This has been one of the hottest summers on record with increasing temperatures continuing through July and August (National Weather Service, 2022). If you have a teen athlete playing fall sports, this is smack dab in the middle of all that heat. Youth are at an elevated risk of being chronically dehydrated (Corcuera Hotz & Hajat, 2020). Heat injury and death are a real concern during these summer months, especially for sports like football with heavy equipment and helmets. Additionally, dehydration is associated with decreased performance and even non-contact injury. Think about the times you have seen a player down on the field clutching their knee or hamstring without even having contact. Or runners crossing finish lines crazy-legged. These are examples of dehydration at work, and extreme dehydration can even lead to hospitalization and death. So, you want your athlete to be safe AND open a can of kick-ass while empowering them to recognize the warning signs of heat injury and appropriate steps for prevention.

Warning Signs

Luckily, the days of “water is for the weak” are over. Tragically though, there were casualties along the way, Korey Stringer being one of the most notable. There are two problems with improper hydration: hypohydration and hyperhydration. Hypohydration is a physiological “state”, while dehydration is the process of getting there. Additionally, hyponatremia is when an individual over-hydrates causing low sodium stores, which can result in a heat injury. Sadly, the warning signs are similar, so misdiagnosis is common.

Common symptoms of hypohydration are:

·   Thirst

·   Flushed skin

·   Apathy

·   Dizziness

·   Nausea, diarrhea, vomiting

·   Chills

·   Headache

·   Difficulty breathing

·   Stomach Cramps

·   Discomfort

·   Body weight loss

Common symptoms of hyponatremia (i.e., low sodium stores caused by an electrolyte imbalance) are:

·   Altered mental status

·   Muscle twitching and weakness

·   Dizziness

·   Out of sorts

·   Headache that increases in intensity

·   Difficulty breathing

·   Swollen hands, feet, or both

·   Mood change

·   Seizure or coma

·   Actual weight gain

(McDermott et al., 2017)

Hot and humid climates, such as Southern states in the United States, present additional dangerous factors. Sweat rates are high in this climate and with high humidity saturation, sweat does not easily evaporate (due to all the water already in the air). The evaporation of the sweat is how the body cools itself and when it doesn’t evaporate, there is an extra layer that maintains or increases body temperature.

Performance Drain and Injury

Hydration is a key factor in performance, even a 1% drop in hydration status can affect performance (Karpinski & Rosenbloom, 2017). Sports skills and decision-making diminish without proper hydration, especially at a 2% loss (Nuccio et al., 2017; Fortes et al., 2018). During preseason practice sessions this can mean the difference of your athlete making the team and starting, or being told to come back next year. It is important to begin each practice session properly hydrated and maintain that throughout the session. Sadly, most teens begin practice dehydrated, and will not catch up during practice. Even more, their dehydration status continues to increase over the course of the week of training camp and multi-day tournaments (Phillips et al., 2014).

Muscle performance decreases as well. Dehydration affects joint and muscle integrity which increases the risk for non-contact injuries (Minshull & James, 2013). Coaches, parents, and athletes involved in a quick change of direction in sports such as football, lacrosse, tennis, field hockey, and soccer must be diligent about hydration.

Finally, the rating of perceived exertion is affected and effort will feel more difficult in a dehydrated state. Additionally, headaches, alertness, and concentration decline (Logan-Sprenger et al., 2012). For an athlete trying to make the team, starting line up, or crush their enemies on the field, this can be the difference between success and failure. Stay hydrated!

Monitoring Hydration

Cheuvront & Swaka ( 2006) suggest a simple three-step approach for monitoring the hydration status of athletes.  The first step is to determine if the athlete is thirsty. The second step is to monitor urine color (see chart below). The third step is to weigh each morning to determine if body mass is lower than normal. If one condition is met, the athlete may be dehydrated. Two conditions present indicates likely dehydration. When all three conditions are present, they are very likely dehydrated. 

Empowered Hydration

The best way to not get dehydrated is to maintain proper hydration before and during practice and to weigh in prior to competition. Four hours prior to practice or an event, drink 5 to 7 ml/kg of body weight. For instance, a 90 kg (approximately 200 lbs) football player would consume 630 ml (22 ounces) of water (Karpinski & Rosenbloom, 2017). This is also assuming that he is drinking at least half body weight in ounces just to keep the body water normal. Continue to monitor urine color, look for pale yellow. If it looks darker, more water is required and if it is nearing clear colorless water is required.

During practice or games, continue to consume fluids. Electrolytes or carbohydrates might be required depending on the length of time of practice and sweat rates. Sweat rates are hard to determine. In general, for practice lasting less than an hour, water is likely all you need. For team sports, 0 to 60g of carbohydrates per hour depending on the sport. For example, lacrosse or field hockey may require 0 to 30g/hour while soccer might need 30-60g/hour (Dunford & Doyle, 2017). There may be some trial and error to find the right carbohydrate type as certain carbohydrate types (i.e., sports drinks or sport gels) can present stomach cramps and issues. The time to test is BEFORE competition not DURING competition. Glycogen is the major fuel source during exercise/sports so replenishing glycogen can delay fatigue and fuel the athlete.

Thirst is not a good guide. It is best to try to stay hydrated when possible, depending on the training schedule. Waiting for thirst can be too late, as the athlete is already dehydrated.

Multi-day events like tournaments have a high risk of dehydration (Phillips et al., 2014). With the possibility of playing multiple times a day, it is important to keep replenishing fluids and electrolytes. Having salty snacks like pretzels available can help keep salt levels up while replenishing before the next game.

Post practice or event is time to replace lost fluids. Weigh again to determine water loss (remember the athlete should not be heavier), and go from there. The athlete should rehydrate with 1.25 to 1.5 liters of water with electrolytes to replace the salt loss. Great news, our friends at LMNT offer a great easy-to-mix electrolyte product.

For teen athletes, dehydration in the summer heat and humidity can be extremely dangerous to their health if not monitored – coaches, that’s on you. What’s the best way you can Empower their Performance during these summer months? Educate YOURSELF and educate your ATHLETES on the warning signs of dehydration and hydration monitoring. This could be the difference between starting, sitting on the bench, or lying down in a hospital bed.

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COACHING: Power Athlete Nutrition Coaching

EDUCATION: Power Athlete Academy