NATA Offers 10 Tips to Prevent Heat Illness and Dehydration

Thursday, July 5, 2018


DALLAS – Many parts of the country are experiencing extreme heat this summer, but for the most part, outdoor activities continue as planned. Young athletes participating in summer and pre-season sports are particularly susceptible in July and August. To guard against heat illnesses and dehydration, the National Athletic Trainers’ Association offers these important recommendations:


  1. Gradually get used to warm weather activities over a seven- to 14-day period. This prepares your body for more intense, longer duration exercise in warm conditions, and helps prevent injury and heat illness. For the first two days in sports requiring protective equipment, only helmets should be permitted (this includes goalies as in the case of field hockey, catchers in baseball, and related sports); during days three to five, only helmets and shoulder pads should be worn; beginning on day six, all equipment can be worn.
  2. Keep water or sports drinks nearby for easy access to help prevent dehydration. Individual containers are ideal so drinking is quick and easy during breaks.
  3. To avoid dehydration and hyponatremiaensure proper hydration before the start of an activity by checking these three things:
  • Urine color: Urine should be the color of lemonade; clear urine indicates full hydration and darker urine (color of iced tea) indicates dehydration.
  • Thirst: Thirst indicates potential dehydration while no thirst indicates full hydration
  • Urine frequency: Urinating less frequently than normal may indicate dehydration.


If you notice more than one of these inadequate fluid intake indications, you are likely dehydrated and should increase your fluid intake.

  1. Choose a flavor or type of drink you like, and, whenever possible, keep the beverages on ice.
  2. Food and rehydration beverages should include sufficient sodium (enough to replace losses but not excessive amounts) to prevent or resolve imbalances that may occur as a result of sweat and urine losses during physical activity.
  3. Use a sunscreen with a sun protection factor (SPF) of at least 30. Apply sunscreen to dry skin 15 minutes before going outside.
  4. Sunscreen should be applied even if the sun is not out. UV rays can be strong, even on a cloudy day.
  5. If you are swimming or sweating, make sure the sunscreen is water and sweat resistant and reapplied during breaks. 
  6. To help avoid heat illness, get plenty of rest (including sleep) between exercise events, and do not push it if you are feeling sick. Even a simple cold can make you more susceptible to heat illness.
  7. An athletic trainer on site ensures proper medical supervision, as well as recognition and treatment of possible injuries and heat illness.

“Many cases of heat illness and dehydration are preventable, but if they do occur, they can often be successfully treated if properly recognized and appropriate care is provided in a timely manner,” said NATA President Tory Lindley, MA, ATC. “By taking these proper precautions, we can stay safe while enjoying activities throughout this hot summer.” For additional information, including the signs of minor heat illness and exertional heat stroke, check out these handouts: sun safety and hydration and heat illness


Following is an overview of the heat-related ailments to be aware of when working or playing in the heat:

Exertional Heat stroke is an extremely serious illness that can result in death unless quickly recognized and properly treated. Signs and symptoms include an increase in core body temperature (usually above 104°F/40°C); central nervous system dysfunction, such as altered consciousness, seizures, confusion, emotional instability, irrational behavior or decreased mental acuity; nausea, vomiting, or diarrhea; headache, dizziness, or weakness; increased heart rate; decreased blood pressure or fast breathing; dehydration; and combativeness.

What to do: It’s very important that treatment for exertional heat stroke be both aggressive and immediate, provided adequate medical personnel (i.e. athletic trainers and sports medicine physicians) are on site. Key steps to take when exertional heat stroke is identified include immediate whole-body cooling, preferably through cold-water immersion, followed immediately by medical treatment in an emergency room or trauma center. Death from heat stroke is 100 percent preventable.


Heat exhaustion is a moderately serious illness resulting from fluid loss or sodium loss in the heat. Signs and symptoms include loss of coordination; dizziness or fainting; profuse sweating or pale skin; headache, nausea, vomiting or diarrhea; stomach/intestinal cramps or persistent muscle cramps.

What to do: Heat exhaustion patients should immediately be transported to a cool, shaded environment with feet elevated, and fluids should be replaced. If their condition worsens or does not improve within 5-10 minutes, they should be transported to the emergency room for evaluation and treatment. Those suffering from heat exhaustion should avoid intense activity in the heat until at least 24 hours. NATA also recommends a trip to the physician to rule out any underlying conditions (i.e. cardiac condition) that may predispose them to heat exhaustion.


Heat cramps are often present in those who perform strenuous exercise in the heat.  Conversely, cramps also occur in the absence of warm or hot conditions, which is common in ice hockey players. Signs and symptoms include intense pain (not associated with pulling or straining a muscle) and persistent muscle contractions that continue during and after exercise.

What to do: People suffering from heat cramps should cease activity, consume high sodium food and stretch the affected muscle. They should also be assessed by an athletic trainer to determine if they can return to activity. If cramping progresses in severity or number of muscle groups, patients should be transported to the emergency room for more advanced treatment.


Hyponatremia is a potentially fatal illness that occurs when a person’s blood sodium levels decrease, due to over-hydration or inadequate sodium intake, or both. Medical complications can result in cerebral and/or pulmonary edema. Signs and symptoms of this illness include excessive fluid consumption before, during and after exercising (weight gain during activity); increasing headache; nausea and vomiting (often repetitive); and swelling of extremities (hands and feet).

What to do: Hyponatremia cases that involve mental confusion and intense headache should be seen by a physician so proper treatment can be administered. A physician should also be consulted prior to resuming outdoor activity in the heat. Always listen to your body. If you are participating in any fitness routines or general activity in the heat, and you start to feel ill or strange, you should stop immediately and seek medical attention, as needed.