Children who play sports in hot weather can be at risk for heat illnesses. There are several types of heat illnesses that range in severity, from heat cramps and heat exhaustion to heat stroke. The good news is heat-related illnesses can be prevented and successfully treated.

Children sweat less than adults, making it harder to cool off. Athletes need to get used to the heat and humidity gradually. Coaches and parents need to be aware of temperature and humidity levels. Practice length, intensity, and equipment can be changed as the levels rise.

Even being a little dehydrated can make an athlete feel bad and play less effectively. It also puts them at risk for more dangerous heat illness. Treatment of dehydration includes moving to a shaded area and drinking fluids. The athlete can participate as soon as symptom-free.

Signs & Symptoms
- Dry mouth
- Thirst
- Irritable or cranky
- Headache
- Bored or disinterested
- Dizziness
- Cramps
- Excessive fatigue
- Not performing as well

Heat cramps are intense muscle spasms that develop after a child has been exercising and has lost large amounts of fluid and salt from sweating. Treatment includes light stretching and massage of cramping muscles and drinking a sports drink to replace the fluid and sodium loss. The athlete may return to activity when the cramp has gone away and they feel up to it.

Signs & Symptoms
- Intense pain (not associated with an injury)
- Persistent muscle contractions that continue during and after exercise

Heat exhaustion is moderate heat illness that occurs when the athlete continues to participate even after showing ill effects of the heat. Treatment includes moving the athlete to shade. Remove extra clothing or equipment. Cool with fans, cold water, or towels. Have them drink fluids if not nauseated. If the athlete does not improve, take to emergency room. Avoid intense practice until at least after the next day. If seen by an MD, a note releasing and return to play guidelines are needed.

Signs & Symptoms
- Loss of coordination, dizziness, or fainting
- Dehydration
- Profuse sweating or pale skin
- Headache, nausea, vomiting, or diarrhea
- Stomach cramps or muscle cramps

Heat stroke is severe heat illness that causes a rapid increase in core body temperature that can lead to permanent disability or death if untreated. Treatment includes immediate cooling of athlete and call 911. Begin aggressive whole body cooling by immersing in a tub of cold water. This athlete should not return to play until cleared by an MD and given return to play guidelines.

Signs & Symptoms
- Increase in core temperature, usually above 104.
- Altered consciousness, seizures, confusion, irrational behavior
- Nausea, vomiting
- Headache, dizziness
- Hot and wet or dry skin
- Increased heart rate, decreased blood pressure, or fast breathing

The best prevention for heat illness is HYDRATION! Indoor athletes need to be aware of this as well.

BEFORE: Athletes should drink 16-24 fl oz. of water within the 2 hours prior to training. At 10-20 minutes prior, they should consume another 8-10 fl oz. of water.

DURING: Athletes should consume approximately 6-12 fl oz. every 10-20 minutes during training. DRINK BEYOND YOUR THIRST!

AFTER: Athletes need to record their weight before and after training. Athletes should replace every pound lost in weight with 16-24 fl oz. of water. This should be consumed within 2 hours of completing training.

Written by: Amanda Sullivan, MS, ATC, LAT
Outreach Liaison – Cardinal Glennon SportsCare
SSM Health Cardinal Glennon Children’s Hospital