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6/14/22 blog post

student athletes should take time during summer workouts

the body needs two weeks to adjust to hot temperatures

As the temperatures continue to rise this weekend, it's important for all to know the signs and symptoms of heat exhaustion vs. heatstroke and when to get help. Especially if you have young athletes practicing or playing their sport in this heat. 

Have you ever wondered why the military can carry all of their gear in the 120 degree desert without getting sick? Or how firefighters can wear full gear in a hot building, but you feel light-headed after mowing the grass in 85 degree heat?

This phenomenon is called acclimatization. If you run a marathon, you develop a training schedule to prepare. If you spend time in the heat, you need to train your body for the heat. This is separate than the physical training for exercise. Just because you can do something in 70 degree weather doesn’t mean your body is prepared to do the exact same thing in 90 degree weather.

Acclimatization describes subtle changes the body makes as it adapts, including how much we sweat, the salt content of the sweat, where the blood is directed in the body, and the best timing for this new cooling system to kick in. It takes about 40 hours of physical activity in the heat for our bodies to fully acclimatize. These 40 hours should be spread out across 10 days or longer. During the acclimatization period, many athletes are unable to do the intense workouts they can do in cooler temperatures. And if you stop exercising in the heat, your body loses these adaptations.

The American College of Sports Medicine has a schedule for how quickly football teams should advance activities. This is based on what we know about acclimatization, including which types of football drills cause the body temperature to rise the fastest, and how long it stays elevated. Football coaches are instructed to slowly add equipment, tackling and two-a-days, as the athletes’ bodies adjust to the heat.

The biggest risk of exercising in the heat is heat stroke. This is a deadly condition where the body temperature rises faster than the body can cool off. Athletes who are fully acclimatized and well hydrated have a lower risk of heat stroke, but it can still happen to anyone. Athletes suffering heat stroke often appear pale and sweaty, and behave in a confused or combative way. Sometimes they lose consciousness.

You will often read that people suffering from heat stroke appear red and stop sweating. Although this is true in some very specific situations, it is NOT the way most athletes appear.

We’ve trained society to think “concussion” whenever they see a confused or unconscious football player. In August, think “heat stroke” instead. Most heat stroke deaths happen the first four days of football camp. If heat stroke is possible, it is critical that you begin cooling immediately. When untreated, heat stroke is 100 percent fatal. Treatment must begin within 20-30 minutes to prevent permanent organ damage. The good news? Treatment is completely FREE. Cool them off. Do whatever it takes. Dump the ice cooler on them, get them into the air conditioning, run the hose over them, put ice packs in the armpits, groin and neck – do whatever it takes. Start this before you even call 911. The main reason that athletes still die from heat stroke is because of our failure to recognize it and start cooling them immediately. You could save someone’s life by learning to recognize and treat heat stroke.

What can you do?

  • Make sure your child drinks plenty of water. Drink until urine has no color.
  • Follow the recommended acclimatization schedules during football camp (and other sports too!)
  • Give athletes unlimited access to water during workouts. Start replacing electrolytes if they exercise longer than 30-60 minutes
  • Adjust workouts if it is an unusually hot day. Decrease intensity, equipment, and contact drills, OR reschedule for a cooler part of the day.
  • Watch for a confused, disoriented athlete and begin cooling them immediately. Call 911 after you begin cooling them.

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Lora Scott, MD

division chief sports medicine
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