Chapter 6: Environmental Conditions

Environmental stress can adversely impact an athlete’s performance and pose serious health threats Areas of concern Hyperthermia Hypothermia Altitude Exposure to the sun Lightening storms Air pollution Circadian dysrhythmia

Hyperthermia Heat Illness - Athletic trainers require knowledge and information concerning temperature, humidity and weather to adequately make decisions regarding environmental dangers Has caused a number of deaths over the years We must manage heat stress appropriately

Heat Stress Extreme caution should be used when training in the heat (overexposure could result in heat illness) It is preventable Athletes that train under these extreme conditions are at risk Physiologically the body will continue to function if body temperature is maintained Body must dissipate heat to maintain homeostasis

Methods of Heat Exchange Metabolic Heat Production Normal metabolic function results in production of heat (will increase with intensity of exercise) Conductive Heat Exchange Physical contact with objects resulting in heat loss or gain Convective Heat Exchange Body heat can be lost or gained depending on circulation of medium Radiant Heat Exchange Comes from sunshine and will cause increase in temperature

Evaporative Heat Loss Sweat glands allow water transport to surface Most effective method Evaporation of water takes heat with it When radiant heat and environment temperature are higher than body temperature, loss of heat through evaporation is key Lose 1 quart of water per hour for up to 2 hours Air must be relative water free for evaporation to occur relative humidity of 65% impairs evaporation relative humidity of 75% stops evaporation

Monitoring Heat Index Heat, sunshine and humidity must be monitored closely Wet bulb globe temperature index (WBGT) provides objective measure for determining precautions concerning participation in hot Sling Psychrometer - Measures relative humidity WBGT incorporates different thermometer readings Dry bulb (standard mercury temperature) Wet bulb (thermometer with wet gauze that is swung around in air)

Heat Illnesses Heat rash (prickly heat) Benign condition associated with red, raised rash, combined with prickling with sweat Result of continuously wet un-evaporated sweat Continually toweling the body will prevent Generally localized to areas covered with clothing

Heat Syncope (heat collapse) Associated with rapid fatigue and overexposure, standing in heat for long periods of time Caused by peripheral vasodilation, or pooling of blood in extremities resulting in dizziness and fainting Treat by placing athlete in cool environment, consuming fluids and laying down

Heat Cramps Painful muscle spasms (calf, abdominal) due to excessive water loss and electrolyte imbalance Occurs in individual in good shape that overexert themselves Prevent by consuming extra fluids and maintaining electrolyte balance Treat with fluid ingestion, light stretching with ice massage Return to play unlikely due to continued cramping

Exertional Heat Exhaustion Result of inadequate fluid replacement Will exhibit signs of profuse sweating, pale skin, mildly elevated temperature, dizziness, nausea, vomiting or diarrhea, hyperventilation, persistent muscle cramps, and loss of coordination Core temperature will be <104o Immediate treatment includes fluid ingestion (intravenous replacement, ultimately), place in cool environment, remove excess clothing Must continue to monitor vital signs

Return to play – must be fully hydrated and be cleared by a physician Unable to sustain adequate cardiac output May develop heat cramps or become faint/dizzy Performance may decrease

Exertional Heatstroke Serious life-threatening condition, with unknown specific cause Characterized by sudden onset - sudden collapse, LOC, CNS dysfunction, flushed hot skin, minimal sweating, shallow breathing, strong rapid pulse, and core temperature of > 104o F Breakdown of thermoregulatory mechanism

Drastic measures must be taken to cool athlete Strip clothing Sponge with cool water Do not immerse in water Transport to hospital immediately Cool first, transport second Athlete should avoid exercise for a minimum of one week and gradually return to full practice Must be asymptomatic and cleared by physician

Malignant hyperthermia muscle disorder causing hypersensitivity to anesthesia and heat Similar S&S to heatstroke - muscle biopsy is needed to detect Athlete will complain of muscle pain after exercise Temperature will remain elevated 10-15 minutes following exercise Athlete with condition should be disqualified from competition in hot, humid environments

Acute Exertional Rhabdomyolysis Sudden catabolic destruction and degeneration of skeletal muscle (myoglobin and enzyme leakage into vascular system) Occurs during intense exercise in heat and humidity resulting in: gradual muscle weakness, swelling, pain, dark urine, renal dysfunction severe case = sudden collapse, renal failure and death Associated with individuals that have sickle cell trait Should be referred to a physician immediately

Exertional Hyponatremia Fluid/electrolyte disorder resulting in abnormally low concentration of sodium in blood Caused by ingesting too much fluid before, during and after exercise May be result of too little sodium in diet or in ingested fluids over a period of prolonged exercise Athletes that ingest large quantities of water and sweat over several hours are at risk (marathon, triathlon) Preventable – must maintain balance

Preventing Heat Illness Common sense and precaution Consume fluids and stay cool Fluid and Electrolyte Replacement Body requires 2.5L of water daily when engaged in minimal activity 1-2% drop in body weight (due to dehydration) results in thirst If thirst is ignored, dehydration results in: nausea, vomiting, fainting and increased risk for heat illness

Using Sports Drinks More effective than just replacing fluids with water Replaces fluids and electrolytes Water alone can prematurely stop thirst response and initiate fluid removal by kidneys Optimal CHO level is 14g per 8 ounces of water More CHO results in slower absorption Small amounts of sodium help in retention of water Flavoring results in increased desire to consume Different drinks have different nutrient levels Effective for both short term and endurance activities

Gradual Acclimatization Most effective method of avoiding heat stress Involves becoming accustomed to heat and exercising in heat Early pre-season training and graded intensity changes are recommended with progressive exposure over 7-10 day period 80% of acclimatization can be achieved during first 5-6 days with 2 hour morning and afternoon practice sessions

Identifying Susceptible Individuals Athletes with large muscle mass Overweight athletes (due to increased metabolic rate) Death from heat stroke increase 4:1 as body weight increases Women are physiologically more efficient with regard body temp. regulation Others that are susceptible include, those with poor fitness, history of heat illness, or febrile condition

Uniform Selection Weight Records Dress for the weather and temperature Based on temperature and humidity Avoid rubberized suits Weight Records A 3-5% loss of BW will reduce blood volume and could be a health threat Keep track of before and after measures for first two weeks If increase in temperature and humidity occurs during the season, weights should again be recorded

Guidelines for Athletes Who Intentionally Lose Weight Predispose themselves to heat related injuries and could create life-threatening situations Weight loss should not be accomplished through dehydration NCAA and high school federations have established guidelines for weight loss in wrestling Gradual process over weeks and months and should be a result of body fat lost