1. Heat Illness & Hydration John Neidecker, DO, ATC Sports Medicine Physician Cooper Bone & Joint Institute

2. Why do we sweat? To cool the body down High body temperatures can lead to organ damage As muscles contract – heat is produced

3. How do we sweat? Neurological response Skin blood vessels vasodialate – stimulating sweat glands Sweat evaporates and cools the skin

4. What does sweat contain? Water Urea Electrolytes –Sodium

5. The composition is highly variable between individuals Person Environment Body weight Acclimated/Fitness level

6. Performance & Hydration Performance has been shown to decrease secondary to dehydration –Physically –Mentally Decreases start to happen when there is a decrease in total body water of 2%

7. Performance & Hydration People do not perceive the feeling of being thirsty until there is a decrease in total body water of 3%

8. When things go wrong… Sweat response becomes dysfunctional resulting in –An increase in body temperature –An electrolyte imbalance

9. Electrolyte Imbalance Levels too high or too low can cause –Arrhythmias –Seizure –Brain damage

10. Hyperthermia Increase in body temperature can lead to –Heat Stroke –Heat Exhaustion –Heat Cramps

11. Heat Stroke Defined by –Body temp > 104 F –CNS Dysfunction –Organ Damage

12. Heat Exhaustion Inability to continue exercising Brain mediated “safety break” Temperature not as high as HS

13. Heat Cramps Painful muscle cramps –calves Associated with large amounts of sodium loss

14. Who’s at risk for heat illness? Those who have had it before Out of shape/Unacclimatized Overweight Age

15. Warning signs Change in mental status Dizziness Difficulty walking Vomiting Hyperventilation

16. Confused with Concussion Take a temperature

17. What to do if suspected Remove athlete from play!!!!! Call EMS Place athlete in a shaded area Ice –Emersion –Bags on head, neck, armpits, groin

18. Quick Aside Sickle Cell Trait –Not a heat illness –Crisis triggered by Dehydration Hypoxemia –NCAA D1 – Screening –Does not disqualify from participation

19. Prevention Go into practice fully hydrated Wear light colored, loose fitting clothing Exercise during the cooler parts of the day Acclimate over time –Start 10-14 days before training camp –Start at 10 minutes –Increase by another 10 minutes every 2 days

20. Hydration Guidelines Drink 16 oz of water or sports drink one hour before exercise Drink 4-8 oz every 15-20 minutes of exercise Exercising less than an hour, drink water Exercising more than an hour, drink a sports drink »16 oz is about half a liter

21. After Exercise Hydration Weigh yourself before and after practice –For every 2 lbs lost drink 48 oz If your urine is dark – you are not drinking enough

22. History of Gatorade Created by researchers at the University of Florida in 1965 –“Gator”-aid Legend of the 1967 Orange Bowl win over Georgia Tech

23. Pickle Juice Anecdotally, helps with muscle cramps High in sodium

24. Chocolate Milk Post-work out drink Increase protein synthesis Increases muscle glycogen 16 oz about 40 min after work out Low-fat

25. References Armstrong, LE, et. al, American College of Sports Medicine Position Stand: Exertional heat illness during training and competition., Med Sci Sport Exer. 2007. pgs 556-572 Sawka, MN, et. al, American College of Sports Medicine Position Stand: Exercise and fluid replacement., Med Sci Sport Exer. 2007. pgs 377-390