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Preventing Heat-Related Illness in Athletes


As summer ramps up and temperatures do the same, athletes of all ages, sports types and levels are at a heightened risk for experiencing some degree of heat illness. In fact, heat-related illnesses are on the rise, especially among high school athletes practicing or competing in the hot summer months, and the Centers for Disease Control and Prevention reports that heatstroke (the most serious heat-related injury) is one of the top three causes of death among high school athletes.

Heat-related illnesses have become such a concern for youth – as well as amateur and professional sports – that in 2014, The Fédération Internationale de Football Association approved sideline physicians to call a cooling break should field temperatures become too extreme, potentially risking the players’ health. In fact, I called the inaugural cooling break under this allowance during a World Cup match between Mexico and the Netherlands. It was fantastic knowing I had science, medicine and a major league sports authority behind me.

Of course, fatalities just from playing sports in the heat sound serious, and they are. However, although the risk exists, all types of heat illness are largely preventable if proper precautions are taken before, during and after exercise. And that starts with knowing what heat illness is and how it presents.

In the simplest terms, heat illness arises when the body’s core temperature rises past a functioning threshold and is unable to cool itself down. In order to run properly, our body’s core temperature needs to be maintained around 98.6 degrees Fahrenheit. During exercise, our body temperature increases and needs to be brought back down to normal, and the body naturally does that by sweating. Producing and evaporating sweat cools and regulates our core temperature. But when you add in extremely hot weather, humidity and strenuous exercise, it becomes much more difficult for the sweat to evaporate and the body’s temperature can begin to rise past normal limits. In addition, profuse sweating without replenishing fluids will eventually deplete the body of necessary electrolytes.

As a result of these bodily reactions to heat coupled with exercise, symptoms of heat illness can develop, and there are several different types ranging in severity from mild cramps to fatal injury. Knowing what to look for can help you resolve symptoms before they become life-threatening.

Heat cramps are the most mild type of heat injury and consist of painful cramping that can occur in the stomach, arms and/or legs, which is caused by a depletion of salt and fluids lost through sweat that are not replaced during exercise. Halting the exercise, stretching the affected muscles and replacing the lost electrolytes will typically resolve this type of heat-related cramping.

If not treated immediately, heat cramps may progress to heat exhaustion, a more serious level of heat-related illness brought on by heavy sweating and a significant loss of fluids and salts that are not replenished. In addition to muscle cramps, heat exhaustion can introduce dizziness or fatigue, nausea, vomiting, a rapid heartbeat and low blood pressure. At this point, the body is still able to cool itself by stopping all exercise, moving into a cool shaded area, using ice or wet towels to speed the process and replenishing salts and minerals with sports drinks or fortified water.

If the body’s core temperature reaches 104 degrees Fahrenheit, it becomes the most severe form of heat injury – heat stroke – and is considered a medical emergency because the body is no longer able to cool itself down. With internal temperatures this high, the body’s organs are unable to function and may begin to shut down. When this happens, the symptoms that may present can include disorientation, possible seizures and loss of consciousness, in addition to the previously mentioned symptoms of heat exhaustion. At this level of injury, emergency medical services should be called, and the athlete should be cooled down as quickly and efficiently as possible. Though this is an extreme scenario, it can unfortunately happen all too often in the hot summer months. The good news is that heat-related illnesses can be prevented or stopped before they progress to dangerous levels. Be constantly aware of how your body feels, and don’t ignore what it’s telling you. Take action as soon as you or someone else experiences any of these signs:

  • Thirst
  • Headaches
  • Dizziness
  • Faintness
  • Nausea
  • Chills

What should you do? Get into the shade or an air conditioned room, replenish liquids with electrolytes (water alone won’t be enough in these situations) and rest until the symptoms subside. If it’s anything more serious, immediate cooling is always a good idea with ice packs, towels or a cold water bath.

It’s vital for anyone who’s going to be exercising in extreme heat to work up to it slowly so your body has time to acclimate to the conditions it’s being put to work under. The most effective treatment for this type of illness is prevention, including proper training, appropriate clothing for the weather (light fitting and light colored is best), and adequate hydration before, during and after exercise. Guidelines recommend 16 ounces up to one hour before exercising, and supplementing with 8 ounces every 20 minutes during the workout. Sports drinks (water with added minerals and salts) are recommended for any sporting event lasting longer than one hour.

Remember to take breaks, don’t overdo it and above all, listen to your body. With awareness and taking the proper precautions, you can keep yourself healthy and in the game all summer long.

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