The beginning of the football season across the country is characterized by hot, August practices and hard work in equipment. But the combination of environment, equipment and intensity can place athletes at risk of heat illness. Heat illnesses represent conditions resulting from heat stress, which can be imposed by a number of factors, but usually result from the environment or the body creating this heat load itself. Heat illnesses can range from minor to severe, and, in particular, exertional heat stroke is a life-threatening emergency. Athletes may not realize when they are reaching their limits and continue to push hard at practice. It is important for you as a coach to modify practices to reduce the risk and learn to recognize and manage heat illnesses.
How does the body handle heat?
High body temperature decreases exercise performance and is a major risk factor for heat illness. During exercise, working muscles produce heat, which is stored in the body until it can be released into the environment. The environment can add heat to the body through high air temperature and radiant heat from the sun. So the body has to keep itself from storing too much heat while continuing to exercise. Sweating is the body’s best way to get rid of heat, via evaporation. As sweat evaporates from the skin, heat is transferred away from the body into
the environment. However, as relative humidity increases, the body’s ability for sweat to evaporate from the skin decreases, resulting in greater heat storage, load and potential for exertional heat illnesses.
How do I protect my athletes?
The best way to protect your athletes is to modify the risk factors that are responsible for causing heat illness. These risk factors can be classified into two categories: extrinsic (factorsoutside the athlete’s control) and intrinsic (factors unique tothe specific athlete). Extrinsic risk factors can be modified by changing practice times, taking off equipment or providing more breaks. Not participating with an illness, maintaining proper hydration and becoming heat acclimatized are all options to decrease intrinsic risk.
What is heat acclimatization, and how can my team do it? Heat illness is most common during the first five days of practice. An easy way to protect athletes during this time is heat acclimatization. Heat acclimatization takes an average of 10-14 days to get the full benefits but still provides important protective benefits while it’s occurring. Heat acclimatization is aseries of adaptations that helps the body prepare for exercise in the heat. These changes help the body maintain lower temperature and heart rate, enhance sweating and store more water. The lower heart rate and body temperature means that athletes can exercise longer and at a higher intensity, which lowers the risk for heat illness.
How do I modify my practice for environmental conditions?
Environmental conditions provide important information about how hard the practice could be on the body. Modifying the length of practice, intensity of practice and the number and lengths of breaks during practice keep athletes safer when conditions are stressful. Wet bulb globe temperature (WBGT) is the best way to determine how stressful the environment is. WBGT is calculated by taking into account air temperature, humidity and radiant energy from the sun. If WBGT is not available, the next best thing is heat index, which is a combination of air temperature and humidity.
What types of fluid should I use for hydrating?
Water is the least expensive and most accessiblefluid during exercise. Sports drinks contain electrolytes, sugar and water, which give athletes important nutrients during exercise. While water is appropriate during all types of exercise, sports drinks are recommended for use during intense exercise that is greater than 60 minutes or during intense exercise in the heat. Also, children like the taste of sports drinks, so it may lead them to hydrate more than if water is the only available fluid.
When should athletes hydrate?
• Hydrate with 16-24 oz. of water or a sports drink
Have unlimited access to water during exercise/activity
Be able to drink as much as they want
Be able to drink for the entire break period if
Access to sports drinks when exercise is greater than 60 minutes or if exercise is going to be intense and in the heat
To achieve this, it’s recommended that all exercise sessions should have predetermined breaks approximately every 15 minutes. The timing and length of breaks should be dependent on the environmental conditions. While athletes may be encouraged, or even required, to bring their own fluids, as a coach, always make sure extra fluids are available for those who have forgotten or need to refill their water bottles.
How do I recognize the various exertional heat illnesses, and what can I, as a coach, do to treat my athletes?
What is exertional heat stroke?
Exertional heat stroke occurs when the bodyreaches temperatures above 104°F and there is obvious central nervous system (CNS) dysfunction.CNS dysfunction can include any of the following: dizziness, collapse, confusion, irrational behavior, hysteria, aggressiveness, combativeness, disorientation, seizures and coma. It is a medical emergency.
What is the cause of EHS?
When the body is unable to give off heat fast enough, heat is stored and core body temperature continues to rise.
How do I treat someone suspected of EHS?
If EHS is suspected in an athlete, immediate action is imperative in order to maximize the chance of survival.
EMS (9-1-1) should be called immediately.Aggressive cooling of the entire body should be done to lower the athlete’s core body temperature
as fast as possible. Whole-body, cold-water immersion is the best treatment for EHS because it cools the body the fastest. If this is unavailable, then any attempts to cool the body through continual dousing of water (shower, running a hose over the entire body whilecovering the body with iced towels) should be donebefore EMS arrives to take the athlete to the hospital.