By G. Douglas Andersen, DC, DACBSP, CCNThe following is an excerpt from a chapter in Strength, Conditioning and Injury Prevention for Hockey, by Joe Horrigan and Doc Kreis.1 Although the information below appeared in a book on ice hockey, it applies to athletes of all sports. This is especially true for your patients who will be participating in sports and activities in the summer heat. Following these guidelines can prevent serious heat-related illness.
There are wide physiological differences in the amounts of fluids athletes require. Sweat rates vary considerably and are affected by an athlete's physical condition, acclimatization and pre-event fluid levels. Weather conditions also play a role. Carbohydrate intake prior to competition tops off glycogen reserves and stimulates fluid retention. Athletes should practice hydration during training; this will improve their ability to hydrate during competition.
A "carbo-load" beverage should contain no less than 150 calories per 8-ounce serving. You can make these using powdered sports drink mixes to make them stronger.
Remember that when an athlete pre-hydrates, approximately 50 percent of the fluid he or she consumes will be lost in the urine. For example, in the hours before a game, if one has consumed 60 ounces, 30 ounces will be lost in urine, leaving a net gain of 30 ounces. Although it does not seem like much, having 30 ounces more fluid in your body than your opponent will give you a physiological and psychological advantage. Between periods, drink as much as you comfortably can. Shoot for between 10 and 20 ounces, depending on how much you played and how much you weigh. (The more you play and the more you weigh, the greater your fluid needs are.)
Cut out the following and give to patients:
Safe Preseason and "Two-A-Day" Practice Guidelines
Drink throughout the day.
Drink one ounce for each 10 pounds of body weight per hour, beginning three hours before practice.
Drink as much as you comfortably can during practice.
Drink before you are thirsty.
Drink 16-24 ounces of fluid per pound of body weight lost after practice.
"Do's" and "Don'ts"
Do weigh yourself before and after practice.
Do observe the color of your urine. (Dark urine means you need to drink more.)
Do watch the volume of your urine. (Small amounts indicate you need to drink more.)
Do tell your coach or trainer if you are on any kind of medications.
Don't consume beverages containing alcohol and caffeine. (They reduce the power of your water-holding hormone.)
Don't come to camp or preseason workouts out of shape.
Don't practice or play if you are sick or injured (unless you are medically cleared).
Warning Signs of Heat Illness
Every year, young athletes decide to be "tough" instead of smart, and every year, unnecessary tragedies occur. Heat illness can progress from simple headaches and weakness to catastrophe within minutes! If you do not feel well, be smart: tell your coach and trainer. It could save your life!
G. Douglas Andersen, DC, DACBSP, CCN
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