Water, Sodium, & Heat Illness: Important considerations for the sports physical therapist

Many of you have heard the saying "Drink more water".  For our athletes in competition, this is especially true.  However, we must also appreciate the importance of sodium.  Specifically, with regards to heat illness, which is common during training camps in the summer/fall.  Below are some highlights to be aware of.

Heat Cramps:  Often due to a negative sodium balance.   
-  Signs:  Painful, involuntary muscle twitching & spasms
-  Treatment:  May need immediate oral sodium or in extreme cases and IV

Heat Exhaustion: 
-  Most common heat illness
-  Two types:  Water depleted & Sodium Depleted
                           1.  Water depleted is typically more dangerous because it can occur more rapidly after exercise starts and therefore can develop into heat stroke sooner.
                           2.  Sodium depleted typically occurs after several days of exercising in heat.
-  Treatment:  Immediate rest, cooling, rehydration

Heat Stroke:  
-  Defined as a core temp greater than 40.5 degrees C (104.9 degrees F) 
-  Dangerous due to possible organ failure due to hyperthermia
-  Shock, pulmonary edema, delirium, and anhydrosis are among the symptoms in addition to those found with heat cramps & heat exhaustion.  
-  Treatment: Rapid cooling to 38.8 degrees C (101.8 degrees F) is critical.  Best= cold and ice water immersion.  


Be mindful of these illnesses when providing outreach to local schools or teams.  

- Brian

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