Ahead of the Game

Heat stroke is a real danger during summer sports

Tips for avoiding heat stroke during summer sports.

At a certain point in the summer, just walking and breathing outside feels oppressive, much less running a mile or playing a game of soccer.

But many sports are still going on — or are just getting underway — as the temperatures and humidity soar. On the one hand, you don’t want your kid melting at the first bead of sweat. On the other, you don’t want to take unnecessary health risks.

Tragedies and illness, which range from kids collapsing on fields to sunburn, can be prevented.

“The days of ‘suck it up’ and ‘run till you puke’ — those days are gone,” says Brian P. Layton, athletic specialist for Anne Arundel County Public Schools. “The mindset has changed.”

With good reason. 

Last year, a Morgan State University football player died from heatstroke. He was 18.

And there have been local and national tragedies. A Montgomery County 16-year-old collapsed during football practice in 2009, and later died from heat and dehydration, according to medical reports. And in 2001, a NFL player died of heatstroke.

“It’s a subject more people are aware of,” says John Ellinger, technical director of the Soccer Association of Columbia/Howard County.

Many schools and teams now monitor the heat index and have defined breaks for athletes, and even cancel practice and games if the temperature exceeds a certain level.

“We also encourage common sense,” Ellinger says. “If the coaches agree, there can be even more breaks.”

The team coordinators also try to avoid having two games on hot days, he says.

When the heat index reaches 104, games and practices at Anne Arundel Public Schools are canceled. And 10-minute water breaks every 30 minutes are mandatory when the heat index reaches 100 degrees.

Coaches and trainers are also looking for signs of heat illness. At the mildest stage, an athlete might have cramps. But it can escalate to heat exhaustion, and, at its most severe, a heatstroke.

“It’s a spectrum disease,” says Dr. Claudia Dal Molin, an osteopathic physician specializing in sports medicine and orthopaedics at the University of Maryland Medical Center.

High humidity and physical exertion can prevent sweat from evaporating properly, which causes the body temperature to rise. If it rises too quickly and too high, to 106 degrees or higher, heatstroke can occur, causing organ damage and, potentially, organ failure.

Symptoms include nausea, dizziness, weak or rapid pulse and confusion.

Antihistamines used to treat allergies and medicine for Attention Deficit Hyperactivity Disorder can make athletes more susceptible to heat illness, Dal Molin says.

Once an athlete has suffered a heat-related illness such as heat exhaustion, he or she is more likely to have another episode.

“It’s just like if you have a concussion, you’re more likely to have another one, but we’re not totally sure why,” says Dal Molin.

Acclimation is important, Dal Molin and other experts say. It’s helpful to gradually build up endurance in hot weather.

“Your body will accept that it’s normal,” she says.

Most of all, parents and coaches should stress hydration — not just during and after the game or practice, but also before, experts say.

“The biggest mistake people make is adequate hydration,” Dal Molin says. “You’re losing water, and also salt.”

While some electrolyte replacement drinks are criticized for their sugar content, during strenuous activity in hot weather, they’re valuable, she and other experts say.

A popular choice for student athletes is Motive Pure electrolyte hydration liquid concentrate mixed with water, says Andy Shilling, lacrosse coach at Boys’ Latin School of Maryland and Baltimore Lacrosse Club.

“If you’re not hydrating a few days before a game, you’re already behind,” he says. “It’s a fairly big concern, especially in the summer.”  

From the Experts:

Acclimate to the hot conditions. Begin practicing under the conditions you’ll be playing in slowly, over several weeks.

Hydrate before, during and after the game or practice.

If there isn’t shade, bring it with you. Umbrellas, pop-up tents and canopies work well on the sidelines.

Work with coaches and referees to incorporate more breaks than just between quarters and at half time.

Have a cooler with water, ice and rags available so athletes can cool their bodies.

Avoid caffeine, antihistamines and amphetamines (ADHD medicine) before playing sports or exercising in the heat.

Apply sunscreen every two hours.

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