It’s probably a good thing that the Indian Premier League, or IPL, moved to South Africa. Only recently, Delhi had the hottest April day (29 April) in 50 years. Our players won’t be missing much. It is not much fun playing in the hot sun, and soldiering on without a care has serious consequences.
Which is why the UK National Health Service has a “Heatwave plan for England 2008”, offering guidelines for all health care agencies to raise public and professional awareness. Almost all Western nations have such documents. We need something similar in India, where high temperature is a far bigger, more frequent problem. Until then, here’s what to remember:
What you already know
• Exercising in hot weather dehydrates you
• You need to replace the lost water
• Extreme heat is injurious to health
What you may not know
When the surrounding temperature is higher than your skin temperature, sweating is the only effective heat-loss mechanism. The factors below can reduce the effectiveness of sweating, causing you to overheat:
• Lack of any breeze
• Tight-fitting clothes
• Certain medications (for example, diuretics for cardiovascular problems, drugs to treat Parkinson’s disease)
Also Read Treadmill earlier columns
Important note: Young children produce more body heat, yet have a decreased ability to sweat, and their body core (internal) temperatures rise faster during dehydration. The Glucon-D TV ad, where the sun is shown to suck water out of children playing cricket in the heat, sends out a very apt message: We need to be very careful about dehydration in this hot weather when we send the young ones out to play.
Symptoms of heat-related illness
• Heat cramps (muscle pains or spasms in the abdomen, arms or legs) are caused by dehydration and loss of electrolytes (low-sodium salts), often following exercise, and are also a symptom of heat exhaustion.
• Heat rashes (small, red, itchy cluster of pimples or small blisters) are caused by excessive sweating during the hot, humid weather. They are more common in young children but can affect anyone. These typically appear on the neck and upper chest, in the groin, under the breasts and in inner elbow creases.
• Heat oedema (swelling of the ankles) happens because blood vessels expand (vasodilation) as your body tries to cool off and fluid pools in the legs.
• Heat syncope (dizziness or fainting) can happen due to dehydration, vasodilation, cardiovascular disease and certain medications (diuretics, among others).
• Heat exhaustion is common, yet often ignored. It can be a result of either water or salt depletion and if left untreated, may evolve into heatstroke. The warning signs are not very specific (which is why it can be ignored) but they may include a general feeling of malaise (tiredness/weakness/dizziness), nausea or vomiting, heavy sweating, paleness, muscle cramps, headache, fainting and circulatory collapse.
• Heatstroke can become a point of no return when the body’s thermoregulation mechanism fails entirely. This is a medical emergency. Symptoms include confusion/disorientation, dizziness, a throbbing headache, strong but rapid pulse, convulsions, nausea, loss of consciousness, skin that feels reddened, hot and dry, extremely high body temperature exceeding 104 degrees Fahrenheit (40 degrees Celsius) for anything between 45 minutes and 8 hours.
Warning: Heat stroke can result in cell death, organ failure, brain damage or even death.
Important note: The most frustrating aspect of heat illness is that sufferers are often completely unaware of their own symptoms. So it is up to friends and family to look out for each other, a good case for playing and exercising together. And have someone else take the call on when you should stop.
What you should do
No matter what causes the symptoms of heat illness, the treatment is always the same: cool the body.
• Move the patient somewhere cooler (an air-conditioned room, if available, or into the shade)
• Give him/her a cool shower, bath or body wash
• Help him/her rehydrate by offering cool, non-alcoholic beverages to replace the lost water and electrolytes
How can you prevent heat illness? Read Surf, bottom left.
How to play it cool
When it comes to the risk of heat illness from exercise or sports in summer, prevention is the better part of valour. Which is not to say you consign fitness to the cooler months! You just need to adopt a few simple measures to keep yourself cool.
1. Stay out of the heat
• Keep out of the sun between 11am and 3pm
• Apply sunscreen; wear a hat before you head out
• Avoid extreme physical exertion. Give yourself time to get accustomed to the heat, gradually increasing time and intensity of exercise
• Wear light, loose-fitting clothes made from a fabric that breathes
2. Stay well hydrated
• Have plenty of cold drinks, but avoid caffeine, carbonated drinks and alcohol (yes, even beer), which encourage loss of fluids.
• Don’t take salt tablets unless advised by a doctor! Sweating removes salt and minerals from your body, yes… but it’s for a good, healthy reason. Yes, they do need to be replaced, but salt tablets can actually dehydrate you faster if incorrectly used.
• The safest way to replace lost salts is through a normal balanced diet (no, you don’t need to add ‘extra’ salt to compensate). Have cold foods, particularly salads and fruit with a high water content.
• Sprinkle water over skin and/or clothing from time to time, or keep a damp cloth on the back of your neck.
• After you’ve cooled off, take a cool shower, bath or wipe yourself down with a wet towel.
Important note: In spite of saying that water consumption is important to avoid heat related illness, it is even more important that water needs to be consumed in moderation.
The author is a practitioner of musculoskeletal medicine and sports and exercise medicine. He is also CEO and medical director of Back 2 Fitness.
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