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Prehydration
and Rehydration
Used with permission from the Gatorade
Sports Science Institute.
"PREHYDRATION CAN HELP TO MAINTAIN BODY WATER
STORES DURING ENDURANCE EXCERCISE." -David R. Lamb, Ph.D.
Experts agree that sufficient fluid intake during endurance exercise is
preferable to drinking only before training or competition. However, total
replacement of sweat lost during exercise is rare among athletes, who typically
replenish less than 50% of their sweat during exercise. To help maintain
a euhydrated state (normal stores of body water), an athlete should prehydrate
before exercise, says David Lamb, Ph.D., emeritus professor of exercise
physiology at The Ohio State University. Prehydrating, says Lamb, will improve
cardiovascular function and body temperature regulation when it's impossible
to drink enough during exercise.
"To avoid dehydration, you should consume
sports drinks both before and during endurance exercise."
To help ensure a state of euhydration, drink at least 500 ml (16 oz) of
fluid before sleeping the evening before exercise and another 500 ml first
thing in the morning, says Lamb. To help "top off" fluid stores,
drink another 500-1000 ml 1 hour before competing. The type of fluid you
consume before exercise is important. Make sure you drink fluids containing
small amounts of sodium, such as sports drinks. The sodium in these drinks
will cut down fluid losses in excess urination, and better maintain hydration.
"Unaccustomed drinking of large amounts of fluid before competition
can cause gastrointestinal discomfort," Lamb says. "Practice your
hydration regimens during training before trying them in competition."
"REHYDRATION IS A VITAL PART OF THE RECOVERY
PROCESS AFTER ANY TRAINING SESSION OR COMPETITION." -Ronald
J. Maughan, Ph.D.
Research confirms that performance is impaired when an athlete is dehydrated.
In endurance exercise, such as running or cycling, a progressive dehydration
seems almost inevitable, says Ronald J. Maughan, Ph.D., professor of human
physiology at the University of Aberdeen in Scotland. Dehydration occurs
when the athlete fails to drink enough fluid to replace the sweat lost during
exercise. The resulting decrease in performance is accentuated if the athlete
begins training or competing in a state of dehydration, says Maughan.
"Rehydration after exercise involves not only
replacement of fluids lost in sweat, but also replenishment of electrolytes,
primarily sodium."
For optimal rehydration, you should drink a carbohydrate- electrolyte drink
as soon as possible after training or competing, says Maughan. The carbohydrates
and sodium in these drinks provide flavoring that helps to stimulate consumption.
The sodium also aids in the retention of the consumed fluids. The result
is better hydration, which has performance implications for your subsequent
training bouts or competitions.
"Working on an effective recovery strategy," Maughan says, "allows
your training sessions to be maintained with less fatigue and decreases
the chance of injury the next time you go out to train or compete."
In
the Heat of the Game: Competition in Hot Weather
By PAGE LOVE, M.S., R.D., L.D., sports nutritionist, Nutrifit and Nutrisport
Consulting (Atlanta, GA) Used with permission from the Gatorade
Sports Science Institute.
Heat illness is one of the most preventable sports injuries. It's a problem
that can sideline an athlete for the game or even end a career. Athletes
need to take steps to reduce the potential for heat injury by making sure
they are prepared for training and competing in the heat. Adequate fluid
intake both on and off the field helps keep energy levels high by regulating
body temperature, preventing heat exhaustion and transporting nutrients
and energy to the muscle tissue.
Warning Signs of Dehydration
ACUTE SIGNS: Nausea, poor concentration, light-headedness, irritability,
unusual fatigue
CHRONIC SIGNS: Loss of appetite, dark yellow urine, little or no urination
and frequent muscle cramps
FLUID GUIDELINES
Proper hydration is the best safeguard against heat illness. Remember the
before, during and after activity fluid guidelines:
 |
OVERALL FLUID NEEDS:
Athletes should drink at least 10 - 12 cups (80 - 96 oz) of fluids
per day to meet daily fluid needs. Athletes may need over 20 cups
of fluid each day during vigorous training in warm environments.
|
|
BEFORE ACTIVITY:
Athletes should drink fluids throughout the day as thirst is not a
good indication of hydration level. As part of the pre-game meal,
players should consume 2 - 3 cups of fluids (i.e. sports beverages,
water, fruit juices, skim milk, vegetable juices). From the pre-game
mealtime up until 1/2 hour prior to practice/game time, athletes can
consume up to 2 cups (16 oz) of fluids every two hours to ensure adequate
hydration in preparing for training in the heat.
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DURING ACTIVITY:
Sports drinks, such as Gatorade, are the best fluid replacement beverages
because they are absorbed quickly and deliver energy to the muscles.
Athletes should drink at least 5-10 oz of fluid every 15 minutes and
especially at breaks/time-outs.
|
|
AFTER ACTIVITY:
Immediately after training or competition is the key time to replace
fluids! New research indicates that for every pound of body weight
lost, an athlete should drink at least 20-24 oz of hydrating fluid
after practice or a game to optimize rehydration. Sports beverages
are an excellent choice.
|
Athletes also should try to consume more carbohydrates to replenish muscle
glycogen stores - a high carbohydrate supplement is a good choice. Replacing
lost fluid immediately following training is crucial to replace the muscle
energy stores.
Adjusting to the Heat
To minimize risk for heat injury, players should adjust to exercising in
the heat by practicing at mild to moderate exercise intensity for 5 to 15
days in the heat. This process will allow a body to cool more efficiently
by increasing sweat production sooner than when not adapted.
Never Restrict Fluid Intake
Athletes who compete in weight classes should lose body fat pre-season and
early in the season with an appropriate calorie controlled eating plan versus
quick weight loss in the form of fluid restriction following heavy sweating.
Preventing Heat Injuries
|
In preparing for
outdoor competition, warm-up in the shade to avoid direct sunlight
that can cause excessive rise in body temperature.
|
|
Rest in the shade
or air-conditioned indoors between competitive events. Even at rest,
additional exposure to heat can dramatically raise the body temperature,
magnify fluid loss and decrease the blood available to the muscles
during subsequent exercise sessions.
|
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Wear loose-fitting,
cotton-blend clothing to help promote heat loss. Less is better for
overall clothing.
|
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Be sure to consume
adequate amounts of fluid before training and competition.
|
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During longer exercise
sessions, replace fluids as frequently as possible.
|
|
The pre-season regimen
for competitive sports should be preceded by two weeks of conditioning
in the heat while wearing minimal clothing and drinking liberally.
|
|
Practice sessions
during unusually hot temperatures and humid conditions should be limited
to very moderate workouts, postponed until cooler times of the day
or cancelled.
|
|
Check your urine
color: the lighter the color, the better hydrated you are.
|
Other
Hydration Hints
|
Avoid caffeinated
and alcoholic beverages. These act as diuretics, which cause the body
to lose fluid. |
|
Avoid salt tablets
as these don't meet an athlete's fluid needs.
|
|
Avoid carbonated
beverages, which may cause bloating and reduce the amount of fluid
consumed.
|
Sports
Dentistry and Dental Safety in Athletics
Every athlete involved in contact sports has about a 10% chance per season
of an orofacial injury, or a 33-56% chance during an athletic career. Dental
injuries are among the most common type of orofacial injury sustained during
participation in sports; the majority of these dental injuries are preventable.
The best method of preventing a dental injury during a practice or competition
is to wear a mouthguard. A variety of sports such as, but not limited to,
football, hockey, boxing and rugby use mouth protection devices to reduce
dental injuries. Mouth protectors not only protect against dental injuries
but also concussions, neck injuries and some serious central nervous system
injuries by decreasing the force transmitted through to the base of the
skull. Experts estimate that mouthguards prevent approximately 200,000 injuries
each year in high school and collegiate athletics. Prevention and preparation
are the key elements to minimizing dental injuries. Treatment of these injuries,
however simple or complex they may be, not only includes treatment at the
dental office, but also treatment at the site of the injury. In sports,
the challenge is to maximize an athlete's participation and limit their
individual injuries. Below you will find links to websites that help explain
what to do if a dental injury occurs as well as information on sports dentistry.
International
Academy for Sports Dentistry
http://www.acadsportsdent.org/
Sports
Dentistry Facts
http://www.qualitydentistry.com/dental/sdentistry/s-dent.html
WHAT
IS SPORTS DENTISTRY?
http://www.qualitydentistry.com/dental/sdentistry/w-sports.html
Types
of Athletic Mouthguards
http://www.qualitydentistry.com/dental/sdentistry/mouth.html
Concussion
Prevention and Athletic Mouthguards
http://www.qualitydentistry.com/dental/sdentistry/concuss.html
A
Guide to Players, Trainers, Teachers, Parents about Sports Guards
http://www.drchan.com/mouthguards2.htm
Recreational
Injury Interventions Mouthguards
http://depts.washington.edu/hiprc/childinjury/topic/recreation/sportsmouthguards.htm
Sports
Dentistry: Mouthguards
http://www.dentalreference.com/html/body_sports_dentistry.html
Athletic
Mouth Guards
http://www.flash.net/~dkennel/guards.htm
What
is Sports Dentistry?
http://www.sportsdentistry.com/sportsdentistry.html
Sports
Dentistry Facts
http://www.sportsdentistry.com/facts.html
What
to do when a tooth is knocked out
http://www.sportsdentistry.com/tooth.html
Treatment
of the Avulsed Permanent Tooth
http://www.sportsdentistry.com/avulsed.html
Skin Infections in Athletics
Dealing with infectious skin diseases in athletics in not as dramatic
as responding to a sudden on-field injury, but it can have a much greater
effect on the overall success of the team. In recent years, the importance
of infectious skin disease prevention in sports has become a major priority.
Most situations involving skin infections are not that sensational, but
prevention can play a major part in an athletes' success. Some infectious
skin diseases can spread during sports participation and have the ability
to threaten long-term health or even the life of an athlete. Athletes
and the general population are exposed to similar infections, however
some may be sport specific. Sports such as wrestling foster skin infections
such as herpes simplex, tinea corporis, and impetigo. Although therapy
allows some wrestlers to return to competition, any athlete with an active
infection should be barred from physical contact during practice and competition
until their breakout has cleared. Physicians must know when to disqualify
a wrestler and how to prevent an outbreak through measures like immediate
diagnosis and good hygiene.
Disqualifying an athlete late in the season due to an outbreak can be
upsetting. Team members, athletic trainers and the entire sports medicine
team must practice the principles of infection prevention routinely. Good
basic hygiene practices and efforts to minimize exposure to specific diseases
form the foundation of good infection prevention. These precautions are
quite simple and probably very familiar. Some of these precautions include
mandatory showers before and after practice, use of antibacterial soaps,
and daily washing of practice gear. Check out the links below to find
out more about good hygiene for your athletes how you can keep your team
infection free.
Preventing
Skin Infections
http://www.gobanana.com/pwn/articles/preventing_skin_infections.htm
Pinning
Down Skin Infections: Diagnosis, Treatment, and Prevention in Wrestlers
http://www.physsportsmed.com/issues/1997/12dec/dienst.htm
NCAA
Guideline: Skin Infections in Wrestling
http://www.ncaa.org/library/sports_sciences/sports_med_handbook/2003-04/2b.pdf
Skin
Disease in Wrestling
http://rasalom.blackmagic.com/wrest/reference/skininf.html
The
Truth about Ring Worm
http://www.amateurwrestler.com/health/ring_worm.html
Wrestlers
learning hard way they must fight skin diseases
http://apse.dallasnews.com/contest/2002/writing/under40/under40.news.third.html
Grappling
With Skin Infections
http://www.physsportsmed.com/issues/1997/12dec/ed_notes.htm
The
Importance of a Clean Wrestling Room
http://www.lhup.edu/~yingram/wrestling%20room/web%20page%20project/newpage2.htm
Peanut
Allergies in School
Approximately 2%-3% of
all school age children in the U.S. suffer from true immunological food
allergies according to the National Institute of Allergy and Infectious
Diseases. In a school of 500 students, that means 15 students may have
some type of food allergy which is life threatening.
There are many
types of food allergies but the one getting a lot of attention lately
is peanut allergies. Peanut allergies appear to be on the rise. Parents
and school health officials need to work together to keep their children
safe at school. Many schools are turning to "peanut free" zones.
For free informational brochures on allergies and anaphylaxis or referral
to an allergist in their area, parents of allergic children are encouraged
to call the AAAAI's Physician Referral and Information line at 800-822-2762,
or visit the Academy's Web site at http://www.aaaai.org.
To obtain emergency action plans for food allergy, the public may contact
the Food Allergy Network (FAN) at 800-929-4040, or visit FAN's Web site
at http://www.foodallergy.org.
Schools
and parents create "peanut-free" zones to keep kids safe
http://www.med.umich.edu/prmc/radio/2003/nuts.htm
Peanut
Allergies in Young Children - Early Childhood Information Clearing House
Approximately 2%-3% of
all school children suffer from a food allergy. The most common allergens
are milk, peanuts and tree nuts, wheat, soy, eggs, fish and shellfish.
Peanut allergies appear to have become more prevalent over the years and
have received a massive amount of attention in the media recently. These
changes may be linked to an increased number of vegetarians and children
consuming peanut butter. The focus on increased peanut allergies has sparked
radical movements such as peanut bans on airlines and in schools. What
are the facts pertaining to peanut allergies?
http://www2.state.id.us/dhw/ecic/HW/Qpeanut_allergies.htm
Students with Peanut Allergies Need Special Monitoring
Learn how to manage a
peanut allergy in elementary school.
http://www.pta.org/parentinvolvement/healthsafety/hs_oc_peanutallergy.asp
Skippy Peanut Butter - Allergy Education
Education from the American
Peanut Council and helpful tips to manage food related allergic reactions.
http://www.peanutbutter.com/allergy.asp
Football
Season and Heat Related Illness
Football season is upon us and that means time for two-a-day
practices. Athletic Trainers and Coaches know that these are some of the
most intense workouts your athletes will undergo throughout the year.
Two-a-day practices have become a part of most early season conditioning
programs. They allow for accelerated physical conditioning, increased
strength training and sport specific skill development. Since these workouts
usually occur in the hot summer months, heat related illness becomes a
serious concern. Some football players will lose as much as 24 pounds
of fluid in one day's practice leaving them susceptible to injury. Additionally,
they are at an increased risk of heat related illness and dehydration
because of the protective equipment they must wear. This equipment is
designed for protection and does not allow for evaporation or cooling.
The Gatorade Sport Science Institute (GSSI) and NATA are working together
to help better prepare you and your athletes for the tough conditioning
season. Below are a few links from them to help educate you on the warning
signs of heat related illness and dehydration.
Heat
Related Illness and Hydration
With schools
back in session, that means its time for fall sports season to begin. Although
the bulk of the season occurs in the fall, the preseason conditioning usually
starts in the hottest months of the summer. From professional athletes to
children at play, no one is immune to heat-related illness, stress and death.
Heat injuries can be immediately life threatening. Heat related illnesses;
such as heat stroke, heat cramps or heat exhaustion occur when the body
cannot keep itself cool. As the air temperature rises, your body stays cool
when your sweat evaporates. On hot, humid days, the increased moisture in
the air slows the evaporation of sweat. With these conditions, it is difficult
for athletes to train properly; therefore, it is important to stay properly
hydrated. To learn more about Heat Related Illness prevention, warning signs,
fluid balance and other safety tips related to heat, check out the links
below. Your athletes will work hard this summer to play at the top of their
game - be at the top of yours and become educated on how to prevent heat
related illnesses.
Lightning
Safety
Lightning is a dangerous
phenomenon and athletic teams that practice and compete outdoors are at
risk when there is inclement weather. It is recommended to take a proactive
approach to lightning safety, including the implementation of a lightning-safety
policy that identifies safe locations for shelter from the lightning hazard.
The safest measure to take is to proceed indoors whenever you see thunderclouds
forming and remain until the storm passes. Just because you cannot see lightning
does not mean you are not at risk if you are outdoors. Other warning signs
of impending bad weather include: sudden decrease in temperature, sudden
change in humidity, increase in air movement, and visible dark storm clouds
(though these are not always present during a lightning strike). Lightning
may be the most frequently encountered severe-storm hazard endangering people
each year. Three quarters of all lightning casualties occur between May
and September, and nearly four fifths occur between 10:00am and 7:00pm,
which coincides with the hours for most athletic or recreational activities.
June 22-28 is National Lightning Safety Awareness Week. Sports Health would
like to help keep you informed on this very important subject. Check out
the provided links to help explain what you can do to keep yourself and
your athletes safe during Lightning Season.
www.lightningsafety.com
www.nata.org/publications/press_releases/lightning.htm
www.nata.org/publications/press_releases/lightningseason.htm
www.nata.org/publications/otherpub/lightning.pdf
www.nata.org/publications/otherpub/lightning/NATASafetyGuidelinesEndorsed.htm
www.usatoday.com/weather/resources/basics/wlightning.htm
www.lightningsafety.noaa.gov
www.ncaa.org/library/sports_sciences/sports_med_handbook/2002-03/1d.pdf
2002
Marks the 30th Anniversary of Title IX
2002 marks the 30th anniversary of Title IX, the landmark legislation that
demanded equal funding and opportunities for women to participate in sports
in schools and colleges. This 1972 equal-rights law dramatically changed
the way women's sports were perceived, encouraging more and more women to
not only participate but to excel in sports. Although Title IX has provided
American women with access to lead fitter, fuller lives, it still comes
under attack as a quota system. Check out the following related links to
read more about this groundbreaking legislation encouraging women and girls
to play sports.
Exercise
Induced Asthma
Exercise-induced asthma can be triggered by vigorous physical activity.
EIA tends to affect children and young adults because of their high level
of physical activity, but can occur at any age. To learn more about Exercise
Induced Asthma, its triggers and how to adapt to it, take a look at the
following links.
Finding
Funding for Athletic Medical Supplies
There are many ideas of how to find funding for athletic medical
supplies. Besides traditional fundraisers, additional monies may
be found through other means such as donations, corporate support,
grants and advertising/promotions.
The following links will help with how to find additional funding
for your athletic medical supplies.
Vital
Signs Trending
While participating in strenuous sports activities it is important to monitor
a students vital signs. It is also very important to record these vital
signs and review trending information. Attached are several links they you
may find useful regarding this subject.
Responding
to Medical Emergencies - Athletic Trainers
As an athletic trainer you will commonly be dealing with medical
emergencies during and after school. This section provides some
informative sites that will help you manage medical emergencies
in your schools.
Saving Lives with Automated
External Defibrillation in Schools
Sudden
Cardiac Arrest Overview
Sudden
Cardiac Arrest is the leading cause of death in the United States, affecting
an estimated 250,000 victims each year. Recent figures from the Center for
Disease Control suggest that sudden cardiac arrest affects as many as 450,000
victims annually. Even at the lower estimates, these numbers are staggering
and far exceed the annual incidence of house fires, breast cancer, prostate
cancer, and automobile accidents combined.
Currently,
a person who suffers a sudden cardiac arrest outside of a hospital has
only a 5% chance of surviving. Scientific research has confirmed that
the single most important determinant of survival from SCA is rapid defibrillation.
An Automated External Defibrillator (AED) is the only way to save their
life, but most victims do not have timely access to defibrillation.
Ninety
percent of sudden cardiac arrest victims who are treated with a defibrillator
within one minute of arrest can be saved, but every minute that a person
goes without treatment decreases a person's chance of survival by 10 percent.
While a defibrillator has a 97 percent success rate in terminating ventricular
fibrillation, fewer than half of the nation's ambulance services, less
than 15 percent of emergency service fire units, and less than 2 percent
of police vehicles are currently equipped with an AED.
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Sudden
Cardiac Arrest in Schools
Many communities are actively looking into ways to improve access to defibrillation.
In addition to equipping firefighters and police, many are now equipping
schools with automated external defibrillators, due to the fact that Sudden
Cardiac Arrest has been increasing significantly over the past several
years among students. It is important to realize that sudden cardiac arrest
does happen to children as well as adults, sometimes due to a blow to
the chest during a sporting event or a genetic defect.
Many school districts
and community members are initiating programs to equip their schools with
AEDs and to provide training to staff. Here are just a few of them:
Resources
|
Frequently
Asked Questions
|
| Q: |
What
is sudden cardiac arrest? |
| A: |
Sudden
cardiac arrest (SCA) can be thought of as an "electrical storm"
in the heart that does not allow it to beat properly. This abnormal
rhythm causes the heart to "quiver" rather than pump blood
properly. Without shocking the heart back to a normal rhythm, the
victim will most likely die within minutes.
|
| Q: |
Who
is most likely to suffer sudden cardiac arrest? |
| A: |
Sudden
cardiac arrest (SCA) is unpredictable and can happen to anyone at
anytime. The risk of SCA increases with age and previous heart disease,
but even a child can become a victim of SCA. In fact, many school
systems are implementing AEDs in their districts because of recent
sudden cardiac deaths in schools.
|
| Q: |
How
common is sudden cardiac death? |
| A: |
Sudden
cardiac death kills approximately 450,000 Americans each year. That
means about 1,250 people a day die from sudden cardiac arrest.
|
|
| Q: |
Is sudden cardiac arrest the same as a heart attack? |
| A: |
No,
a heart attack (a myocardial infarction) is very different from a
sudden cardiac arrest. Sudden cardiac arrest is often mistakenly referred
to as a "heart attack" by the public. SCA is caused by an
abnormal heart rhythm (arrhythmia) that does not allow the heart to
pump blood to the body. The only way to return the heart to a normal
rhythm is by shocking the heart with an AED. In comparison, a heart
attack is caused by a blockage of blood to the heart muscle which
causes the muscle to die.
|
| Q: |
How
much time do I have to respond to a sudden cardiac arrest victim? |
| A: |
For
every minute that the heart is not beating normally, the chance of
survival decreases by 10 percent. After 10 minutes, the chance of
survival is minimal.
|
| Q: |
I
know CPR, why do I need an AED? |
| A: |
While
CPR is very important, an AED is the only thing that can save a SCA
victim. Because SCA is caused by an abnormal heart rhythm, you need
to deliver a shock to the heart to reverse the abnormal rhythm and
return it to normal. This can only be done through the use of an automated
external defibrillator (AED).
|
|
| Q: |
Is
an AED hard to use? |
| A: |
An
AED is very easy to use thanks to advanced technology. There are only
2 buttons on the LIFEPAK 500 - the power button and a shock button.
A voice and LCD display will prompt you through the necessary steps
and tell you whether or not a shock is advised. The AED will only
allow a shock to be delivered if the heart rhythm is shockable. The
AED will NOT allow a shock to be delivered if the victim does not
need it.
|
| Q: |
Do
I need to be trained to use an AED? |
| A: |
Yes,
you need to be trained to use an AED. The training course is generally
given along with a CPR course and is available through American
Heart Association, American
Red Cross, American
Safety & Health Institute, Save-A-Life
and other local providers.
|
| Q: |
Do
I need a prescription in order to buy an AED? |
| A: |
Yes,
AEDs are class III medical devices which require a prescription for
sale and use.
|
| Q: |
Do
I need a medical director for my AED? |
| A: |
Every state
has different legislation specific to AEDs. We invite you to review
state
AED legislation information provided on the Medtronic Physio-Control
web-site. In the majority of states, medical director oversight
is required for the Good Samaritan laws to provide protection.
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