Jul 31, 2017The Ultimate Heat Illness Prevention Guide – Rebecca Moore
In 2015, the National Athletic Trainers’ Association (NATA) published a Position Statement on Exertional Heat Illnesses to present best-practice recommendations for the prevention, recognition and treatment of exertional heat illnesses and to describe the relevant physiology of thermoregulation. This document outlines years of research and data that give athletic trainers a solid foundation to understand and prevent heat illness. In terms of prevention, their tips can be broken down into three categories: acclimation, hydration and education.
Heat Illness Prevention Strategy #1: Acclimation
Just like you wouldn’t ask an athlete to enter a practice or game without warming up, you shouldn’t expect them to start practicing in warm temperatures without adjusting them to the heat first. The NATA suggests that developing a pre-season heat acclimation policy should be your first step in heat illness prevention.
“Individuals should be acclimatized to the heat gradually over 7 to 14 days…The first 2–3 weeks of preseason practice typically present the greatest risk of exertional heat illness, particularly in equipment-intensive sports. All possible preventive measures should be used during this time to address this high-risk period” (Casa et al. 2015).
Alongside this policy, a careful medical screening should be administered during pre-season to identify athletes with risk factors. Some of these risk factors include history of heat injuries and a prior muscle, tendon or ligament injury (Casa et al. 2015).
Heat Illness Prevention Strategy #2: Hydration
According to the NATA’s Position Statement covering Fluid Replacement for Athletes, establishing a pre-exercise hydration, hydration and rehydration protocol for athletes is another key staple in preventing heat illness. Here are the NATA’s recommended considerations while building an efficient hydration strategy:
- Athlete’s sweat rate
- Sport dynamics
- Environmental factors
- Acclimatization state
- Exercise duration
- Exercise intensity
- Individual preferences (SOURCE 2).
Getting ahead of hydration issues can prevent them from happening in the first place. “To ensure proper pre-exercise hydration, the athlete should consume approximately 17 to 20 fl oz of water, or a sports drink two to three hours before exercise, and 7 to 10 fl oz of water or a sports drink ten to twenty minutes before exercise” (Casa et al. 2000).
Hydration During Activity
It’s easy for both coaches and athletes to get carried away during practices and games; everyone wants to compete, keep up a strong pace and get the most out of every minute. However, not taking breaks to maintain proper hydration levels is extremely detrimental to the health of each athlete; no matter how much of the event they’ve participated in or the environment in which the event is taking place. Just how much should athletes be hydrating? According to the professionals at the NATA, it depends on the sport.
“A proper hydration protocol considers each sport’s unique features. If rehydration opportunities are frequent (e.g., baseball, football, track and field), the athlete can consume smaller volumes at a convenient pace based on sweat rate and environmental conditions. If rehydration must occur at specific times (e.g., soccer, lacrosse, distance running), the athlete must consume fluids to maximize hydration within the sport’s confines and rules” (Casa et al. 2000).
An appropriate hydration plan involves many factors, but most notable is having unlimited beverages available to athletes at all time. To check this off your hydration plan checklist, purchasing equipment like the Cramer PowerFlo Pro Hydration Unit gives everyone access to safe hydration on the field. Especially convenient when working in multiple locations and changing fields regularly, this unit has a rechargeable battery and zero-maintenance wheels that never go flat. Portability and stability that can’t be beat!
Post-exercise rehydration restores any fluid loss accumulated during a game or practice. Ideally completed within two hours, rehydration should contain water to restore hydration, carbohydrates to replenish glycogen stores, and electrolytes to speed rehydration (Casa et al. 2000).
Many athletic trainers or team physicians measure hydration with urine color against a color scale. But, an easier (and less invasive) method of hydration measurement is monitoring body weight; athletes should see less than 2% body weight reduction post-activity.
“I think it all starts with educating our athletes,” said Mike Harrison ATC, LAT, Sports Medicine Coordinator and Head Athletic Trainer at Allen High School. “We weigh our athletes in and out every day in the hot months, and for every pound that they lose they have to make that up with 20-24 ounces of fluid.”
Heat Illness Prevention Strategy #3: Education
You can’t prevent what you don’t understand or aren’t anticipating. As healthcare professionals, it’s essential that athletic trainers take control of their athletic environments and properly inform coaches, athletes, administrators, parents on the signs and dangers of heat illness.
Need help getting started? Here are some potential topics that you can cover:
- Preventing heat illness
- Recognizing heat illness
- Treating heat illness
- Best drinks for hydration
- Sleep regulations
- Proper diet
- How to rest the body effectively
To find data to support these topics, expert advice on heat illness and return to play recommendations, read through the NATA’s Position Statement on Exertional Heat Illnesses. Together, we can all play a huge role in reducing or eliminating these conditions and keep the athletes where they belong; on the field.
Cramer® | 800-345-2231 | www.cramersportsmed.com
Casa, Douglas J., et al. 2015. National Athletic Trainers’ Association Position Statement: Exertional Heat Illnesses. Journal of Athletic Training 50.9: 986-1000.
Casa, Douglas J., et al. 2000. National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes. Journal of Athletic Training. 2000;35(2):212-224.