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Preventing Heat Illness in Athletes

Rising temperatures combined with intense sports training present the greatest risk of heat illness, especially in the first weeks of practices. Additionally, indoor athletes and performers aren’t immune from heat illness. Long practices in poorly ventilated gyms or studios carry a higher risk of heat illness.

What is Heat Illness?

The spectrum of heat illness ranges from muscle (heat) cramps, heat syncope, and heat exhaustion to life-threatening heat stroke. Here are the differences:

• Heat Cramps: tend to be painful and dramatic with normal temperature and ability to think and communicate
• Heat Syncope: involves fainting or passing out during or after exercise in the heat. In this case, you must consider possible heart problems as a cause in addition to heat exposure.
• Heat Exhaustion: is the inability to maintain blood pressure and sustain adequate blood flow from the heart. Signs and symptoms include weakness, dizziness, nausea, feeling faint, and headache. The core body temperature is less than104°F (40°C).
• Heat stroke: is severe illness with changes in the nervous system (delirium, loss of consciousness, convulsions, or coma) and other body organs. This results from an elevated core body temperature over 104°F [40°C]). This must be considered in any athlete with nervous system problems during/after exercise in extreme heat.

Heat Illness is 100% Preventable

Why Do Kids Get Heat Illness?

There are a number of reasons why athletes can get heat illness. These include:

• A lack of education and emergency action plans.

  • Each organization should have an emergency action plan that outlines how to handle heat illness.
  • This emergency action plan should be discussed and practiced before practices/games begin.

• Too much or too intense of exercise in hot environments.

  • This includes not modifying or rescheduling activities and not enough breaks or access to fluids.

• Insufficient recovery between practices/games due to closely scheduled or repeated events in a short time period.

• Inappropriate clothing, equipment and uniforms.

  • Allow removal of wet clothes that reduce ability to reduce body temperature.
  • Lighter clothing colors do not absorb as much heat.
  • Remove or restrict pad/helmet use in practice days with extreme heat.

• Lack of access to shade.

• Poor or inadequate fluid intake, both before, during, and after practice.

  • Regular breaks with full access to fluids is essential
  • Enough fluid must be available and placed at various stations around the practice field
  • Allow players sufficient time to drink during each practice and conditioning session

For more information, see

Pre-Season Preparation to Reduce Heat Illness

The best preparation any team can do to reduce heat illness is to implement a pre-season heat acclimatization policy. This allows athletes to adjust to hot conditions gradually over a period of 7 to 14 days. This is optimal for full heat acclimatization. The National Athletic Trainers Association provides key insights on the management of Heat Illness ( These include:

• Plan rest breaks and modify the work-to-rest ratio in hot conditions. More heat means more rest, less work, and reducing the intensity of the activity.
• Ensure that a cold-water immersion tub and ice towels are available to quickly help athletes with suspected heat illness.
• Athletes recovering from heat illness should be closely monitored by a physician or athletic trainer.
• Athletes suspected of having heat stroke must be cooled via cold-water immersion for the full treatment time prior to being transported to a hospital. This must be stated in the Emergency Action Plan.

Any individual or organization holding training or competition in hot conditions should review these recommendations. Appropriate on-field access to equipment and trained personnel should be part of a well-constructed Emergency Action Plan.

Is your team or organization prepared to prevent heat illness?

Of course, if you ever have any questions about your athlete’s health, give us a call.

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Athlete Health Coach ActiveKidsMD