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Continued from Page 8 exercise in the heat but can also occur in “normal” environmental conditions. It is important to understand how EHIs occur and how to spot the signs and symptoms of EHIs in order to prevent emergency medical conditions and/ or death.

There are five classifications of EHIs according to the National Athletic Training Associations (NATA) position statement:

— Exercise-Associated Muscle Cramps (EAMCs) – they are sudden or sometimes progressively and noticeably evolving, involuntary, painful contractions of skeletal muscle during or after exercise. The signs and symptoms of mild EAMCs are tics, twinges, stiffness, tremors, or contracture, and may or may not be painful. Although causes are not fully confirmed, proposed factors and conditions include dehydration, electrolyte imbalances, altered neuromuscular control, fatigue, or any combination of these factors.

— Heat Syncope – orthostatic dizziness (fainting). Often occurs in unfit or heat-unacclimatized persons who stand for a long period of time in heat or during sudden changes in posture, especially when wearing a uniform or insulated clothing that encourages and eventually leads to maximal skin vasodilation (more blood near the skin). The factors that can lead to heat syncope are dehydration, venous (vein) pooling of blood, reduced cardiac filling, or low blood pressure with resultant cerebral ischemia (inadequate blood supply to the brain). Heat syncope usually occurs during the first 5 days of unaccustomed heat exposure (e.g. during preseason training), before the blood volume expands and cardiovascular adaptations are complete, and in those with heart disease or taking diuretics.

— Heat Exhaustion – the inability to effectively exercise in the heat, secondary to a combination of factors, including cardiovascular insufficiency, hypertension, energy depletion, and central fatigue. This condition occurs when the core body temperature is elevated (105ºF) and is often associated with a high rate or volume of skin blood flow, heavy sweating, and dehydration. It occurs usually in hot or humid condi- tions, but it can also occur in normal environmental conditions with intense physical activity.

— Heat Injury – is a moderate to severe heat illness characterized by organ and tissue injury associated with sustained high body temperature resulting from strenuous exercise and environmental heat exposure. (Body temperature is not always greater than 105ºF.

— Exertional Heat Stroke (EHS)

– this is the most severe EHIs!! it is neuropsychiatric impairment and a high core temperature, typically above 105º F. This is due to the combination of the body’s increase in core temperature caused by metabolic heat production and environmental heat load. The thermoregulatory system becomes overwhelmed due to excessive heat production and/or inhibited heat loss (i.e., decreased sweating or decreased ability to evaporate sweat). The first sign of EHS is central nervous system dysfunction which includes: collapse, aggressiveness, irritability, confusion, seizures, and altered consciousness. EHS can progress to a systemic inflammatory response and multi-organ system failure unless promptly and correctly recognized and treated.

WARNING: The risk of morbidity and mortality increase the longer an individual’s body temperature remains elevated above 105 degrees.

Prevention and Treatment of Exertional Heat Illness

Each exertion heat illness is not treated the same.

Prevention

• Pre-participation medical screening before the start of the season to identify risk factors of heat illness.

• Acclimatized to the heat gradually over 7-14 days.

• Athletes who are currently sick with viral infections or other illness or have a fever or serious skin rash should not participate until the condition is resolved.

• Maintain hydration and appropriately replace fluids lost through sweat during and after games and practices. Eat or drink sodium-containing foods.

• Get proper sleep and rest (at least 7 hours a night).

• Eat a balance diet to replenish energy reserves.

• Rest breaks during physical activity should be planned.

Treatment

• Exercise-Associated Muscle (Heat) Cramps

• Treatment – Stop exercising, provide sodium-containing beverages

• Recovery – Often occurs within minutes to hours

• Heat Syncope

• Treatment – Lay patient supine and elevate legs to restore central blood volume

• Recovery – Often occurs within hours

• Heat Exhaustion

• Treatment – Cease exercise, remove from hot environment, elevate legs, provide fluids

• Recovery – Often occurs within 24 hours; same-day return to play not advised

• Exertional Heat Stroke

• Treatment – Immediate wholebody cold-water immersion to quickly reduce core body temperature and call 911

• Recovery – Highly dependent on initial care and treatment; further medical testing and physician clearance required before return to activity

Knowing what to look out for and how to treat exertional heat illnesses could be lifesaving. Planned ahead and be aware of environmental conditions during physical activity. Environmental conditions do not need to be at extreme levels for EHIs to occur. Be prepared and be ready to act if needed. When in doubt, sit out.

For more information, visit NATA. org.

Ryan Ramirez is a certified athletic trainer at Compete Sports Performance and Rehab in Orange County.

As athletes begin the school year, a very hectic schedule begins to build.

As the school year unfolds and homework loads, along with activities and sports practices beginning to increase, it is easy for an athlete to get caught up in the craziness of the year. This leads to less sleep, less hydration, and greater training loads for athletes, which all decrease an athlete’s ability to perform.

Here are three practical tips on how to increase your performance this school year.

1) Time Management/Sleep

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It is a very common occurrence to see athletes studying late at night after they have gotten home from their late-night practices. While this is important for athletes to maintain good grades, it is often an indicator of poor time management if the athlete is staying up into the late hours of the night every night. As an athlete, it is vital that you utilize every portion of free time to either sleep, eat, or get your schoolwork done. Utilizing your free time will in turn help you increase your amount of time to sleep, rest, and recover. Athletes are recommended to sleep a minimum of seven hours and on top of that spend time recovering in between or after practices (ice, foam roll, stretching, etc.).

2)

As the school year begins, the practice load for most athletes begins to ramp up. So it is important that the athlete takes the time to figure out how they will approach the coming school year to train at a high volume but not over reach or over train. Most coaches preach that more is better, but sometimes that isn’t the case. For most sports, the human body cannot handle 30-plus hours a week of repeating the same motions. Now, this doesn’t mean that you should skip practice or not work hard. But rather it is recommended that athletes take a look at their training schedules with their coaches/ trainers to see if there is any way that they can adjust the work to rest ratio for the athlete. Most elite athletes spend 25-35 hours a week training, however most elite athletes have built up to this amount of time and spend nearly just as much time recovering. So if you plan on training at a high volume, then you need to recover just as much. If you find yourself training 30-40 hours a week, it is recommended that you drop a small amount of time from that training and use that time to focus on another part of your sport. (An example of this for a football or soccer player would be to maybe take a couple hours a week of training and use them to watch film and break it down, instead of using that time to hit the weight room for the fifth time of the week). This allows you to better your game but also physically rest.

Often people underestimate the power of your diet and hydration and how it can affect your performance. When it comes to diet during school, it is important for most athletes to be consuming a diet of more calories and protein than a normal person. In order for an athlete to properly prepare for workouts and to heal any damaged muscles from workout sessions, it is imperative that the athlete be eating consistent meals of good nutritional value. Eating balanced meals with all food groups included is what will benefit many athletes in their performance. In order to perform at a high level, you need to take the time as an athlete to consider many of these aspects. This will increase your likelihood of high performance and therefore help you have a better season as an athlete. Tanner Smith is a strength coach at Compete Sports Performance and Rehab in Orange County.