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Researchers Share Experiences of Heat Impact on Athletes

Experts Say Proper Planning Can Avoid Tragedy 

VAIL/COLORADO SPRINGS, COLO., June 8, 2023 – Dealing with heat may seem like an everyday problem, but for the elite athlete, knowing how to handle a heat-related injury could be the difference between life and death. 
On day two of the 7th Annual Injury Prevention Symposium, virtually presented by Steadman Philippon Research Institute (SPRI) and the United States Olympic & Paralympic Committee (USOPC) on June 8, 2023, three experts shared their stories about the severe impact of heat.

William Adams, Ph.D., ATC, FACSM, Associate Director of Sports Medicine Research at the USOPC, focused his talk on the eight million kids now participating in high school sports in the U.S. Tragically, every year, a few young athletes die from exertional heatstroke. That should never happen. 

“Exertional heat stroke is not 100% preventable, but it is 100% survivable with the appropriate plans in place for recognition and care,” said Dr. Adams. “We identified four steps for survival: rapid recognition, rapid assessment, rapid cooling and rapid advance care. For a successful outcome, all four of these steps, in that order, need to be in place.”

Adams went on to say there are many examples where one or more of these steps were missing, which resulted in a catastrophic outcome for the athlete, whether it be death or long-term health issues that prohibited them from continuing their athletic careers.

He emphasized the importance of treating and cooling the patient onsite before transporting them to the hospital, and for this to be successful, it must be a coordinated effort with all personnel involved in the care athlete. 
That led to the next speaker, who had direct experience coordinating and developing a heat injury plan at a major sporting event. 

Yuri Hosokawa, Ph.D., ATC, FACSM, is an Associate Professor at Waseda University in Japan. She shared her experiences preparing for heat risk mitigation during the 2020 Tokyo Olympic Games, held in July 2021.

Preparing for heat-related medical services was critical, as Tokyo was one of the hottest Olympic and Paralympic Games in history. 

While heat risk is not new to the Olympic or Paralympic Games, Hosokawa found that policies and procedures regarding exertional heat stroke management were rare in Japan. 

“Collapsed athletes would be at risk for delayed treatment, which we know can be catastrophic or even fatal,” said Hosokawa. “Therefore, it was extremely critical that we established and executed appropriate policies and procedures that outlined lifesaving steps for exertional heat stroke in the pre-hospital setting.”

She said the preparation ahead of the Tokyo 2020 Games started with identifying the appropriate location for the heat deck, which is the area designated for exertional heat stroke diagnosis, treatment and monitoring.

Regarding the Paralympic Games and athletes, they faced the same heat concerns. However, there were many questions from local medical volunteers about possible special health considerations because many had little or no experience working with Paralympic athletes. 

“One of the big takeaways I learned from my experience at the Tokyo Paralympic Games was to acquire as much of the athlete’s medical history as possible,” said Hosokawa. “Competition classification does not always indicate the type of impairment one may have, and submission of one’s medical history to a local medical volunteer was not a mandatory or regular practice.”

Dr. Hosokawa concluded by suggesting it is the responsibility of the host organization to prepare and implement a heat safety plan well before an event, to keep all athletes safe from heat-related injuries. 

The final speaker and expert on preventing heat injury was Sebastien Racinais, Ph.D., Research Scientist and Head of Athlete Performance at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. 

Dr. Racinais discussed his experience at several international events, the first being the 2016 Road Cycling World Championship in Qatar. 

He pointed out that after that race, while on the podium, one racer’s body temperature was 106.7 degrees Fahrenheit; even though the athlete was asymptomatic. Conversely to common belief, the highest temperatures are generally not reached on the longest event, but rather on an event lasting one hour or so, due to the heat production associated to the exercise intensity.

After researching heat-related injury in several sports, Racinais determined the best way to avoid heat injury may be in the hands of the coach.

First, the coach must check the athlete’s health status before the competition. A recent sickness is a significant risk factor for heat illness. 

“Our research also confirms the importance of the coach in planning heat acclimation in the preparation of the athlete,” said Racinais, as it reduces the proportion of athletes “not finishing competitions or being admitted to medical facilities.

“Lastly, as a coach, we generally focus only on core temperature because it is one of the diagnostic criteria for exertional heat stroke. But from a coaching point of view, we also must manage the skin temperature before the event,” as skin temperature and core-to-skin gradient are important determinants of the athlete’s thermoregulatory capacity.

For further information, contact Lynda Sampson, VP External Affairs (lsampson@sprivail.org, 970/479-1563)

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