Heat (muscle) cramps tend to occur later in activity with muscle fatigue and after fluid and electrolyte imbalance and increased. Dehydration, diet poor in minerals, and large losses of sodium and other electrolytes increase the risk of severe often whole body muscle cramps.
- Recognition: Intense pain in muscles and persistent muscle contractions after prolonged exercise, most often with exercise in heat.
- Treatment: Regain normal hydration status and replace sodium losses via an electrolyte drink or other sodium source. Salty sweaters may need additional sodium earlier in activity. Light stretching, relaxation of involved muscles.
- Return to play Considerations: Student-athletes should be assessed to determine if they can return to participation. Diet, rehydration practices, electrolyte consumption, fitness status and level of acclimatization and use of dietary supplements should be assessed and possibly modified.
Heat exhaustion is a moderate heat illness that occurs when the student-athlete continues physical activity after they start suffering from the ill effects of heat, like dehydration. The student-athletes body struggles to keep up with the demands, leading to heat exhaustion.
- Recognition: Physical fatigue, dehydration and or electrolyte depletion, coordination loss, fainting, dizziness, profuse sweating, pale skin, headache, nausea, vomiting, diarrhea, stomach/intestinal cramps, rapid recovery with treatment.
- Treatment: Remove student-athlete from play to a shaded or air conditioned area, remove excess clothing and equipment. Cool student-athlete with legs propped above heart level. If not nauseated, or vomiting rehydrate with chilled water or sports drink. If student-athlete cannot take fluids orally intravenous fluids are indicated. Transport to an emergency facility if rapid improvement is not noted with prescribed treatment.
- Return to play Considerations: Student-athlete should be symptom free and fully hydrated. Clearance from a physician or at least consultation with a physician is recommended. Underlying conditions or illness needs to be ruled out. Intense practice in heat should be avoided for at least one day. If lack of acclimatization or inadequate fitness level was the cause of illness, correct this before the student-athlete returns to full-intensity training in heat.
Exertional Heat Stroke
Heat Stroke is a severe heat illness that occurs when a student-athlete’s body created more heat than it can release, due to the strain of exercising in the heat. This results in a rapid increase in core body temperature, which can lead to permanent disability or even death if left untreated.
- Recognition: Increase in core body temperature, usually above 104°F. Central nervous system dysfunction(CNS) (altered consciousness, seizures, confusion, emotional instability irrational behavior or decreased mental acuity. Other indicators include: nausea, vomiting, diarrhea, headache, dizziness, weakness, hot and wet or dry skin, increased heart rate, decreased blood pressure or fast breathing, dehydration, and combativeness.
- Treatment: AGGRESSIVE AND IMMEDIATE whole body cooling. Cold water immersion (35°-38° F) within minutes is the best treatment until core temperature reaches 101° -102°F. Contact emergency medical services for transport. Monitor airway, breathing, circulation, core temperature, and CNS. If immersion is not possible use alternate methods such as spraying the body with cold water, fans, ice bags or cold towels (replaced frequently), and transport immediately to a medical facility.
- Return to play Considerations: Physician clearance is necessary before return to physical activity. The severity of the incident should designate the length of recovery time. The student-athlete should avoid exercise for the minimum of one week after release from medical care. Underlying conditions or illness needs to be ruled out. A gradual return to physical activity should begin under the supervision of an certified athletic trainer or other qualified medical professional.
J.D. Boudreaux, PT, SCS, LAT, ATC
McLeod-Trahan-Sheffield Physical Therapy Services, LLC