UPMC Sports Medicine Experts Offer Pre-Season, Heat-Illness Prevention Tips For High School Athletes
PITTSBURGH, August 1, 2006 — Although summer vacation may be ending soon, the heat and humidity are not. With formal fall sports practices at most local high schools about to begin, athletes participating in pre-season training must be cautious of the season’s warmth.
UPMC Sports Medicine certified athletic trainer Larry Grollman, sports medicine physician Tanya Hagen, M.D., and sports nutritionist Leslie Bonci, R.D., offer the following tips to help prevent injury and illness during pre-season training.
Get Acclimatized to the Heat
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“Pre-season conditioning and acclimatization to the heat and humidity are essential in the prevention of heat-related illness and injury,” said Grollman.
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Athletes should get their bodies used to hot, humid weather workouts before formal practice begins to decrease the risk of injury and illness. They should begin gradually increasing their exercise time outdoors in weather situations similar to what is anticipated during formal practice.
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During pre-practice training, athletes should wear the same type of workout attire they expect to wear at practice.
Know the Stages of Heat Illness
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“There are three major stages of heat illness, each with specific symptoms and treatments,” said Grollman. “Athletes, coaches and parents need to be aware of all of the symptoms so they can treat the athlete immediately and appropriately.”
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Heat cramps usually occur after strenuous exercise. Symptoms include severe pain and cramps in the legs and abdomen, faintness or dizziness, weakness and profuse sweating. Muscle massage, rest and replacement of lost body fluids will relieve the cramps.
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Heat exhaustion happens when one is exposed to heat for a prolonged period of time. Symptoms include nausea, dizziness, weakness, headache, pale and moist skin, weak pulse and disorientation. The athlete should be moved to a cooler area, laid down with his or her feet propped up, bathed in cool water and given fluids. If rapid improvement is not observed, paramedics should be called.
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Heat stroke strikes suddenly and with little warning and can be life threatening. Signs include very high body temperature, hot, dry skin, lack of sweating, fast pulse, confusion and possible loss of consciousness. The athlete should be given emergency treatment with rapid body cooling and fluids and should be taken to an emergency room immediately. While awaiting transport, the body should be cooled with running water or ice packs. If the athlete is unconscious, do not force fluids. Breathing should be monitored closely.
Conditioning Can Help Prevent Musculoskeletal Injury
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“When athletes return from summer vacation, they may feel a sense of competition and a need to do their best. Consequently, they often end up pushing themselves harder than they should after a summer of not working out,” said Dr. Hagen. “It is essential that they let their bodies physiologically acclimatize to increased intensity of workouts.”
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Athletes should do cardiovascular and muscular workouts for several weeks before practice starts.
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Pre-season conditioning should include repeated bouts of exercise varying in intensity and rest periods.
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Athletes should perform sport-specific conditioning activities before practice begins. For example, football players should lift weights and run sprints, and soccer players should run and do footwork.
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Stretching before and after exercise reduces the risk of injury and can relieve soreness, as stretching makes the muscles more elastic, thus, less vulnerable to tearing.
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Stretching should include the large muscles of both the upper and lower extremities. Stretches should be held for 30 seconds and repeated three times.
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Athletes should complete pre-season evaluations. “Medical health providers screen for any signs or symptoms that may indicate an athlete is at an increased risk for injury or illness,” said Dr. Hagen. “The screening focuses on an athlete’s musculoskeletal and medical history, which is comprehensive and includes questions on family history of heart disease and other illnesses. The evaluation should also include a physical exam that focuses on previous injury, agility, body composition and range of motion.”
Fluid Replacement Is Essential
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“It is important to focus on hydration in the summer heat because dehydration and heat illness go hand-in-hand,” said Dr. Hagen.
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To avoid sickness, athletes should acclimatize to drinking increased amounts of fluid by gradually working up from their customary fluid intake to the recommended amount.
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Athletes should start hydrating 24 to 48 hours prior to activity, gradually increasing to about 16 ounces of fluid every two hours. Two hours before exercise, athletes should drink 20 ounces of fluid. Fifteen minutes before exercise, athletes should drink 10 ounces of fluid. Every 10 to 20 minutes during exercise, athletes should drink seven to 10 ounces of sports drink.
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After exercise, athletes should drink 24 ounces of fluid for every pound lost. Athletes should hydrate after their workout with sports drinks, which effectively replace the carbohydrates and electrolytes that athletes can lose during their workout.
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Athletes should abstain from caffeinated drinks and alcohol because they act as diuretics, causing the body to lose fluids.
Good Nutrition Will Fuel the Body
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“To give it your all during practices and games, your body needs to be well-fueled,” said Bonci.
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High school athletes should eat something within one hour of waking up in the morning and every three to four hours after that. If they have afternoon practices and games, they should try to eat or drink something more than just water one hour before activity.
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Pre-practice energy sources should be mostly carbohydrates, such as bread, pretzels, cereal and cereal bars.
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Athletes should try to eat something within 15 minutes of finishing exercise, such as a granola or cereal bar, a handful of crackers or a piece of fruit to help the body to restore and replete more rapidly.
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Athletes should lower their fat intake because fat leaves the stomach slowly and can cause cramping. They also should avoid foods that are high in protein, which increases metabolic heat and water loss.
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Athletes should be careful with supplements. Some, such as ephedra and caffeine, can raise the body’s temperature, increasing the risk of heat illness. Others, such as protein powders, may replace more valuable fuel sources such as carbohydrates. “Do remember that the supplements are the icing, whereas the fuel, fluid and training are the cake. If we just eat the icing, we won’t get very far,” said Bonci.
UPMC Sports Medicine provides certified athletic training services to the largest number of organizations in the region, including 46 high schools and nine colleges. The program, with emphasis on research and education, is part of the region’s largest staff of primary care sports medicine physicians, orthopaedic surgeons, physical therapists, certified athletic trainers and affiliated health professionals to treat all types and aspects of sports-related injuries.
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