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Exercising in the Heat

The summer months are finally upon us, and with that comes getting outside and active in the heat! While it may feel great to feel the sun and the sweat after many months of cold, gray winter, exercising in the heat poses its own risks and should be monitored for signs of heat injury.  Especially here in the Northern Michigan, where the winters are so long, we have to be patient and let our bodies adapt to exercising in the heat.  In this month’s article we are going to go over the signs and symptoms of the three levels of heat injury, and what to do if you find yourself in these situations.

Level 1- Exercise Associated Muscle Cramping (EAMC)

The first level of heat injury is muscle cramping. Muscles that cramp during exercise in heat are trying to tell you that there is a deficiency or you are reaching your exercise limits for that level of heat/conditioning.  These are often caused by muscle fatigue and/or by large losses of water and sodium through sweat.  The specific muscle that cramps is often random, but does signify a more systemic loss of water and sodium.  The treatments for EAMC include: ingesting electrolyte rich fluids; rest; and stretching the affected. While the condition itself is not considered serious, it needs to be recognized and addressed as it can be a precursor to more serious complications. 

Level 2- Exertional Heat Exhaustion

Exhaustion is defined as the “inability to continue to exercise”, it can occur in all temperatures, and may or may not be associated with physical collapse.  Exhaustion may actually be a mechanism put in place by the brain to forcefully stop the body from continuing to exercise in dangerous temperatures.  Signs of heat exhaustion include: pale, ashen skin; headache; weakness; dizziness; “heat sensations”; chills; nausea; vomiting; and decreased muscle coordination.  An athlete with this clinical picture should be placed in a shaded area, have extra clothes removed, be placed on their back with the legs raised and have their vitals monitored very closely.  If the athlete is able, an electrolyte rich drink should be ingested as soon as possible. External cooling, such as ice packs, will also help speed along recovery.  The majority of heat exhaustion will respond to these measures. But, if symptoms persist or worsen, they should be transported to an emergency facility immediately. 

Level 3- Exertional Heatstroke (EHS)

Heatstroke is defined by a core temperature exceeding 104 degrees.  While heatstroke includes the symptoms from heat exhaustion, the significant symptom that distinguishes heatstroke from heat exhaustion is a rapid decline of the central nervous system (CNS). A decline in the CNS may present itself as a change in personality, irritability, disorientation, confusion, delirium and profound fatigue.  EHS is a life-threatening medical emergency that requires immediate whole-body cooling.  Emergency protocols should be activated and cooling should begin as soon as possible, even before emergency professionals arrive. The best method is cold/ice water immersion, such as in an ice bath.  If one is not available, ice packs should be applied to the neck, armpits and groin and rotated frequently to keep the athlete cool until emergency personnel arrive. Even if the EHS athlete mildly improves with cooling methods, emergency procedures should still be followed, as the athlete can re-heat quickly after the cooling methods are stopped.  The bottom line: If there is any possible concern of heat stroke, emergency protocols should be activated, and the athlete cooled until they can be taken to an emergency facility.  

Summers are great for getting outside and exercising, but be sure to stay hydrated, find shade, cool down, and pay attention to signals from your body so you can stay safe and healthy!