Keeping your cool in the heat: Tips for avoiding heat-related illness

Keeping your cool in the heat:  Tips for avoiding heat-related illness

While many think of August as back to school season, it also marks the start of fall sports season. It is the time many athletes begin pre-season conditioning with their teammates. While it is an exciting time for most athletes, a few will suffer from an exertional heat illness.

Exertional heat illness, specifically heat stroke, is among the leading causes of death among young athletes and the rates seem to be increasing. Exertional heat illness is a collection of conditions that includes heat cramps or exercise-associated cramps, heat exhaustion, heat injury and heat stroke. These conditions are on a continuum and may develop into a more serious condition if it goes unrecognized or untreated.

August is a time of high temperatures and humidity in our region. Exercising in these conditions is one of the risk factors for exertional heat illness. Other risk factors include obesity, poor physical condition, prior exertional heat illness, dehydration and certain medications, including some used to treat ADHD, seasonal allergies and seizures.

Signs & Symptoms

It is important to know the signs and symptoms of exertional heat illness in order to start treatment early to prevent serious injury or even death. The signs and symptoms can include:

  • Muscle cramps
  • Dizziness
  • Fatigue
  • Exhaustion
  • Excessive sweating
  • Abdominal cramping
  • Vomiting
  • Diarrhea
  • Passing out

Symptoms of heat stroke, the most serious exertional heat illness, can also include:

  • Disorientation
  • Confusion
  • Seizures

While a lack of sweating has previously been associated with heat stroke, this is incorrect and many with heat stroke will be sweating.


If an athlete is suspected of having exertional heat illness, it is important to begin treating the condition as early as possible, which consists of cooling the athlete.

This can be accomplished in a variety of ways such as moving the athlete to the shade, taking the athlete into an air conditioned area or having them drink cold water. Putting the athlete in a tub of ice water is the preferred way to cool someone with suspected heat injury or heat stroke, but if a tub is not available, then putting cold rags or ice packs behind the neck, in the armpits and in the groin will lower the athlete’s temperature.


There are several ways to prevent exertional heat illness from occurring.

  • Avoid exercise during the hottest parts of the day, typically between 10 a.m. and 4 p.m.
  • Maintain good physical condition year round.
  • Another way to prevent heat illness is by acclimatization, which involves slowly increasing the amount of exercise done in hot, humid conditions over 10 to 14 days to allow the body to get used to exercising in such weather.
  • Finally, make sure the athlete stays hydrated.It is important that athletes start drinking water prior to starting exercise.  On average, an athlete should consume about 16 ounces of fluids at least 30 minutes prior to exercise and continue to drink fluids every 15-30 minutes during practice. It is important to drink plenty of water even after practice is over.

The start of fall sports season in August is an exciting time for athletes and their parents as the anticipation for the upcoming season builds. By knowing and understanding how to spot and treat exertional heat illness we can better ensure the safety of our athletes.


David Rupp, MD

Dr. Rupp is a board-certified, fellowship-trained family medicine physician who specializes in sports medicine. He is an assistant professor with the department of family & community health at the Marshall University Joan C. Edwards School of Medicine.