Staying safe while training, competing in extreme heat

Young athletes take a water break during a football camp conducted by Atlanta Falcons wide receiver Roddy White on Wednesday at Fort Johnson Middle School. The heat index hovered around 103 degrees during the camp. Leroy Burnell/Staff

This might not be breaking news, but it’s hot outside. Those of us who play sports and exercise here in Charleston are battling heat indexes that have topped 100 degrees recently. We are facing what many elite athletes experience routinely this time of year.

Some of the world’s most popular sporting events take place in the heat. Major League Baseball, the Summer Olympics and even this year’s FIFA Women’s World Cup can require their athletes to compete in hot and humid conditions.

These conditions can place tremendous stress on the bodies of elite athletes, weekend warriors and young recreational players alike. The heat and humidity also pose a risk for serious medical illness related to physical activity in this environment.

One option for dealing with the heat would be to avoid it altogether. Many sporting events take place outside during the day in summertime, so we must often find a way to safely train and compete. This column in no way serves as medical advice, and you should check with your doctor for individual recommendations. Here are some ideas, though, that might help you prepare for sports and exercise in the heat.

• Acclimatization — It can take elite athletes anywhere from a few days to two weeks for their cardiovascular systems to adjust to the hot temperatures. Rather than training at full speed right away, it is likely safer and better for performance to gradually increase your exposure. Slowly increase the volume, duration, and intensity of your training. Add protective equipment and uniforms throughout the adjustment period.

• Hydration — Ideally you want to stay euhydrated while training, meaning that you take in roughly the same amount of fluid you lose in sweat. To do so, you must drink fluids throughout the day, including before, during and after sports and exercise. Water is a good start. For intense heat or longer training sessions, drinks with sodium and electrolytes can help restore fluids. For athletes training or competing over many days, weighing yourself daily can help you determine if you are adequately replacing lost fluids.

• Cooling — Many options to cool your body before and during activity exist. Precooling your body with ice towels before you compete, like what many of the soccer teams are doing this week in Canada, is one option. Fans, ice vests and even cold water baths can help athletes in extreme conditions.

• Breaks — While you might not be able to take breaks during a competition, you can add them to your training sessions. Try breaking up physical exertion into shorter blocks of time with frequent breaks. If possible, go in the shade or indoors for a few minutes.

• Rest and recovery — If you must play several games or matches in a single day, as many teams must do in weekend tournaments, try to work with event organizers to schedule at least two hours of rest and recovery between contests.

Finally, it is critical that you stop and seek medical attention if you develop any signs or symptoms of heat illness, such as dizziness, weakness, or nausea. Pay attention to your teammates and watch for signs that they might be struggling.

Exertional heat stroke is rare, but it can occur even in highly trained athletes. Fortunately we can prevent most of these events by preparing ahead of time and taking some simple steps while we train and compete in the heat.

David Geier is an orthopaedic surgeon and sports medicine specialist in Charleston. For more information about heat illness and other sports medicine topics, go to his blog at