Fluid Replacement and Prevention of Heat IllnessEnvironmental Conditions
NASPE/NCAT Sport Injury Resource
The National Athletic Trainers’ Association (NATA) recommends the following
practices regarding fluid replacement for athletic participation. For more information,
log onto http://www.nata.org,
then click on Publications > Position Statements.
1) Establish a routine for water or hydration consumption.
Remember, by the time your athletes become thirsty, they are already dehydrated.
Increase water breaks during practice. Instruct and require athletes to drink
7 to 10 fluid ounces every 10-20 minutes. Water is the more practical fluid
to consume, however, if other types of sport drinks are used, make sure to read
the label. The carbohydrate concentration should read below eight percent. Carbohydrate
concentrations above 8% compromise the rate of fluid emptying from the stomach
and absorbed from the intestine. Fruit juices, carbohydrate gels, sodas, and
some sport drinks have carbohydrate concentrations higher than 8% and are NOT
recommended during activity as the sole beverage. It is helpful to dilute prepared
sports drinks if uncertain as to the carbohydrate levels. Discourage young athletes
from drinking beverages containing caffeine or carbonation during activity.
They can dehydrate the body by stimulating excess urine production, or decrease
voluntary fluid intake.
2) Instruct athletes to drink plenty of water prior to and after practices
and games. Two to three hours before activity, have athletes drink
17-20 ounces of water or sports drink such as Gatorade®. Approximately 10-20
minutes before the event, have them drink another 7-10 ounces of water or sports
drink. Within two hours after activity or the game, youth should replace any
weight loss from exercise. A guideline to follow includes drinking approximately
20-24 ounces of water or sports drink per pound of weight loss.
Other Heat Illness Prevention Guidelines:
- All athletes and coaches should be familiar with heat illness
prevention, recognition, and treatment.
- Adapt athletes to exercising in heat gradually over 10-14 days (acclimatization).
- Educate athletes to maintain adequate hydration. Replace
fluids between practices on the same day and on successive days to maintain
less than a 2% change in body weight. Athletes exercising in hot conditions,
especially during two-a-day practices, require extra sodium in fluid replacement
drinks and/or diet.
- Check the environmental conditions before and during the activity, and adjust
the practice schedule accordingly. Avoid practicing during the hottest
part of the day (10 am to 5 pm) during extreme periods of heat and humidity.
Modify activity/practice under high-risk conditions: (1) high temperature and
humidity; (2) athletes susceptible to heat illnesses: over-weight and/or obese
individuals, those in poor condition or who are sick, athletes wearing excessive
or dark-colored clothing/equipment, athletes who take certain medications with
a dehydrating effect.
- Plan adequate rest breaks. Fluid and rest breaks should
be scheduled for all practices and scheduled more frequently as the heat and
humidity rise (i.e., when temperature/humidity is extreme), allow for 5-10 minute
rest and fluid breaks every 15 to 20 minutes and practice in shorts/loose-fitting
mesh shirt with no equipment such as pads/helmet. As an example, a full football
uniform prevents sweat evaporation from more than 60% of the body. A supply
of cool water and/or sport drink should be readily available for all practices.
- Weigh at-risk athletes before and after practice to estimate the amount of
body water lost during practice and to ensure a return to pre-practice weight
before the next practice. In high heat/humidity conditions or during multiple
practice schedules, all athletes’ weight should be monitored (pre
and post-workout weights recorded).
- Ice should be available for active cooling in case of heat
illness and to keep beverages cool.
- A tub (cold whirlpool) or “kiddie pool” full of cool water should
be available when environmental conditions are immoderate.
- Make sure athletes receive 6-8 hours of sleep each night in a cool environment.
eat a well-balanced diet, and maintain proper hydration. Implement rest periods
at mealtime by allowing 2-3 hours for food, fluids, nutrients, and electrolytes
(sodium and potassium) to move into the small intestine and bloodstream before
the next practice.
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