08.10.21

With the start of fall sports approaches, pre-season is just around the corner for many young athletes. In addition to getting new cleats, equipment, water bottles, uniforms, etc. it is just as important to get your child’s body ready to participate. Summer temperatures and heat indices are still quite high and precautions should be taken to ensure practices and games can take place safely for all participants. When starting a new season, be sure to ask your child’s coach or league administrator how they will handle heat and keeping your child safe.

The National Weather Service defines heat index as what the temperature feels like to the human body when relative humidity is combined with the air temperature. It is important to know the heat index because it can impede the body’s natural mechanism to cool itself via sweating. As our body temperature increases, we start to sweat and evaporation helps to cool the body. If there is high humidity, evaporation is not efficiently cooling the body as it is unable to occur. Further complicating the body’s ability to cool would be the equipment athletes wear to participate in their sport. During this time, athletes, coaches and parents should be aware of potential for heat related illness, how to prevent, recognize and treat.

HEAT RELATED ILLNESS

• Cramps: involuntary muscle contraction, sweating, fatigue, electrolyte loss
  

• Exhaustion: Inability to continue to exercise in heat, weakness, headache, heavy sweating, dizziness, fainting, nausea, vomiting, heat cramps, fast & shallow breathing
  

• Syncope: fainting or lightheadedness episode
  

• Exertional Heat Stroke: Rectal Temperature above 105⁰F, Central nervous system dysfunction, confusion, disorientation, combative behavior, unconsciousness, collapse, weakness

PREVENTION

Proper hydration is key before, during and after events. Encourage your child to regularly drink water (the best) throughout the day, between 9-10 cups/day for 9–13-year-old females/males and 10-14 cups/day for 14–18-year-old females/males. Urine color can provide a quick check of hydration status, - pale yellow(lemonade) indicates fairly well vs. darker yellow (apple juice) potential dehydration.

ACCLIMATIZATION

Acclimatization is just as important, to gradually prepare our young athletes to participate in hot conditions. It is especially important for our equipment sports (American football, field hockey goalie, catchers) to acclimate, starting with shorter practices and lighter/less equipment. Heat Acclimatization should occur over a period of 2 weeks prior to the first competition. Regardless of fitness status or prior workouts, all athletes should follow the same schedule for heat acclimatization over the next 14 days of practice. It is also recommended athletes self-pace their intensity of workouts, similar to the Military, utilizing simply a Rating of Perceived Exertion (RPE) scale of 1-10.

The table below is the Connecticut Interscholastic Athletic Conference (CIAC) Exertional Heat Illness Program &Annual Review and the Korey Stringer Institute is the heat acclimatization guide for football that can be modified for other sports.

TREATMENT

It is important to recognize when your athlete may be suffering from heat related illness. Something that seems minor can quickly turn to a life-threatening event, even death. Death from exertional heat stroke is 100% preventable and survivable when proper measures are taken. Having a certified athletic trainer at your event, planning, checking the weather and heat index, moving practice to a cooler time of day or cancelling can avoid a potential problem. Also, recognizing the signs and symptoms of heat stress, removing the athlete from play, into a shaded area, provide fluids, cooling devices (rotating ice towels, fans, ice bags).

For more severe cases of exertional heat illness (EHI), it is a medical emergency, call 911, rapidly cool the person down in a cold-water immersion tub. It is imperative to COOL FIRST, TRANSPORT SECOND. The individual’s core body temperature needs to be brought down quickly to avoid long term damage and/or death. To determine core body temperature, a rectal temperature is the only method to ACCURATELY measure and a certified athletic trainer can complete this task safely.

• Cramps: Stop activity, move to shaded area, rest, fluids, electrolytes, gentle stretching
  

• Exhaustion: Move to cool/shaded area, fans, ice towels, elevate legs, fluids

• Syncope: Move to shaded area, sit or lie down, monitor vitals, elevate legs, fluids
  

Exertional Heat Stroke: COOL FIRST, TRANSPORT SECOND; CALL 911, Cold Water Immersion to lower core temp to 102 within 30 minutes

PREVENTION IS KEY!

• HYDRATION before, during and after activity

• REST, which includes adequate SLEEP each night

• ACCLIMATE during pre-season over the first 14 days

• RECOGNIZE SIGNS AND SYMPTOMS OF A POTENTIAL INJURY/ILLNESS

REFERENCES/MORE INFORMATION

• National Weather Service-Heat Index

• Korey Stringer Institute-Heat Illness

• CIAC Medical Handbook 2021-22

• At Your Own Risk

• Casa DJ, Csillan D, et al. Preseason Heat-Acclimatization Guidelines for Secondary School Athletics. J Athl Train (2009) 44 (3): 332–333.

• Adams WM, Hosokawa Y, Casa DJ, et.al. Roundtable on Preseason Heat Safety in Secondary School Athletics: Heat Acclimatization. J Athl Train (2021) 56 (4): 352–361.

TAGS

#PRESEASON #HEATILLNESS #PREVENTION #COOLFIRSTTRANSPORTSECOND #YOUTHSPORTSAFETY #AT4ALL