Play it Safe on the Field in the Summer Heat

Although school is not yet back in session, high school students who participate in sports are back in action. Upper St. Clair students officially take to the fields to gear up for another season Monday, but with that first step onto the practice field comes an ounce of prevention, as playing in summer’s heat and humidity can take its toll on the players.

“The biggest danger of playing sports in the heat and humidity is heat injury and heat exhaustion,” said Scott Schweizer, MD, sports
medicine physician at Canonsburg General Hospital. “The range of symptoms can be mild cramps and decreased performance to moderate heat exhaustion due to water or salt depletion. The most severe condition is heat stroke, which is life threatening.”

According to the American Academy of Orthopaedic Surgeons, there were 31 deaths between 1995 and 2007 due to heat injury during high school football practice and games.

“There are several symptoms that occur that can alert coaches and other staff that a player is having a health issue,” Dr. Schweizer
said. “These include cramps, dizziness, fatigue, fainting, nausea,
weakness and headache. It should be extremely concerning if the athlete stops sweating.”

The best course of action if something happens is to move the person to a cool, shaded area, according to Dr. Schweizer. In addition, tight clothing should be removed, and if the person is conscious, they should be given plenty of fluids. Fans or ice towels also provide aid.

“Refer to a physician to assess the needs of fluid and electrolyte replacement and further medical attention, especially if the athlete is nauseated and vomiting.”

For treatment of heat stroke, Dr. Schweizer suggested taking the following measures:

• Call 911 immediately.
• Monitor core body temperature and lower it as
  quickly as possible by immersing the person in an ice bath.
• Remove as much clothing as possible.
• Apply ice packs to the armpits, groin, and neck
  areas.
• Continue cooling efforts until an emergency crew
  arrives.

“These health problems can be prevented through a number of ways, including practicing during the coolest times of the day, ie, morning and night, participating in preseason conditioning to acclimate to the climate, taking frequent breaks for hydration, and drinking at least 24 ounces of non-caffeinated sports drinks or water two hours prior to exercise and an additional eight ounces of water or sports drinks right before exercise. In addition drink eight ounces of water for every 20 minutes of activity,” Dr. Schweizer said. “Also, wear lightweight and light colored clothing, and drink before you are thirsty, as you will likely be about five to 10 percent dehydrated before you feel it.”

Children are of particular concern when they are playing sports outside in the summer, according to Dr. Schweizer. They dehydrate more quickly and, in general, are less effective in regulating body temperature.

“Other high risk populations are individuals with high body fat, people on diuretics and stimulants, and people with sickle cell disease.”

More than four continuous hours is too long to be outside engaging in vigorous activity, Dr. Schweizer noted. Adults require four to seven exercise sessions, about one to four hours in length, in the heat just to be able to adjust to the high temperatures. Children require longer to adjust and typically need about seven to 10 sessions.

“Less time should be spent outside when temperatures and humidity are high,” Dr. Schweizer said. “The ‘heat index’ is a measure of both
temperature and humidity. Sports practices should be limited to T-shirts and shorts—no football pads—when the heat index is greater than 100 and avoided outside altogether if the heat index is greater than 110.”

The main message to coaches is that practicing in extreme conditions does not “toughen” the athletes, but instead, exposes them to the
extreme dangers of heat exhaustion and heat stroke, Dr. Schweizer emphasized. In addition, they put themselves at risk for other injuries by practicing when their concentration is not at its peak.

“It has been shown that when practicing outdoors in high temperatures, frequent breaks and adequate hydration increase performance.”