Heat Exhaustion and 6 Tips to Help the Older Athlete
Our body regulates our temperature within a narrow range of 97 to 99 degrees Fahrenheit... and it's not easy. Air temperature, humidity, medications, the types of clothes you are wearing, your body size, and exertion levels all can dictate how hard it is for your body to maintain its temperature.
Add age to the equation, and our bodies' response to heat stress changes throughout the years.
Heat Exhaustion vs Heatstroke
Heat exhaustion is when your body has to work really hard to cool you down. While you have heat exhaustion, your core temperature is usually less than 104 degrees Fahrenheit, but your blood pressure is low and your heart isn't pumping blood as efficiently as it should.
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So far, your body is doing what it's supposed to — you'll be fatigued, you'll sweat a lot, and you'll be thirsty. This is our natural defense against heat and dehydration, and they are still working properly.
Heat exhaustion doesn't always lead to heatstroke... but it could, notes exercise physiologist Michael Bergeron, PhD, president and CEO of Youth Sports of the Americas. Bergeron goes on to define heatstroke as "a clear medical emergency affecting multiple body systems." This generally occurs when your core temperature rises above 104 degrees.
Heatstroke causes the nervous system to malfunction and could damage multiple organs including:
- Muscle Tissue
Your body loses the ability to thermoregulate, so at that point, it's much more difficult to reverse itself.
Here's How Age Affects Heat Loss
The elderly, children, and babies are at the greatest risk for heat-related illnesses when compared to young and middle-aged adults.
Babies and children have less skin surface area available for evaporative cooling. This is a fancy term for sweating. Hot environments can cause them to store a lot of heat and struggle to then get rid of it. Very young children often lack the ability, autonomy, or even the understanding to move out of a hot environment, to remove layers of clothing, or to reduce their activity levels.
On the other end of the spectrum, you have the elderly. They are put at a greater risk due to a lack of mobility. But studies suggest that physically active older adults suffer more than younger adults in the heat.
A 2016 study showed both the younger group, aging from 19-28 years of age, and the older group, aging from 55 to 73 years of age both responded similarly to heat exposure during the first hour. They found the older group stored more heat, which means their heat loss has decreased, as time went on.
Researchers cite reduced blood perfusion to the limbs as a potential limiting factor for evaporative cooling in the older group.
Another 2016 study examined the sympathetic nervous system activity in response to heat, and they found there was a reduced sweat response in older athletes. They found that older adults — 67 years of age — had a reduced vasodilation reflex in the skin, but that reflex was blunted in aged skin.
How Does Fitness Affect Weight Loss?
One key adaptation of being physical is that people will start sweating earlier, more profusely, and from other areas of their skin in response to being more physically active. As you increase the amount of work, your body ramps up its cooling mechanisms to be ready for the demand. As you increase the amount of work, you increase the amount of heat.
Your body mass plays a role in your heat loss, too. Both overweight non-athletes and athletes store more heat when compared to smaller individuals. The military has researched this as they try to adapt training methods for larger recruits.
Cooling a larger body puts more strain on the cardiovascular system since there are more blood vessels perfusing more skin surface area.
Older Athletes are More Vulnerable to Heat Storage
While fitness improves your "sweat efficiency" when compared to sedentary people, it is different for older people. Similar to the way your VO2 max gradually declines after 40, your fitness-related adaptation to sweat response diminishes as well.
A 2015 study compared younger and older firefighters, along with non-firefighters of a similar age — 27, 57, and 53 years of age. Researchers concluded that both of the older groups stored more heat during intermittent exercise when compared to the younger group, but the older non-firefighters stored a significant amount more heat than the older firefighters.
Another study conducted in 2015 studied female athletes and proved that the older group — 58 years of age — dissipated less heat through sweating when compared to the younger group of 23 years of age. The subjects were matched for skin surface area and fitness level, which wasn't the case for the firefighter study.
This study found that as the exercise workload increased, the heat generated increased. The differences between the groups' responses grew as the exercise workload increased.
6 Signs of Heat Exhaustion
Everyone is affected by heat differently, but here are six common signs of heat exhaustion.
#1 - Cramps, Headache, Nausea
The first signs of a heat-related illness often starts with cramping or nausea. This can indicate dehydration or an electrolyte imbalance in your body. They are closely linked with heat illness, since your body needs water, and you need electrolytes like sodium to properly regulate your temperature.
The bad part is you lose electrolytes and water through sweat, so a headache is also a common first sign of dehydration.
It's hard to know if your GI distress is from heat while you are exercising, but if the conditions warrant you thinking this, assume it is heat-related. Take a break when you are feeling better.
#2 - Dark Colored Urine
The color of your pee can tell you a lot. If you are out exercising and drinking water during your breaks and your urine is fairly clear, that's a good sign of staying hydrated. The problem is when your urine is a dark color.
This is a sign of being dehydrated, which means you can't efficiently release heat through sweating. This puts you at risk to overheat.
#3 - Thirst and Heavy Sweating
It's common sense that when we start sweating more, our body is producing a lot of heat. This can lead to heat exhaustion if the conditions don't improve or they get worse. Heat is most dangerous on humid days since our sweat can't evaporate off of our skin.
Feeling thirsty is a sign that your body needs more water. Even if you don't feel thirsty, try to sip water frequently on hot days. If you are a construction worker or out in the heat for more than an hour, you should look into trying a sports drink to help replenish the electrolytes you've sweat out.
#4 - Lack of Sweating
If you are out exercising in the heat and your skin is totally dry, that should be a red flag. When our body reaches a certain internal temperature, the body's natural defense to cooling off like sweating to release heat starts to shut down.
You don't always have to get to the point where you stop sweating to be in the danger zone, so don't assume that someone sweating heavily is okay — especially if they exhibit any other of these signs of a heat-related illness.
#5 - Weakness, Dizziness, Collapsing
Heat exhaustion often makes people feel dizzy, want to sit down, or pass out momentarily. This is good because it is our body telling us to stop before we get into serious trouble. The hotter the temperature, the more of these symptoms you could experience.
#6 - Confusion, Convulsions, Coma
Unfortunately, if heatstroke progresses enough, you can cause damage to your brain. This is when you start to feel confusion or even delirium. This is dangerous because if you are confused, you may not do the things you normally do to cool down like seek shade or get some water.
You Don't Have to Feel Hot
Exhibiting signs of heat illness isn't as obvious as it sounds. Developing overheating, which can lead to exertional heatstroke, can make someone feel chilled, even when in the heat.
This is because our body experiences exercise- or heat-related stress it protects itself by producing inflammatory proteins. These proteins can interfere with your body's thermoregulation, which can bring symptoms like the chills, goosebumps, or cold and clammy skin.
Listen to Your Body
Most of the heat in our body is produced internally from muscle exertion. In hot and humid conditions, lowering the intensity of your workout may be smart. Wear sweat-wicking clothing, drink plenty of fluids, and take precautions before you start.
If you feel like you are overheating, stop what you are doing and cool down. If you notice any sign of deterioration in your performance or any sign of struggling should be a reason to take a break.
Get Out of the Sun
Getting out of the sun is one of the most important things you can do to help yourself or someone else who is suffering from a heat-related illness. Ideally, get to an air-conditioned area, but shade can help.
The US Occupational Safety and Health Administration cites a location that is bathed in direct sunlight can have a heat-related index value of up to 15 degrees higher than a shaded spot nearby.
Get More Air Circulating
The process of blowing air or water over your skin will help transfer away the heat. Increase the air exposure to your skin. Loosen your clothing and remove everything you don't need.
Sit in front of a fan and relax while you try to lose your excess body heat.
Elevate Your Legs
Your blood flow could be compromised during a heat-related illness, so if you can sit or lie down, elevate your feet about 12 inches. This can help prevent any swelling in your legs and improve blood flow to the brain.
It's also smart to sit down if you are feeling faint to reduce your risk of a fall injury.
Drink Cold Water and Use to Cool Your Body
If you or whoever is suffering from a heat-related illness is conscious, have them drink some water or a sports drink. The cool fluids can help lower your body temperature faster than room temperature fluids.
Apply cold water or ice directly to the skin — if you or the person are not sweating, spraying them with some water can help mimic the sweating process and evaporate some of the heat off of the body.
If the person has reached a dangerous heat level, a full-body immersion into an ice bath or cold body of water is the most effective at lowering temperatures quickly. Apply ice packs or a towel soaked in cold water to help.
Seek Medical Help
If you or someone is showing signs of heatstroke, get medical attention immediately. They will need to have their blood pressure, heart and respiratory rate, temperature, and central nervous system monitored closely even once they start to feel better.
Advice for Older Athletes
If you are over 50 and feel that you are less tolerant to heat than you used to be, you're probably right. While there is a lot of personal variability, someone's tolerance or performance in heat changes differently than another athlete.
Stay on Top of Hydration
Dehydration hurts your performance, but for older athletes who are more likely to store heat and have a diminished sweat response, staying hydrated becomes critical.
Watch Your Medications
There are some medications that can adversely affect your ability to deal with heat. A beta blocker is a good example — it slows a person's heart rate, which can make it harder for your circulatory system to move heat to your skin.
Some antihistamines and antidepressants have been shown to hinder sweating, so consult your physician to review your medications and see whether they will affect your heat or sun sensitivity.
If you're carrying more weight than you should, losing weight can improve your heat tolerance. You won't have to work as hard to maintain the same pace with less mass to move. This means your heart won't have to work as hard and you won't have as much insulation to keep the heat in.
This means your "sweat efficiency" will improve.
Wrapping It Up
When it comes to heat, you need to be prepared. Keep an "exit plan" in case you have heat-related illness symptoms.
Find shade, drink and pour cool water on your body, know your limits, and seek medical attention if you are worried you are having heat-related symptoms.
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