Beat the Heat

How hot is too hot?

Unfortunately, there is no "magic number" to answer this question. There are numerous factors that decide this, including physical condition and genetics. And it doesn't have to even be hot outside, some people just react differently to different environments.

In fact, a study in the Journal of Medicine and Science in Sports and Exercise discusses a "well-trained male runner in his late 30s" who collapsed just a mere ten meters short of the finish line of a marathon from heat stroke. His body was at a core temperature of 105.3 degrees Fahrenheit half an hour after he collapsed. And the real kicker here - the temperature outside?A high of 49 degrees. Fahrenheit. No, not Celsius, Fahrenheit. And remember, this was a seasoned athlete here, not some out of shape weekend 2-mile runner.

The key is that you need to find what works for you. If you are running and begin to feel weak or dizzy, an unusually rapid heartbeat or get a headache - you may be experiencing the warning signs of heat exhaustion, the precursor to heat stroke. Your body will give you plenty of advanced warning of heat-related illness, making it easy to prevent if you just listen to the messages your body sends you. Ignoring the early warning signs can have some disastrous results, possibly sending you to the emergency room - or worse.

If you are in a new area which is warmer than what you are accustomed to, it may take your body up to a week to acclimate itself to your new surroundings. You should avoid strenuous workouts in the heat until that week has passed.

Moral of the story? This can happen to anyone, even you.

The Sweaty Six

There are six main heat-related illnesses that you will need to concern yourself with. All are serious to some degree, however one is potentially fatal.

#1: Heat Exhaustion

Heat exhaustion is thought be the onset of other heat related illnesses. It typically begins when the core body temperature is in the range of 98.6 degrees Fahrenheit to 104 degrees Fahrenheit. Some of the symptoms of heat exhaustion are heavy sweating, nausea, dizziness, fainting, weakness, headache, vomiting or cold and clammy skin.

To treat heat exhaustion, a mild case requires little more than getting into a cool place, resting and hydrating with sodium-containing liquids such as sports drinks. In more severe cases, fluids may be given intravenously and ice packs may be used for rapid cool down of the body.

#2: Heat Cramps

Heat cramps are one of the first warning signs that your body is in danger of overheating. It is thought that profuse sweating combined with a lack of water and electrolyte intake lead to muscle spasms that make it very uncomfortable to continue exercising. It should be noted that getting heat cramps does not predispose you for any further heat-related illnesses.

Treatment for heat cramps will include stretching of the muscles, massage and icing the muscles down. You should also make sure to hydrate yourself, as well as getting some sodium into your system .

#3: Heat Edema

Heat edema is a mild heat illness that occurs when the body has not yet become acclimated to a new, warmer surrounding. There will be mild swelling and redness in the extremities as blood pools there in an attempt to cool off the body. This is more common in older adults who are getting acclimated to tropical climates.

Heat edema is treated by rest and elevation of the limbs. You can also use compression stockings in extreme cases, but it will usually take care of itself in 7-14 days, or when the athlete returns to their normal climate.

#4: Heat Rash

Miliariarubra, commonly known as "heat rash" is an itchy, and sometime painful set of small red bumps that appear on the skin when you are in the heat too long. You will most commonly find this in highly sweaty areas such as the waist, trunk or groin. It is caused by obstruction of the sweat ducts. Excessive scratching can cause Staphylococcus infection as well.

To treat heat rash, cooling of the area is the best thing you can do, sometimes changing the clothes you wear when running will help. If the rash does not go away on its own in a few days, you may get a cream from the doctor such as an antibacterial/steroid combination that will eliminate it quickly.

#5: Heat Syncope

Another mild heat illness, heat syncope is caused again by pooling of the blood in the extremities, combined with a rapid change in body position such as standing up after riding a bicycle in the hot weather.

The most common remedy for heat syncope is to put the patient into a supine position (laying down, face up) in a cool spot. Elevation of the legs may help, but is often not necessary. You also want to make sure you are taking in liquids, as dehydration is probably one of the things that caused the illness in the first place.

#6: Heat Stroke

There are two types of heat stroke, classic and exertional. Between the two of them, they are responsible for around 400 deaths per year.

The first type, classic, is where the environment takes on a larger role, such as a particularly bad summer heat wave. These cases are common among the elderly who may not have air conditioning in their homes. This is often a result of the body not having time to get acclimated to the climate.

The second type, exertional is the one that runners really need to be careful of. This is where the heat is generated by the athletes body from an aggressive workout. Exertional heat stroke is the third leading cause of death among athletes, with football players seeing the largest number of individual deaths each year.

In both cases, the symptoms will be similar to heat exhaustion, only more pronounced, with the added possibility of collapse, seizures or unconsciousness. The core body temperature will have rise to over 104 degrees Fahrenheit. At this point the person will definitely require medical attention, as an aggressive cooling plan needs to be put into place, the body must be returned to normal temperatures between 30-60 minutes from the time of the initial onset.

Who Is At The Greatest Risk?

The two easiest groups to pick out are the young and the elderly (under age 15, over age 75). Their bodies are far more susceptible to heat than the rest. People who have a history of heat-related illness are not only at a greater risk of developing heat-related illnesses in the future, but also at greater risk for further complications down the road.

People with medical conditions such as eczema or psoriasis are at higher risk, as are those who are overweight and/or in poor cardiovascular health. Even something as simple as not getting a good night's sleep can increase your risk considerably.

There are also several external factors that can contribute to heat illness susceptibility. One of which is taking certain medications. The long list includes allergy medicines, cough and cold medicines, blood pressure and heart medication, products containing pseudo ephedrine, diet pills, medication for irritable bladder and bowel syndromes, laxatives, benzodiazepines like Klonopin, Valium or Librium, seizure medicines, thyroid pills and diuretics.

Best Ways To Stay Safe

There are a few simple ways you can be sure you are safe when exercising in the heat. These are really all common sense, but I will mention them anyway. 

Early To Bed, Early To Rise...

It's a simple fact - in the middle of the summer, mid-day is just TOO hot to be out running. You would need to carry around a gallon jug of water to replace what you are going to lose sweating for an hour in 90 degree heat. So you have two options - early morning, or late night. I know it can be hard to wake up that early - but you will get SO much more accomplished in your day when you get up early, and start out with some breakfast and a nice bit of exercise.

Keeping Hydrated

Your body can lose an incredible amount of water in a short amount of time exercising in the heat. Make sure you drink plenty of water before you even leave the house, and it is a must to have a supply of water with you. Add a tablespoon of sugar and a quarter teaspoon of salt to your bottle of water and save the buck on the sports drink (and spare your body from a few chemicals).

Take It All Off

It is important to dress appropriately when the temperatures start to climb. Light, airy fabrics should be worn - try to avoid synthetic based materials as they will just trap the heat next to your body. The moisture wicking fabrics are much better suited to summer exercise. When it's steamy, shorts and a tank top are really what you should be wearing.

Frozen Towels

You just take a small (hand-sized) towel, get it wet - then throw it in the freezer overnight. When you leave for your morning run, you grab it and drape it around your neck. Having a cold towel on the back of your neck makes your whole body feel cooler, and it will stay cold for quite a while in the heat. Plus you get the added protection from sunburn on your neck.

Post-Run Cleanup

It is always a good idea to bring a few clean towels and a change of clothes. with you for when you are finished with your exercise routine. Wiping off that oily film of sweat will help open your pores and let your body cool down easier when you are finished, as will having some nice dry clothes to wear. This is especially helpful for preventing heat rash.

Conclusion

Heat-related injuries and illnesses are easily preventable, all that is required is a little care and common sense. Make sure you stay hydrated - bring water or a sports drink with you every time, even if you are only going to be running 20 minutes. Be mindful of the temperature forecast - and remember that it will feel almost twenty degrees hotter than it really is once your heart starts pumping.

If you start to exhibit signs of heat related illness, stop immediately, get into the shade or air conditioning, and drink lots of fluids. If you do not recover within a reasonable amount of time you may need to seek medical attention as heat stroke can be life-threatening.

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