SPORTS MEDICINE: Avoiding and treating heat stress when engaged in hockey and fitness training in hot conditions

Unfortunately pre-season hockey and fitness training is generally done in hot and often humid conditions. You need to be wise about the conditions of training because if not accounted for can lead to heat illnesses. Keeping a constant body temperature of around 37 °C is vital. To lose heat and maintain core temperature, blood vessels in the skin expand and bring body heat to the skin surface. Perspiration floods out of sweat glands and evaporates from the skin to cool the body.

Heat stress occurs when sweat can’t evaporate fast enough to keep the body sufficiently cool. Many of the symptoms occur as a result of excessive loss of body salts and water. At rest and in comfortable temperatures, a person sweats about two litres of fluid every 24 hours. During hot weather (35°C), this fluid loss can leap to around 10 litres over the same time period. Pre-season hockey and fitness training in hot weather accelerates fluid loss even more.

Symptoms of heat stress

The symptoms include:

  • deterioration in performance
  • muscle cramps
  • headache
  • dizziness
  • nausea

If the symptoms are ignored and left untreated, it can lead to a life-threatening complication known as heatstroke.

Treatment for Heat Stress

If you, or anyone else, have symptoms of heat stress, it’s essential to immediately get out of the heat and rest, preferably in an air-conditioned room. If you can’t get inside, try to find the nearest cool and shady place.

Other recommended strategies include:

  • Drink plenty of fluids, especially sports drinks to replace lost salt (avoid caffeine and alcohol).
  • Remove any tight or unnecessary clothing.
  • Take a cool shower, bath, or sponge bath.
  • Apply other cooling measures such as fans or ice towels.

If such measures fail to provide relief within 15 minutes, seek emergency medical help, because untreated heat stress can progress to heat stroke.

After you’ve recovered from heat stress you’ll probably be more sensitive to high temperatures during the following week. So it’s best to avoid hot weather and heavy training until a medical authority  tells you that it’s safe to resume your normal training.

Prevention of heat stress

You can take a number of precautions to prevent heat stress and other heat-related illnesses. When temperatures climb, remember to:

  • Wear loose fitting, lightweight clothing.Wearing excess clothing or clothing that fits tightly won’t allow your body to cool properly.
  • Protect against sunburn.Sunburn affects your body’s ability to cool itself, so protect yourself outdoors with a wide-brimmed hat and sunglasses and use a broad-spectrum sunscreen with an SPF of at least 15. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or sweating.
  • Drink plenty of fluids.Staying hydrated will help your body sweat and maintain a normal body temperature.
  • Take extra precautions with certain medications.Be on the lookout for heat-related problems if you take medications that can affect your body’s ability to stay hydrated and dissipate heat.
  • Take it easy during the hottest parts of the day.If you can’t avoid strenuous activity in hot weather, drink fluids and rest frequently in a cool spot. Try to schedule hockey or physical fitness training for cooler parts of the day, such as early morning or evening.
  • Get acclimated.Limit time spent working or exercising in heat until you’re conditioned to it. People who are not used to hot weather are especially susceptible to heat-related illness. It can take several weeks for your body to adjust to hot weather.
  • You can purchase cooling garments. Cooling neck ties, headwear and chest garments are available commercially. They help prevent body temperatures from rising quickly.

Heat Stroke

Heatstroke is a condition caused by your body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. This most serious form of heat injury, heatstroke, can occur if your body temperature rises to 104 F (40 C) or higher. Heatstroke requires emergency treatment. Untreated heatstroke can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death.

Heatstroke signs and symptoms include:

  • High body temperature.A core body temperature of 104 F (40 C) or higher, obtained with a rectal thermometer, is the main sign of heatstroke.
  • Altered mental state or behavior.Confusion, agitation, slurred speech, irritability, delirium, seizures and coma can all result from heatstroke.
  • Alteration in sweating.In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.
  • Nausea and vomiting.You may feel sick to your stomach or vomit.
  • Flushed skin.Your skin may turn red as your body temperature increases.
  • Rapid breathing.Your breathing may become rapid and shallow.
  • Racing heart rate.Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
  • Your head may throb.

Treatment

Seek medical attention immediately.

Take immediate action to cool the overheated person while waiting for emergency treatment.

  • Get the person into shade or indoors.
  • Remove excess clothing.
  • Cool the person with whatever means available — put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water, or place ice packs or cold, wet towels on the person’s head, neck, armpits and groin.

Finally hockey clubs should have in place a ‘Heat Policy’

Source: various

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