Checking for signs of heat related illnesses

I was watching the Australian Open Tennis Championships last week between the number #1 seed and the number #4 seeds. The #1 was not performing well and had missed serves, unforced errors, and was losing games because of his poor performance. Having watched sports and been an athletic trainer for a number of years I made the comment, “There is something wrong with him. He is not performing at his usual level.” Between watching athletes perform below expectations and having experienced a few episodes of poor performance myself I could see something was not right. The first thing that came to mind was the start of heat exhaustion. The strokes were there but they were missing the ‘sweet spot’ on the racket, he was outside the lines and hitting the net. Australia is in a hot time of the year and dangers from heat are common. I write a column every year reporting the signs of heat cramps, heat exhaustion, and heat stroke. The problem with heat illness is that they are accumulative in nature. Activities you did earlier in the day may affect performance in an activity later in the day. I thought that he may have spent too much time warming up before his match and now those subtle changes were affecting his performance.

The heat can affect performance in many other forms. Laborers, landscapers, carpenters, AC workers, etc. The carpenter is suddenly missing the nail head more than usual. The drill is not straight in the screw and does not sink into the wood. The person moving furniture into the house finds that his feet are stumbling, steps are catching the toe of his boot. The work is being done but the quality is gone and mistakes are more frequent. These are the “pre-warning signs” of the “warning signs” of heat problems.

One early warning sign for a runner is their pulse rate. If the pulse rate is 10 or more beats above normal when they wake up this is a pre-warning sign that it is time to miss a workout or go slower and shorter that day. If the legs feel “heavy” during the run this is another subtle sign that things are going to get worse. Catching the toe on cracks or uneven points in the sidewalk because the knee and foot are not being lifted to their normal height. Trouble focusing on tasks, or trying to recall your schedule for the day do not seem to be heat problems but are the start of these problems that will appear quicker than you might think. I remember being tired and thirsty but wanted to dig one more hole to plant a bush and found myself lying on the ground unable to move. Some cold water and cold towels brought me back to normal. That bush was planted the next day. A day spent working out in the morning, mowing the lawn in the early afternoon, left me time for a quick three mile run. A little over a mile into the run I was walking, had no recollection of where I was until I saw my house two blocks away. How I got to that point I have no idea. The try at running those last two blocks lasted about ten steps and a slow walk for those two blocks got me inside the cool house. I missed all the pre-warning signs.

It is the early signs of problems that not many people will even recognize. Performance is “okay” but not up to your usual good performance and you count it as having a ‘bad day’. This accumulative effect is not just limited to a few hours before your activity. That accumulative effect may have started as much as two days before and you did not fully recover from those previous day’s activities.

The other reason can be the start of an illness. You had a ‘bad day’ in an activity a couple of days ago and now you find that you have a cold or start of the flu. Taking the time for some necessary rest and allowing the body to fully recover may not prevent the cold from happening but it will make it much easier to handle. When the body is over trained or pushed hard in a workout and not allowed to rest and recover “fully” that cold or flu finds a weakened immune system and settles in for a few days.

While I do not know the status or comments from the #1 seed after the match I would be curious to know how long it took him to recover from that match. Sometimes it is hard to listen to the body and those early warning signs but if you are having a ‘bad day of activity’, maybe listen a little closer to what your body is trying to tell you and think back to previous activity – even from a day or two back. Stay healthy and safe and learn to recognize those ‘pre-warning signs’.