Sports Medicine: Heat Illness

Players who practice or play in hot conditions are susceptible to heat illness. The three stages of heat illness, in increasing order of seriousness, are heat cramps, heat exhaustion, and heat stroke.

Heat cramps are involuntary muscle cramps that are excruciatingly painful. They occur primarily in the muscles of the trunk and the lower body.  The cause of heat cramps is thought to be dehydration and electrolyte imbalance. Replenishing fluids and electrolytes, particularly sodium, is critically important in the prevention of heat cramps.  Once an athlete has heat cramps, you may try icing or massaging the area that is cramping; however, the ultimate treatment is prevention by ensuring proper hydration strategies are in place.

Heat exhaustion is defined as an overload to the body’s thermoregulatory system resulting in extreme sweating and often heavy breathing, rapid pulse, and fatigue. Heat cramps often occur, along with other systemic symptoms such as dizziness, nausea, and an obvious outward appearance of distress.  Players may try to continue playing, but they should not. Have them rest in a cool, shaded place; give them cool water; and apply ice to the neck, back, or stomach to help cool the body. Monitor them carefully in order to ensure their condition doesn’t worsen. In this stage of heat illness, the body’s thermoregulatory system is still working, but it is not able to keep up with current physical demands.

Heat stroke occurs when the body’s thermoregulatory system fails. The body can no longer cool itself, and the victim will die if formal treatment is not initiated.  This is an emergency situation that requires emergency medical support.  Treatment includes cooling procedures and intravenous fluids and electrolytes, as well as careful monitoring of all vital signs.  The victim often is not sweating, has loss of memory and balance, and may lose consciousness.  Failure to recognize this condition and to initiate immediate medical treatment can result in the victim’s permanent injury and even death. 

The best treatment for heat illness is prevention.  Maintaining proper hydration is essential and rehydrating the player with both fluid and electrolytes is critically important to prevent injury and allow continued performance.