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Summer time exercise

Steve Vighetti, MPT, MTC, CSCS, FAAOMPT

I am an avid runner, some would even say I’m addicted.  I train 6-7 days per week through most kinds of weather and especially enjoy the heat of the summer.  Last year I was lucky enough to participate in the Falmouth Road Race held in Cape Cod every August.   “This will be easy,” I thought since the race is run in relatively cool New England and I regularly train in the Florida heat.  Boy was I mistaken!  By the 4th of 7 miles I began to feel the symptoms of heat exhaustion.  I was dizzy, weak and nauseous. Since I had made a long trip to run this race I pushed through to the end.  I only wish I could remember finishing.  I do remember being wisked away to the medical tent, having my temperature monitored in a manner fit only for infants and then being dunked in a kiddie pool sized ice bath for more than 15 minutes.  My core temperature was 107° when I entered the tent.  I had suffered heat stroke, the most serious of all heat related illnesses, which could have lead to my death had the medical staff not been prompt in their response. 

The continuum of heat related illness begins with heat cramps, progresses to heat exhaustion and if left untreated, can ultimately lead to heat stroke.  Symptoms of heat exhaustion include muscle cramping in those who sweat a lot during strenuous activity as well as paleness, fatigue, weakness, dizziness, headache, nausea/vomiting and can develop after several days of exposure to high temps and poor fluid replacement. As in my case, heat stroke is a true medical emergency and can be fatal in not treated immediately.  In addition to the symptoms of heat exhaustion, heat stroke victims will also exhibit strange behavior, rapid heart rate, ABSENCE of sweating, confusion, disorientation and ultimately organ failure and death.

Normally, with strenuous activity, the body will generate heat as a result of metabolism.  It is able to get rid itself of this built up heat through evaporation of sweat among other things.  In extreme heat and humidity or vigorous activity under the sun our body is less effective at dissipating heat which can lead to a sky rocketing of our core body temperature, upwards of 106° or more.  Dehydration plays a significant role as well since someone who does not drink enough fluids is unable to sweat fast enough to dissipate heat.

 Anyone can develop heat exhaustion or ‘heat stroke’, not just athletes.  In our Florida temperatures one could develop heat exhaustion performing regular yard work.  If you suspect that you or a family member exhibits the signs of these heat related illnesses it is important you move the victim to a shady area and apply cool water to the skin to promote cooling.  If you are unable to make rapid improvements in the victim’s condition, it is imperative that you call 911 as it may be fatal. 

 As with many physical issues, prevention is the best intervention.  To prevent heat related illness in the first place, avoid strenuous activity during the heat of the day.  If this is impossible, drink plenty of fluids (water, sports drinks) and avoid alcohol and caffeine since they may contribute to dehydration.   

 Armed with a greater knowledge, I intend to race Falmouth again and this time, expect a completely different ending to my day.

 Dr. Vighetti is a fellowship trained physical therapists with over 12 years of experience in orthopaedic and sports related injuries.  He is also a Certified Strength and Condition Specialist as well as certified in manual physical therapy and Augmented Soft Tissue Manipulation.