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Combating Heat Illness in the Fall Athlete

Young boy on a soccer field drinking water.
Blog Health Information

/ by Ryleigh Cunningham, LAT, ATC

When temperatures begin to rise, concerns of an athlete succumbing to heat illness begin to rise as well. If an individual is active in the heat for too long, there are usually negative consequences, such as fainting (syncope), dizziness, nausea, excessive sweating, elevated core temperature and, if not monitored, death. To help prevent these consequences, here are simple yet crucial guidelines for nutrition, hydration and acclimatization to combat heat illness.

There are five types of heat illnesses that coaches, parents and athletes should be on the lookout for.

Exercise-associated heat cramps

Exercise-associated heat cramps are possibly the most common and easily identifiable heat illness. The athlete will begin to cramp after an extended period of physical activity in a hot and humid environment.  Dehydration, electrolyte imbalance, altered neuromuscular control and fatigue are some factors that contribute to these heat cramps. To treat this illness, the athlete must stop physical activity to rest and stretch. The athlete should also drink fluids and eat foods that are rich in sodium and carbohydrates. If the athlete has more episodes of exercise-associated heat cramps, further testing should be performed to rule out more serious neuromuscular conditions. 

Heat syncope

Another common heat illness is heat syncope. This normally occurs in those who are unfit and not acclimated to the heat. Those affected by heat syncope normally wear a uniform and have to stand for long periods, so it’s common among those serving in the military. They usually are dehydrated and have venous pooling of the blood, reduced cardiac filling or low blood pressure. The individual should be moved to a shaded area to cool down, and their vitals should be monitored. They should also be given fluids to help rehydrate them. 

Heat exhaustion

Heat exhaustion is the inability to exercise efficiently due to factors such as cardiovascular insufficiency, hypotension, energy depletion and fatigue. It is normally accompanied by high volume of skin blood flow, heavy sweating, dehydration and a core temperature of 104 degrees. Heat exhaustion may not be an immediate medical emergency. It can be treated with rest, cooling and rehydration

Heat injury

If left untreated, heat exhaustion can lead to heat injury. Heat injury is when organs and tissues become damaged due to the increase of the core temperature.

Heat stroke

If heat exhaustion is still left untreated, heat stroke, the most severe form of heat illness, will occur. It is characterized by high core body temperature and neuropsychiatric impairment. The first symptom of heat stroke is central nervous system dysfunction, such as collapse, aggression, irrationality, confusion, seizures, loss of consciousness and a core temperature at or above 105 degrees. Heat stroke is a medical emergency. The athlete should begin being cooled down immediately, and EMS should be called. Cooling before transporting is key to increasing the athlete’s chances of surviving heat stroke.

Even though heat illnesses may seem hard to avoid, there are ways athletes and coaches can reduce the chances of heat illness occurring.

Coaches should encourage frequent water breaks, change practice times and have an emergency action plan (EAP). If the heat index is expected to be high, have water breaks every 20 to 30 minutes when the intensity is expected to be low to moderate. If intensity is expected to be moderate to high, then water breaks should be every 10 to 15 minutes. An athlete should never be denied access to water.

During the summer months, the hottest part of the day is between 10 a.m. and 4 p.m. Changing practice times to early morning or late evening will help ensure the heat index should be low enough to safely practice. 

Lastly, having an EAP is key so everyone knows the proper protocol to follow to increase the chances of survival of the one needing assistance. EAPs must be reviewed and practiced frequently so everyone knows what his or her role is during emergency situations.

Although athletes can’t control practices, they can control what they eat and drink to assist in preventing heat illness .

Athletes will spend hours upon hours perfecting their skills, but one aspect they ignore is nutrition. This is partly due to lack of knowledge. Most athletes do not understand the nutritional value of foods and how to cook them. It can also be due to inadequate resources, such as funds and transportation to buy nutritionally rich food, which is even more difficult in food deserts – an urban area where it is difficult to purchase high-quality food. As travel ball and AAU keep gaining popularity, athletes are normally fed low nutritional quality food from concessions stands or fast-food chains due to convenience and affordability.

To fight against these bad habits, athletes can follow these recommendations to improve their nutrition. According to Harvard School of Public Health, a person’s plate should be 25 percent whole grains, 25 percent healthy protein, 30 percent vegetables and 20 percent fruit. Athletes should space their meals throughout the day. If an athlete eats breakfast at 7 a.m. and lunch at noon but eats nothing until after a late afternoon or early evening practice, most of the calories they ate during the day will have been burned by the body. A light snack before practice should give the athlete enough energy for practice. After practice is also a critical time for the athlete’s nutrition. He or she needs to eat carbohydrates and protein immediately to help restore glycogen and prevent muscle fatigue. Then, about an hour after practice, the athlete needs to eat carbohydrates and protein-rich foods to recover. 

Lastly, the athlete needs to stay hydrated throughout the day. It is recommended that athletes consume 16 to 24 fluid ounces of water two hours before training and seven to 10 fluid ounces 10 to 12 minutes before training. During training, an athlete should consume six to 12 fluid ounces every 10 to 20 minutes. For every pound lost during training, an athlete should consume 16 to 24 fluid ounces. Sports drinks are also an easy was to consume electrolytes and carbohydrates needed after training. 

By following these guidelines, coaches and athletes can help prevent heat illnesses from occurring. Coaches can change practice time and intensities, while athletes can improve their nutritional intake and hydration levels. If a heat illness does occur, it is always important to have an EAP in place to improve the chances of a quicker recovery or survival in the case of heat stroke.

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