Heatstroke is a real risk for youth athletes. Here's how to keep them safe in the summer

When Jill Williams looks back at her athletic career, she sees a line she was constantly pushing up against to be the best, even when she was injured.

“I do not feel that I often recognized the signs my body was giving me to take a break,” Williams, a two-time Olympian at shot put in 2008 and 2012, tells USA TODAY Sports. “When I was a younger athlete, I felt invincible. I wanted to be that athlete that was every coach’s dream. As I got older, I listened to my body more." 

We love players who constantly push themselves like Williams, of course. With them, though, we run the risk of one of us – coach, parent or athlete – crossing that invisible line, especially in the summertime.

“I have had the unfortunate opportunity to watch others collapse from heat exhaustion, sent off in an ambulance because they become non-responsive,” Williams says. “It is a terrifying situation to watch someone being carried off, lifeless, due to the heat. I learned to make sure I was prepared for what conditions I would be competing in." 

Can we beat the heat? The answer is no, but it’s a question even the most elite athletes in the world grapple with, teetering to the point where their bodies shut down and they’re crawling across the finish line. Or worse.

We’ve witnessed the football deaths of Korey Stringer, Jordan McNair and Marion Barber and a number of others at the college and high school levels from heatstroke. As sports parents, we worry about our kids at camp or playing a summer sport. Their bodies will take even longer to adapt to sweltering conditions than those of a high-level athletes.  

While a large chunk of our country has been enveloped by a heat dome, we need to watch those young athletes as close as ever.

"To those who continue to push their kids/athletes in the heat, I would caution that continuing such behavior can put lives at risk unnecessarily without any true benefit to their fitness or readiness for sport," says Dr. Benedict Ifedi, who practices family and sports medicine at Memorial Hermann Health System near Houston.

Ifedi says there is almost always some warning sign present for heat-related injuries such as heat exhaustion or heatstroke. Here are ways to spot those signs and help our young athletes stay healthy in the heat.

1. To compete in the heat, you first need to acclimate to playing in it

Dustin Williams, Jill’s husband, will be the co-head athletic trainer overseeing the care of about 140 American athletes this summer at the Paris Olympics.

He got a taste of the challenges that might await him at the finish line of the U.S. Olympic Marathon trials in February.

“That's where they just fall apart,” he says. “We had a couple of severe instances where we had to really take care of them.”

The trials were held in Orlando, much warmer that time of year than where many of the runners trained. Some weren’t accustomed to the heat.

Our bodies need 7 to 14 days to acclimate to hot playing conditions in order to cope with higher sweat rates, body temperatures and salt losses. You should gradually increase your exposure to the sun, as well as the duration and intensity of your workouts, in it during that time.

Here are some more tips to ease into the hotter months:

• During the summer when kids are off from school, have them practice in the coolest periods of the day and slowly work into those hotter periods.
• Take frequent breaks (every 15 to 20 minutes) for water and shade and, if you’re playing football, have the players take off their helmets. Per the recommendations from the the National Athletic Trainers’ Association, keep practices to one hour or less if the temperature is above 90 degrees.
• If your team isn’t practicing regularly before an event, try riding a bike or walking to a friend’s house each day, which also helps with overall fitness. A better conditioned athlete will acclimate to the heat more quickly, and an acclimatized one will have a competitive advantage.

2. Hydrate with water and electrolytes; your diet before and after events is crucial, too

In addition to acclimation to heat, hydration with water and electrolyte beverages are necessary to avoid heatstroke, Ifedi says.

It’s crucial your child stays hydrated throughout an event, but the hydration process begins well ahead of it. Here's how to prep:

• Starting several days beforehand, drink 100 ounces of fluids (five 20-ounce water bottles) per day, a process you will carry through your competition. Maintain around a 50/50 balance of water and electrolytes. Electrolytes can be found in sports drinks like Gatorade, Powerade and Pedialyte; avoid drinks with excessive sugar or with caffeine.

“With my college athletes, my two things I tell them are, one, if Gatorade or Powerade taste good, you need more electrolytes,” says Jill Williams, who now an assistant track and field coach at Utah Valley University. “I always felt when they tasted salty, my body had enough electrolytes, but when they tasted good, I needed to drink more. Two, check your pee. Yes, it’s gross, but it is the simplest way to see if you are hydrated or not. If your pee is dark yellow you need to drink; if your pee is clearer, they you need to keep drinking but are in a better hydration state.”

Think of this process as building energy or power for your swings or throws. That energy also comes from a balanced diet of carbohydrates and protein, which can not only fuel you but help with recovery. Think lean meats like grilled or baked chicken, fish and a variety of vegetables and fruits. 

• You'll want healthy carbohydrates before you play, and mix in a little protein. Think whole-wheat toast with nut butter, oatmeal with fruit, low-fat yogurt with berries, whole-grain crackers with cheese or low-sugar cereal with milk.
• To store electrolytes, you can also salt your food leading up to your event but avoid processed and fast foods and sodas or sugary juices. What you consume is crucial to how you play.

“I think that's sometimes a mistake that the youth make is, is like, ‘Oh, I can have this cheeseburger, it's not gonna be a big deal,’ ” says Dustin Williams, who also serves as BYU's head athletic trainer for men's and women's cross country and track. “And you can have one here and there, that's OK. But if you're doing it every day, it's not going to be the feeling you need to perform.”

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3. Don't overdo the warmup; let the heat do the work

A warm-up of jogging or even sprints and other rapid movements can give you the confidence to play your best at games, matches or meets.

“But young kids must remember, it’s just a warm-up to prime your body,” Jill Williams says. “If you exert all your effort during the warm-up, you will be gassed for the competition. When the weather turns warm, know the few exercises that do the most for your own body and cut out all the other stuff that can drain your energy. 

“I knew on a hot day, jogging, carioca, skips, and a few specific flexibility exercises were all I needed to prime my body.  Get the most bang for your buck, and let the heat help your body."

Use the remaining pregame time to find the shade. Other ways we can stay cooler before and during events:

• Wear light-colored clothing and hats, towels wrapped with ice and cooling vests, which you can load with ice packs.

At the marathon trials, American Clayton Young put his hats inside water bottles, which froze them. He then put them on his head as he ran the race.

4. Know the signs for heat-related illness

Get your child’s annual physical exam before the start of the summer sports season to ensure a clean bill of health. Once they’re out there playing, watch for the key warning signs for heat-related illness:

• Fatigue
• Headache
• Dizziness
• Nausea
• Muscle cramping
• Heavy sweating
• Rapid heart rate.

Before the sporting event begins, locate the first aid station and any medical professionals who might be on hand. If a child experiences any of these symptoms, move him or her to the shade and find them immediately or call 9-11.

During a heatstroke, the body temperature can rise to higher than 105 degrees.

“Get them cooled,” says Dustin Williams, who is working U.S. Olympic track and field trials this week. “It's amazing the difference if you get out of that direct sunlight, how that can help the body. Shade can feel like a 20-to-30 degree temperature change to the body, which can help with the prevention of exertional heat illness.”

The risks of having a heat-related illness remain horrifyingly real. The death certificates of more than 2,300 people who died in the United States last summer mention the effects of excessive heat, according to an Associated Press analysis of Centers for Disease Control and Prevention data.

Before you take our kids to their next sporting event this summer, know there are steps you can take to acclimate, hydrate and nourish them, and perhaps even save them.

Steve Borelli, aka Coach Steve, has been an editor and writer with USA TODAY since 1999. He spent 10 years coaching his two sons’ baseball and basketball teams. He and his wife, Colleen, are now sports parents for a high schooler and middle schooler. His column is posted weekly. For his past columns, click here.

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