SPORTS MEDICINE

Dr. Steve Badolato

Elevated Body Temperature Occurs Quickly in Florida Heat

STAYING COOL and well-hydrated while exercising is very important. Brevard County, Florida, with its average high temperatures of 90 degrees and its high relative humidity resulting in "feels like" temperatures topping 100 degrees, can make this a difficult task.

Heat illness as a result of elevated body temperature or hyperthermia can occur in a very short period of time in these conditions.  There are various forms of heat illness, which can potentially harm or even be deadly for individuals exercising outdoors.

What are Heat Cramps?
Heat cramps are painful muscle cramps that can occur in the legs, arms, and abdominal muscles.  The cause is generally believed to be caused by fluid loss and inadequate consumption of fluids and/or electrolytes.  This form of heat illness, although quite painful, will not cause prolonged or permanent health problems.  The remedy for this condition is simple rest in a cool environment, stretch/massage of the affected muscles, and rehydration with a water/electrolyte (sports) drink.

ACCLIMATIZATION to heat, which is the process of physiologic adaptation to a new environment is important to athletes and those from cold weather environments that suddenly begin training in the warmer weather conditions of Florida.

What is Heat Exhaustion?
Heat exhaustion develops after extended periods of exposure to high temperature while exercising.  This may or may not be preceded by heat cramps and is characterized by excessive sweating, electrolyte imbalance especially sodium and potassium, and weakness. Prolonged exposure may lead to dizziness, headaches, nausea, vomiting, and pale, clammy skin.

This situation is common in children and can occur quicker as a result of their decreased body surface area available to dissipate heat while exercising.  Urgent rest in a cool environment, water/electrolyte drink, cool mist fan, elevation of legs, and in some cases even intravenous fluids may be required. Core body temperature of 100.4 F to 104.9 F is the norm for heat exhaustion and, if exercise and exposure continue unabated, this condition can progress to the potentially fatal form of heat illness known as heat stroke.

What is Heat Stroke?
Heat stroke is the most advanced state of hyperthermia.  It occurs when the body absorbs more heat than it can dissipate. A core body temperature typically greater than 104.9 F, which is over 6 F higher than human's average normal temperature of 98.6 F, distinguishes this condition.

Heat stroke results from overload and failure of the body's cooling mechanism, is a medical emergency, and is manifested by mental status changes, irritability, hot dry skin, physical collapse, and cardiovascular shock.  Emergent transport via emergency medical system to the emergency room for intravenous fluids, ice packs to armpits, groin and neck or water immersion is necessary.

Prevention of Heat Illness
Fluid hydration prior to and during exercise is the cornerstone of preventing heat illness.  The following are basic general guidelines prior to hot weather exercise:

• Drink about 16 ounces (5-8 percent carbohydrate sports drink with sodium) two hours before exercise.
• If exercising for a prolonged period of time, attempt to match fluid losses from sweating; replacement fluids can range from 5-10 ounces of cool fluids every 15 minutes depending on your size or about 5 ounces every 30 minutes during exercise for an 80 pound child.
• Post exercise rehydration is important and the required amount of fluids can be determined by measuring pre-exercise and post-exercise body weight; generally replacement of 16 ounces of water for every pound of weight lost is required.
• The time of day you exercise is also important in preventing heat illness. Choosing to exercise in the cooler early morning or late evening hours can greatly reduce your risk of developing heat illness. Exercise apparel should be light and loose fitting to allow for quicker and more efficient cool-down.

Acclimatization Important
Proper conditioning is essential and can be attained with initial exercise sessions being shorter and less intense and then building to higher levels, depending on your level of fitness.

Acclimatization to heat, which is the process of physiologic adaptation to a new environment, is also very important. This process is particularly important to individuals from cold weather environments that suddenly begin training in the warmer weather conditions of Florida. Total adaptation typically requires about two weeks, with the majority adaptation occurring by five days.

Beware the Heat Index
Humidity, temperature, and heat index play a big role in the risk of developing heat illness.  High humidity reduces your body's ability to get rid of excess heat by sweating. At any given temperature, the higher the relative humidity -  which is the water vapor in the air -  the higher the apparent temperature, which is referred to as the heat index ("feels like temperature").   For example, if the air temperature is 86  F and the humidity is 50 percent, the heat index is 88 F. However, at the same temperature of 86  F with the relative humidity of 90 percent, which is not uncommon in Brevard County, the heat index or "feels like" temperature is 105 F.  In other words, your body will have to sweat as much to get rid of extra heat at 86 F with 90 percent humidity in Florida as you would in a dry desert at 105F.

Be careful trying to beat the heat, but if you must, recognition of the early trouble signs and symptoms of heat illness are essential. Remember prevention and know when to say "no" when exercising in hot and humid weather.  A little common sense and education can make exercise and sports during the summertime on the sunny Space Coast safe and enjoyable.

A Florida native, Dr. Badolato received his medical degree from the University of South Florida School of Medicine and did his residency training at St. Vincents' Medical Center in Jacksonville. Dr. Badolato is Board Certified and has fellowship training in sports Medicine with a specialization in non-operative musculaskeletal medicine. Formerly a team physicians at Ohio State University, he was also the medical director for the world-renowned IMG Bollettieri Sports Academy in Bradenton, Florida. You can reach Dr. Badolato at 321-253-2169, or log on to PremierUrgentCare.com

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