Hydration / Heat Illness

Heat-induced illness is one of the most preventable sports injuries. Parents, young athletes and coaches need to understand the factors that put children and adolescents at risk for heat-related illness and take steps to prevent it. Children face unique stresses when they exercise in the heat. Like adults, young players may have trouble adapting to the demands of soccer practice and game situations played in high temperatures. Problems can be made worse when the young player is dehydrated. Unchecked dehydration increases the the risk of heat illness.

Heat illnesses are three separate degrees of severity: heat cramps, heat exhaustion, and heat stroke (the most serious and deadly heat illness). The symptoms outlined below are not always additive and do not necessarily occur in an orderly, predictable progression. A young athlete could experience heat stroke in absence of other indicators.

Dehydration – Warning Signs

Dehydration during exercise is a common problem. Some young athletes can begin to suffer the consequences of dehydration if they become dehydrated by just 2 percent of their body weight during exercise in the heat. That’s why it’s important to recognize the warning signs, which are as follows:

• Noticeable Thirst
• Irritability
• Decreased performance
• Fatigue
• Weakness
• Nausea
• Headache
• Muscle cramping
• Dark yellow urine (or no desire to urinate)
• Lightheaded feeling or dizziness
• Difficulty paying attention

Dehydration – Treatment

Treating the symptoms of dehydration is crucial in preventing more serious conditions such as heat exhaustion may include:

• Rest the player in a cool place
• Provide a sports drink containing electrolytes
• Prevent dehydration in the future by insuring the player consumes fluids before, during and after exercise (educate everyone and allow ample time to re-hydrate)

Muscle Cramping – Signs and Symptoms

Muscle cramping can be associated with exposure to excessive heat. Painful involuntary whole-body muscle cramps are often associated with loss of fluids and sodium.

Some of the signs and symptoms of muscle cramps may include:

• Muscle spasms
• “Knotting” of muscles and muscle pain
• Excessive sweat loss
• Excessive saltiness of sweat over the skin or visible dried salt on the skin
• Excessive dehydration

Muscle Cramping – Treatment

To treat a young athlete suffering from muscle cramps:

• Have them drink fluids with electrolytes, like a sports drink
• Gently stretch and massage cramped muscles
• Have them rest in a cool, shaded area
• Apply ice to the cramped area
• Consider additional sodium in palatable food source, like pretzels, etc.

Heat Exhaustion – Signs and Symptoms

As a child becomes dehydrated, the likelihood of heat exhaustion may increase if left untreated. Eventually, fatigue and exhaustion occur because the cardiovascular system can no longer support both exercise and control the core body temperature.

Common symptoms of heat exhaustion may include:

• Dizziness & fatigue
• Feeling chilly
• Rapid pulse

Heat Exhaustion – Treatment

Treatment – 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 – Signs and Symptoms

Heat stroke is a medical emergency. It can result in death when not recognized promptly and treated properly. Exertional heat stroke occurs when the thermoregulatory system is overwhelmed, fails to act in an appropriate manner, or both. Damage to critical organs can occur if the organs remain overheated for an extended period of time, hence the need for rapid cooling. If rapid cooling does not occur, the cellular damage to the organs could be extreme and have fatal consequences.

Symptoms and results of heat stroke may include:

• Very high core body temperature
• Altered CNS 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

Heat Stroke – Treatment

Treatment – It is important to remember that 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! It is probably safe to say that you are not qualified to treat exertional heat stroke.
• Immediately begin to cool the victim down by whatever means possible:
  • An ice bath is preferable due to the superior cooling rates (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.

Please click here for the Colonial Soccer Club emergency action plan for heat-related illnesses. 

Please visit the USA Soccer Environmental Conditions for more information, or download their PDF on heat guidelines.