Through an Athletic Trainer’s eyes: Heat Illness

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On August 1st, 2016 the boys of Eastland High School gathered on the field for the first practice of summer camp; otherwise known as two-a-days. As the Athletic Trainer, hydration and heat illness during the hot August days is always at the top of the priority list. As stated by the UIL, “During the 1995 through the 2000 football season there have been 17 heat stroke deaths in football”². Although the first practice occurred in the morning, the boys did not take into consideration how much water they would need to drink leading up to those first drills. Although, the majority of the boys had been participating in summer workouts the addition of full pads on day 5 of practice creates a whole new situation.

Acclimatization to full pads is required by the University Interscholastic League (UIL). The coaches must follow a progression from helmets only (lasting from Aug. 1st to Aug 4th) to full pads on August 5th. It is to be noted that the dates may vary based on the classification of the school. On August 5th, the ball gets rolling; the boys are allowed full contact.²

The UIL has provided a list of precautions/recommendation that the coaching and athletic training staff should follow:

1. Every athlete should complete a medical and a pre-participation form
2. Gradual acclimatization to hot weather
3. Water is to be available in unlimited quantities
• A ten minute water break is suggested for every 30 minutes of heavy exercise in the heat.
4. Be aware of the temperature and the humidity
• Acknowledge the surface of the field (artificial turf, grass)
5. The use of weight charts
• Athletes should weigh in prior to and after practice
• 3% weight loss through sweating is safe
6. Know the stages of heat illness²

In the state of Texas, the athletic trainers and coaching staff must be able to identify when an athlete is suffering from heat illness. Heat illness is divided up into classifications based on severity.

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Stage one: Heat edema (swelling) is the beginning stages of heat illness. The first symptom an athlete may show would be sudden and excessive sweating during physical activity.¹

Stage two: Heat cramps are the second sign of heat illness. Heat cramps are “painful spasms of the skeletal muscles”.¹

Stage three: Heat syncope (temporary loss of consciousness. The individual will lose consciousness due to an inadequate cardiac output and postural hypotension caused from prolonged standing or the sudden movement of sitting or lying position to and standing position. Some other symptoms of heat syncope are weakness and fatigue.¹

Stage four: Heat exhaustion is the inability to continue exercising. Common symptoms may include: profuse sweating, headaches, weakness, vertigo, heat cramps, chills, nausea/vomiting, tachycardia, hypotension, and irritability.¹

Stage five: Heat stroke is the most severe form of heat illness. Symptoms of heat stroke are absence of sweat, disorientation, seizures, and are possible for the athlete to become unconsciousness.¹

As the days went by and the Eastland High football boys become more acclimated to the Texas’ heat, the risk of heat illness decreased. Throughout summer camp, as the athletic trainer, being on high alert for any of the heat illness symptoms was just as important as any other possible injury. Being aware and understanding the severity of heat illness can save a life.

References:

¹Coris, E. E., Ramirez, A. M., & Durme, D. J. (2004). Heat Illness in Athletes. Sports Medicine, 34(1), 9-16. doi:10.2165/00007256-200434010-00002

²T. (2014, October 10). Heat Stress and Athletic Participation. Retrieved September 15, 2016, from http://www.uiltexas.org/health/info/heat-stress-and-athletic-participation