Beware of heat as practice returns

Over six million children will soon be heading out to athletic fields across the country to participate in a variety of fall sports. Unfortunately, practice sessions begin during the warmest months of the year, subjecting these athletes to one of the most frequent causes of death in sports.

Heat-related illnesses are a spectrum of conditions. Muscle cramps and exhaustion are fairly common. Cramps are usually related to poor hydration and electrolyte imbalances. Many athletes have a genetic predisposition to cramping and may require salt supplements.

Heat exhaustion is a sense of fatigue that results when the demand for increased blood flow cannot be met due to dehydration and cardiac failure. This can lead to syncope (fainting) when blood supply to the brain is inadequate.

Exertional heat stroke is a medical emergency that can potentially lead to death in minutes. It involves the escalation of hyperthermia to the point that it leads to cardiac failure and coma. It must be identified and treated swiftly and aggressively.

Treatment of heat-related illnesses involves adequate hydration either orally or intravenously. Heat stroke is treated by immediate immersion into a cold bath. This is followed by emergency transport to a medical center for further evaluation, treatment and observation.

“Acclimatization is the process that allows an athlete’s body to perform in warm climates by gradually increasing the amount of exposure to extreme conditions,” reports Dr. Rebecca Stearns, Chief Operating Officer of the Korey Stringer Institute at the University of Connecticut. “Parents should be sure there is a heat acclimatization and weather policy that is followed by youth sports organizations before allowing their children to participate.”

First aid training for coaches and officials is crucial to identifying heat-related illnesses.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

Performance-enhancing drug problem at new level

Among the biggest pre-Olympic stories has been the disqualification of athletes due to widespread use of performance-enhancing drugs (PEDs). Although PEDs have been a part of individual efforts to cheat, the revelation that there was a nationally sponsored program to hide the use of PEDs by Russia has taken this problem to a new level.

PEDs are medications approved to treat specific medical problems and instead are used outside of their approved use to improve athletic performance. These include anabolic steroids, banned supplements, amphetamines and diuretics.

Anabolic steroids, including testosterone, human growth hormone and androstenedione are taken to increase muscle size and strength. This will also result in improved endurance.

Many banned supplements are designed to increase muscle efficiency. Some include creatine, an essential muscle component. Another pitfall of supplements is that they are not FDA regulated and often contain unknown substances that may be banned.

Stimulants include amphetamines, caffeine and some cold remedies. These substances increase heart rate and blood pressure. Oddly, these substances can also have a negative impact on athletic performance.

Diuretics increase kidney function and urine output. This will help athletes lose weight and compete at a lower weight class in some sports. It can also result in dehydration during competition and lead to muscle cramps.

Diuretics have also been used as “masking” agents that dilute urine and make the detection of banned substances more difficult.

“The ability to avoid a positive test while using a PED has become a new science and has led to increasing competition among researchers on both sides of testing,” reports Dr. Jeffrey Anderson, Medical Director of UConn Student Health Services. His conclusions are based on his efforts to make professional and amateur athletics fair.

The incidents involving Russian athletes included a state-sponsored program to replace tainted urine with clean urine from other athletes at the time of testing.

Hopefully, this 31st Olympiad will represent a step closer to fairer play when it comes to PEDs.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu