When you are managing athletes that are possibly in danger of heat exhaustion you want to really ask about how their muscles feel and look for cramping.
Muscles are SUPER particular about how much hydration and salt they have when they are being exerted. When they are out of whack many athletes will get heat cramps, and those cramps can happen in any of their legs or arms. Being hot and tired for an extended period can induce cramps.
Here’s the phrase I will burn forever into your brain :
“It’s time to switch when you see the twitch.”
The earliest sign of heat cramps is a slight little tremor twitch on a muscle, and sometimes the eyeball will give you that first indication. The “switch” part means that you have to switch what the athlete is taking in for beverages – specifically electrolytes and sugars. Six to 12 ounces of sports drinks at a rest stop may not be enough to combat what the body is consuming; 400-800 ML/hour is the optimum rate of liquid intake for an athlete on the trail.
They don’t need just more liquid- they need fuel. Look to salty broth mixtures with heavy carbohydrates to aide the body’s consumption. Over hydration will exasperate the problem plus lead to rapid nausea, and nothing is more disgusting than a surprise liquid splashing chow-blowing. If they get dizzy and blow, they have too much water and not enough fuel.
A heat cramp later on (from over extension) can be signaled when an athlete lilts, weaves, or changes gait without even knowing it because they are hyper focused on their endurance goal.
Heat cramps also come in the abdomen but we will cover those in a different blog because abdomen cramps can mean a lot of things. FYI parents – I see abdominal heat cramps a lot more in younger athletes (pre-teen/high school) and it is misdiagnosed on the sports field frequently. “My stomach hurts” is usually a common heat cramp from overexertion in youth.
Most cramps come from muscle tightness, but heat cramps are actually easy to identify. Tension cramps are from a type of tightness, and in the onset a tension cramp will “snap” in and feel like a knot. The biggest way to know if it is heat related or tension related is when rubbing doesn’t actually help and the larger muscle is having spasms. Heat cramps will NOT subside until the body has been cooled and the correct amount of water and salt is replaced into the muscle. That can take more than 30 minutes, so trail drivers will have to pay attention to early onset and keeping athletes regularly cooled down.
Heat cramps are a warning sign that the athlete is approaching heat exhaustion, so it’s a really good idea to use an external cool down method as well as an internal hydration method.
Immediately get out of direct sunlight.
Try to cool the entire body.
Give clear juice like apple.
Give sports drink with electrolytes.
Broth mixtures (with marrow) are also good.
Wrapping athletes in ice soaked towels will help manage core temperature, but the relief won’t come until the muscle has been put back in equilibrium.
If an athlete is going to try to run through heat cramps they absolutely need to be taking in sports liquids with heavy carbs, but if those cramps are more than an hour long they will have to shut down and rest in order to get relief.
To keep them on the trail remember “It’s time to switch when you see the twitch.”