Environmental Injuries
Environmental Injuries can be an inconvenience, such as a cramp, or deadly as in heat stroke or hypothermia. When considering these types of injuries, most people think of heat disorders vs. cold injuries. While in my tenor as an Athletic Trainer I have seen many more heat issues vs. cold, depending on the sport and time of the year, cold can be just as life threatening and not to mention the possibility of secondary injuries from extreme cold (frost bite or falls from an icy surface).
Heat Disorders
What are heat disorders and what causes them?
Heat disorders causes while may seem obvious, cramping athlete's that following all of the steps to reduce their odds to cramp, still cramp during competition, shows that the concept of "prevention" to stop these issues can be very confusing.
The majority of the time why someone is effected by the heat during conditioning, practicing or competing is the fact that most athlete's do not acclimate themselves to the heat. Air conditioning, the lack of outdoor activities during the day and conditioning are all factors to add to the chance of a heat disorder to occur.
Basically the body wants to be in the state of homeostasis, the same body temperature, the same acid/base levels, water levels, etc... When the body temperature increases with activity in the heat increases, the body will react to bring before mentioned levels back to normal. The body will begin to open capillaries, to increase blood flow to the skin, to increase "heat loss", the body will begin to sweat more for evaporation for the body to cool off. If the humidity is high, the body will not be able to evaporate as efficiently, the body temperature will continue to increase. In order for the body to work appropriately the body must stay within a range of temperatures, and once the temperature gets too high, systems will begin to shut down, eventually to the point where vital organs will soon dysfunction, and severe damage to organs which could be life long to the possibility of the loss of life.
Heat Disorder Classifications:
- General Information: typically most people will experience the heat disorders in order from least severe to the most, in order with an overlapping of stages. If the environment is bad enough, and causing factors are high, higher stages can occur quicker than typical.
- Heat Cramps: skeletal muscle is generally thought of as consciously controlled muscle of three in human anatomy. When there is decrease in blood serum (dehydration) and a drop in electrolytes (salt in the body that regulate contractions/relaxing of muscle cells by nerve cells) from sweating or lack of through diet. As these factors increase the muscles will not behave as normal and start contracting on their own, which causes dysfunction and pain. Athletes experiencing a muscle cramp will need to rehydrate slowly with a electrolyte solution, ice the area (decrease the nerves from firing) and use soft tissue manipulation to reduce the contraction. Other factors now considered by sports research are various chemical mediators (hence the use of pickle juice & the spices in it) and the lack of conditioning (which could explain the confusing part of prevention).
- Heat exhaustion: when the internal core temperature of the body increases to about 102-4 F, possibly less, the body starts essentially let the athlete know, through symptoms, that it can no longer handle the heat caused by activity and the external environment. The person will be sweating, hot, and start to experience fatigue. Also the person might be dizzy, nauseated, and confused, almost to the point of lost consciousness. Vomiting is not uncommon with someone whom is in a state of heat exhaustion, which will add to the loss of blood serum or dehydration. Athlete's that experiencing these symptoms need to stop activity and get out of the heat/humidity, remove wet clothing and equipment, cool the body down rapidly and monitor inter-core temperature and vital signs.
- Heat stroke: when the inter-core temperature starts in go over 105 F and above the body will start to shut down. Sweating will usually cease and the inter-core temperature will start to raise dramatically. It this point the athlete will most likely be unconscious or confused beyond cognicence of their environment. This is a 911 situation and ”inner core” temperature must be dtermined and moniotered, while total body cooling must be implemented and vital signs must be monitored. Life saving skills must be implemted if needed.
Cold Disorders
What are cold disorders and what causes them?
Cold disorders are caused when the external environment (cold/wet/windy) and the person is not properly dressed for hypothermica weather. Most athletes do not like to use a lot of layers for competition. Areas that have the most surface area and least amount of fat/blood flow can be effected. If the inner core temperature starts to drop (95 F. or less) the body will start to shut down cause a medical emergency. The NJSIAA has policies on the cold if it's "safe" to go outside or for a pre-determined amount of time.
Cold Disorder Clarifications:
Two of the most common cold disorders are frostbite and hypothermia. Frostbite occurs when distal extremities (fingers or toes) or other anatomical projects (nose & ear) get below inter-core temperature, cold enough that the body part actually starts to freeze. Rewarming slowly, wrapping and referral to a medical professional are the most common forms of care.
The second type of cold disorder is hypothermia (which is most likely the most to occur in sports), happens when the temperature is low, it's wet and windy. The inter-core will begin to drop and when it start to get dangerously low, the body will begin to involuntarily start to shake to produce heat to raise the inter-core temperature up. Athletes that have a cold compromised internal temperature, must get out of the cold, re-warm slowly, and remove all wet clothes. Prevention is paramount.