaths due to heat injury.  This year University of Florida freshman Ernest Austin also collapsed and died on the practice field from heat stroke.  Heat injury is also preventable with the proper precautions and adherence to strict fluid guidelines.

During physical activity muscles generate heat.  Your body eliminates excess heat by sweating.  If fluids are not replaced you become dehydrated and place your health at risk.  In hot conditions, athletes lose between 1 – 2.5 liters of sweat per hour, or 10 liters in a long game.  It is not uncommon for players to lose 5 – 15 lbs during a game or workout.  Football padding does not allow for quick evaporation or cooling, and a player’s helmet decreases the body’s ability to release heat thus increasing the risk of heat illness.  Athletes not acclimatized to the heat lose much more sodium during sweating.

Kids don’t release body heat as easily as adults.  Kids absorb heat from their surroundings more easily than do adults.  By the time active kids become thirsty, they may already be dehydrated.

Warning signs of dehydration

Early signs in children – nausea, poor concentration, light-headedness, fatigue, flushed skin.

Late signs in children – dry lips and tongue, sunken eyes, dark yellow urine, muscle cramps, infrequent urination.

Fluid Guidelines

Proper hydration is the best safeguard against heat illness.  Drink on a schedule to replace fluids as you go.  Before activity, drink 16 oz (2 cups) approximately 2 hours before exercise.  During activity, drink 4 – 8 oz ( 1 cup) of fluid every 15 minutes.  After activity 16 oz (2 cups) per pound of body weight lost.

It is important to weigh each player before and after practice to monitor fluid loss.  A player should not be allowed to participate in the next game or practice if they have lost more than 2 % of previous weight.

What should you drink?

A sports drink containing 6% carbohydrates is the best fluid source.  It provides energy to working muscles and sodium that is lost in sweat, preventing muscle cramps.  Water is a good beverage, but doesn’t provide energy and lacks sodium that is lost in sweat.  Avoid carbonated drinks (soda pop).  They cause bloating and decrease the amount of fluid absorbed.  Caffinated drinks cause the body to lose fluids.

First Aid for heat injury

If an athlete shows any sign of heat exhaustion, (face pale, headache, nausea, skin cool and clammy, profuse sweating) immediately find shade, increase fluid intake, and attempt to cool down with wet compresses.  Signs of heat stroke (skin hot, dry, no sweating, confused, altered mental status) cool immediately with ice packs and seek medical attention immediately.  This is a medical emergency.

What parents can do!

Make drinking fun by giving kids lightly flavored sports drinks like Gatorade.  Have your children drink on a schedule before, during and after activities.  Weigh your children before and after activity.  Check the color of your child’s urine to see if fluid intake is adequate.  Avoid exercise in the hot, humid times of the day. Following these guidelines will help ensure a safe and enjoyable football season.

If you have any questions you would like addressed in future articles you can log on to fmasportsmedicine.com or email us at ghoffman@fmasportsmedicine.com.  For appointments call (817) 447-1151.

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