What You Need to Know About Playing Sports in Extreme Heat

how-much-drinking-water-do-we-need_71690_990x742Too hot to play? We have seen extreme temperatures these past few years all over the country…even in Orange County, a region with very moderate temperatures, we have recently seen a few days of extreme heat, then normal temperatures, then extreme heat. This makes it difficult for young athletes to acclimate to the hotter weather, making them more inefficient at staying cool while playing sports. I must admit, this is probably the first time I’ve been happy both of my kids play ice sports!

It is important during these hot, hot days that coaches, parents and players recognize there are adjustments that need to be made in order to keep everyone safe. Heat related illnesses are the second most common type of sports injury in young athletes, and they’re completely preventable!

First, let’s review heat related illnesses, because as coaches, parents and players, we need to be able to recognize and quickly treat these potentially life threatening conditions.


Dehydration increases the risk of heat illness. The symptoms outlined below do not necessarily occur in an orderly, predictable progression. A young athlete could experience heat stroke in absence of other indicators.

I’ve written about the signs and symptoms of dehydration in my Blog on Hydration, so let’s focus on heat exhaustion and heat stroke.

  • Heat Exhaustion 

As a young athlete becomes dehydrated, the likelihood of heat exhaustion increases if left untreated.

Common symptoms of heat exhaustion are:

  • Dizziness & fatigue
  • Feeling chilly
  • Rapid pulse

Treatment of heat exhaustion is similar to that of dehydration and should take place immediately. This treatment includes:

  • Rest the child in a cool, shaded and place ice cold towels on them
  • Drink a sports drink that contains electrolytes
  • Have the child lie down with legs elevated to promote circulation
  • Athlete should begin to feel better relatively soon, if not, assume heat stroke
  • Heat Stroke

Heat stroke is a medical emergency! It can result in death when not recognized promptly and treated properly. Damage to critical organs can occur if the organs remain overheated for an extended period of time (even just 30 minutes), hence the need for rapid cooling.

Symptoms of heat stroke include:

  • Very high core body temperature (measured rectally because other sites are not valid immediately following intense exercise in the heat)
  • Altered mental function (i.e. confusion, unconsciousness, altered mental status, feeling out-of-sorts, extreme lethargy)
  • An otherwise healthy athlete collapses during intense exercise in the heat

It is important to distinguish that athletes get better relatively quickly with heat exhaustion, but they get worse with heat stroke. Heat stroke must be treated immediately by doing the following:

  • SEEK MEDICAL ATTENTION IMMEDIATELY. Heat stroke is a medical emergency. Always transport a suspected exertional heat stroke to the hospital!
  • Do NOT wait for paramedics to arrive! Immediately begin to cool the athlete down by whatever means possible −An ice bath (holding head out of bath) −Ice packs over as much as body as possible −A cool shower −Cool, wet towels −Water spray

Do not provide fluids since nausea and vomiting are extremely common. Remove the player from cooling source(s) when core temperature is lowered to 102 degrees F.

Precautions when practicing or playing in extreme heat

  • Young athletes MUST drink during the day, BEFORE practice, ideally at least 16 ounces of water 2 hours before practice. DURING practice, they should drink 8-12 ounces of fluid every 20-30 minutes. In extreme heat, players should use a sports drink while practicing, for adequate electrolyte replacement.
  • Players should wear loose, light-colored clothing if possible, and only necessary additional gear.
  • Have someone (ideally not a coach) in charge of monitoring players for signs of dehydration, muscle cramping, heat exhaustion and heat stroke.
  • Make sure there’s a shady area to cool down between plays or during breaks
  • If a player feels weak, dizzy, nauseous or lightheaded, notify the coach immediately!

Hope everyone stays safe and cool!

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