Preventing Exercise Thermal Distress

The problems of thermal distress can be minimized by following a few simple heat injury prevention principles:

1. Ensure that athletes are in good physical condition. There should be a gradual increase in intensity and duration of training in the heal until the athletes are fully acclimatized.

2. Ensure that athletes avoid becoming overheated before exercising in a hot environment (i.e., that they avoid pre-exercise heat storage).
3. Be aware of the early symptoms of heat injury, such as thirst, fatigue, lethargy, and visual disturbances.
4. Clinical signs of hyperthermia are typically more meaningful than temperature measurements. Core temperature is often underestimated because common sites of temperature measurement (i.e., mouth or axillary sites) are too superficial.
5. Athletes should not run faster than their normal training intensity.
6. Athletes should not compete if they have any illness accompanied by fever or had a fever shortly before the event. Other conditions that decrease heat tolerance include sleep loss, glycogen depletion or hypoglycemia, or recent heavy alcohol consumption (i.e., "hangover") for heat injury prevention.
7. Schedule practice sessions and games during the cooler times of the day.
8. Modify or cancel sessions when the wet bulb globe temperature is 25.5 degrees or greater. Wet bulb temperature is used to determine humidity and black globe temperature is an indication of radiant heat.
9. Plan for regular fluid breaks. Have athletes drink approximately 200 ml (1 cup) of fluid replacement beverage every 15-20 minutes.
10. Supply a drink that’s cold (8 - 13t) and contains some carbohydrate (6-8g/100ml), with a small amount of electrolytes (sodium/potassium).
11."Tank - up" before practice or games by drinking 600 ml (2.5 cups) of fluid two hours before the activity and an additional 400 ml (l.5 cups) 15 minutes before.
12. Fluid replacement should be particularly encouraged during the early stages of practice and competition. As exercise progresses, splanchnic blood flow decreases, which diminishes water absorption from the gut.
13. Athletes should be weighed every day before practice. Any athlete showing a decrease of 2 - 3% should consume extra fluid. Athletes with weight losses of 4 - 6% should decrease training intensity, and those with weight losses greater than 7% should consult a physician. People who lose a lot of weight in the heat should be identified and closely monitored for heat injury prevention.
14. Salt tablets are prohibited. However, athletes should be encouraged to consume ample amounts of salt at mealtime.
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