Tips To Avoid Exertional Heat Illness.

This article will provide you with information on how to reduce the risk of developing a heat related illness. Read on to learn more.

Each year the media reports at least one tragic story of an athlete who dies from a heat related illness. The sad case is that most of these deaths may have been avoidable if either prevention strategies were implemented or immediate medical attention was available.

Medical professionals are unable to attend all practices or games, so it is important for coaches and athletes to implement strategies to prevent heat related illness as well as recognize common signs that a heat related illness is occurring.

This article will provide you with information on how to reduce the risk of developing a heat related illness. Common signs of heat related illnesses are also presented. A thorough explanation of how to treat a heat related illness falls outside the scope of this article.

Heat related illnesses occur as a result of exercising in high temperatures, exercising while dehydrated or with an electrolyte imbalance, or a combination of the two 4. During exercise, it is normal for one's core body temperature to increase.

If the body does a poor job of dissipating heat though, a heat related illness will develop.

Recognition Of Heat Illness

Exertional heat illnesses range in intensity from heat cramps to the severe critical condition of heat stroke. The onset of heat illness necessitates immediately stopping exercise and seeking first aid treatment. Table 1 presents common signs and symptoms of a few heat related illnesses 1.

Table 1.
Common Signs & Symptoms Of Heat Related Illness

  • Heat Cramps
  • Dehydration Thirst
  • Sweating Fatigue
  • Muscle Cramps
  • Heat Exhaustion
  • Elevated core body temperature Dehydration
  • Dizziness Lightheadedness
  • Headache Nausea
  • Cool, clammy skin Sweating
  • Heat Stroke
  • High body core temperature Dizziness
  • Drowsiness Confusion
  • Irritability Hot and wet or dry skin
  • Vomiting Tachycardia
  • Possible loss of consciousness

Tips To Reduce Your Risk Of Heat Illness

By adopting the following recommendations, you will reduce your risk of experiencing a heat related illness.

Keep Hydrated:

    Many athletes begin practice or an exercise session already dehydrated. Proper hydration at all times is necessary for maintaining vital physiological functions. The National Athletic Trainers' Association (NATA) recommends that athletes should consume 17 to 20 ounces of water or a sports drink 2 to 3 hours prior to exercise and drink another 7 to 10 ounces 10 to 20 minutes before starting exercise to ensure proper hydration 2.

Rehydration And 'Sport Drink' Ingredients!
Not all sports drinks are created equal. Make sure you do your research when picking out these drinks. Below I have broken out what some major sports drinks contain.
[ Click here to learn more. ]

    It is also recommended that one drink 7 to 10 ounces of water or sports drink every 10 to 20 minutes during exercise. After exercising, rehydrate by drinking 20 to 24 ounces of a sports drink or water per pound of weight loss (it is necessary to record your pre exercise weight) 2.


Monitoring Weather Conditions:

    Exercising in hot and humid conditions increases the chance of an individual developing a heat related illness. The use of a sling psychrometer is employed to measure both dry and wet bulb temperatures4.

    What Is A Sling Psychrometer?
    An instrument that uses the difference in readings between two thermometers, one having a wet bulb and the other having a dry bulb, to measure the moisture content or relative humidity of air.

    These readings combined with humidity are used to determine the safety of practicing in hot, humid conditions. If your facility does not have the means to measure the heat stress index, use caution practicing or exercising in a hot and humid environment. You should choose to exercise early in the morning or in the evening when temperatures are cooler.


    Even top athletes who are unaccustomed to hot, humid conditions are at risk for exertional heat illnesses. One must become acclimatized gradually to the heat. Slowly increase your intensity of exercise and duration of exposure to the heat. Usually a period of 7 to 14 days is necessary for full acclimatization4,1,3.

How Long Do You Need To Acclimate To Hot, Humid Conditions?

Less Than 5 Days.
6-8 Days.
8-10 Days.
10-12 Days.
12-14 Days.
At Least 15 Days.


    The use of certain medications can increase the risk of developing a heat related illness. Review with your primary care provider how the side effects of any of your medications will affect your ability to exercise in hot, humid conditions. Even some over the counter medications and supplements (including caffeine and ephedra) may also increase fluid loss4.

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Appropriate Clothing:

Tank Top

    Wearing excessive clothing will affect one's ability to dissipate heat. Wearing dark colored clothing will absorb heat from the environment 1. It is best to wear lightweight, light colored clothing4. If you sweat a lot, during breaks change out of the wet clothing into dry clothing4.


To learn more about heat related illnesses, log on to

This article originally appeared in NSCA's Performance Training Journal, a publication of the National Strength and Conditioning Association. For a free subscription to the journal, browse to

About The Author

Jason Brumitt is a board-certified sports physical therapist that is employed by Willamette Falls Hospital in Oregon City, Oregon. His clientele include both orthopedic and sports injury patients. He provides athletic training to local high schools. He also serves as adjunct faculty for Pacific University's Physical Therapy program. To contact the author, email him at


  1. Binkley HM, Beckett J, Casa DJ, Kleiner DM, Plummer PE. (2002). National Athletic Trainers' Association Position Statement: Exertional Heat Illnesses. Journal of Athletic Training. 37(3): 329-343.
  2. Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Reiff RV, Rich B, Roberts WO, Stone JA. (2000). National Athletic Trainers' Association Position Statement: Fluid Replacement for Athletes. Journal of Athletic Training. 35(2): 212-224.
  3. Girard Eberle, Suzanne. (2000). Endurance Sports Nutrition. Champaign, IL: Human Kinetics.
  4. Landry GL, Bernhardt DT. (2000). Essentials of Primary Care Sports Medicine. Champaign, IL: Human Kinetics.