Preventing Cramps and Illness within the Heat

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A Question we get asked a lot is: What are muscle cramps and why do muscles cramp? We try to explain the phenomenon in our second video of the “explained series”.
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Schwabe et al. (2014): https://www.ncbi.nlm.nih.gov/pubmed/24815928.
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This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.

Summer is here! Paul J. Porter, Jr., MD, from The Miriam Hospital Emergency Department, describes the signs and symptoms of heat stroke and other heat-related illnesses and shares tips for staying safe this summer. For more info: http://www.miriamhospital.org/

We learn why heading out in the heat can sometimes be dangerous, and what steps you should take in order to prevent heat exhaustion and other heat illnesses. We also look at what to watch for in terms of potential symptoms. Plus, what to do for someone you think may be experiencing heat exhaustion, and when it’s time to seek medical attention.

Heat illness can quickly turn deadly! Don’t let intense heat and humidity interfere with your workouts, athletic training or outdoor sports activities. Dr. Eric Coris, director of Primary Care Sports Medicine at USF Heath offers tips for preventing for preventing heat stroke and heat exhaustion.

Emily gets advice from an expert form the Red Cross on what to do about heat cramps.
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Heat-Related Illness and Young Athletes.
Playing it Safe in Hot Weather.
Living and playing in Central Florida means hot days and high humidity — and an increased risk for dehydration, heat stroke, heat exhaustion and heat syncope (fainting). The best defense against these potentially life-threatening heat-related illnesses is a game plan you can put into action quickly if needed..
Dehydration.
Dehydration, or water loss, can lead to dangerous changes in blood electrolyte levels (such as sodium and potassium). If these signs of dehydration develop, take a time-out for a water break:
• Mild symptoms: thirst, dry mouth, muscle cramping – take a break and rehydrate.
• More severe symptoms: weakness, dizziness, fainting – take a break and rehydrate and make sure you fully recover before considering returning to physical activity.
Game Plan: Rehydration.
• Encourage drinking water, electrolyte replacement drinks or sports drinks until you have to urinate..
• If nausea or vomiting occurs, intravenous (IV) rehydration at an urgent care center or emergency department may be needed..
• If urine is dark yellow, continue rehydrating..
• If an athlete is confused or unusually sleepy (lethargic) or does not urinate within 12 hours, seek emergency medical care..
When to Hydrate and How Much.
During physical activity in hot weather, try to schedule water breaks roughly every 20 minutes. In rare cases, drinking too much can actually be dangerous, but this typically only occurs when someone has been exercising for a few hours. In these instances when young athletes are exercising and rehydrating for several hours, try to limit the amount of fluid to around 34 fluid ounces per hour for teens and around 14-16 fluid ounces per hour for children ages 12 and younger..
Heat Stroke, Heat Exhaustion and Heat Syncope (Fainting).
When a young athlete is overheated, it can be a life-threatening situation. That’s why it’s important to recognize the signs and symptoms of a heat-related illness and move quickly to cool and rehydrate with fluids..
Heat stroke occurs when the body’s temperature exceeds 104°F (40°C) and can no longer cool itself. It is the most serious and severe type of heat related illness and can result in brain damage and even death. For any sign of heat stroke, call 911. Signs of heat stroke include:
• seizure (unresponsive, shaking arms and legs).
• unconsciousness.
• confusion.
• lack of sweating (hot, dry skin).
• rapid pulse.
• rapid breathing.
Heat exhaustion is less severe than heat stroke and emergency treatment is typically not required. It should; however, still be taken seriously with the athlete resting, rehydrating and ideally being moved to a cooler or shady area to recover. Signs of heat exhaustion include:
• increased thirst.
• profuse sweating.
• lightheadedness on standing.
• cramps.
• headache.
• weakness.
• poor coordination.
• nausea / vomiting.
Heat syncope (SYNC-uh-pea) is fainting due to a hot environment. A young athlete with heat syncope should recover immediately after falling to a horizontal (lying down) position. If an athlete remains unconscious or confused, treat the condition as heat stroke and call 911..
Game Plan: Cooling an Overheated Player.
For any signs of heat stroke call 911. To quickly cool an overheated player:
• Move the athlete to the shade or an air-conditioned space (under a tree, inside a house, building or car)..
• Remove all unnecessary clothing.
• Consider placing the athlete on their side to maximize the surface area of the body that is exposed to the air and to help prevent aspiration if they vomit.
• If available, apply ice packs to the athlete’s neck, armpits and groin regions.
• Circulate air across the athlete’s skin using an electric fan or manual fanning..
• Use a wet cloth or spray mister to keep skin and hair moist..
• If the player begins to shiver, reduce the cooling efforts..
• If the athlete is conscious and alert enough to safely drink, then rehydrate with water, electrolyte replacement drinks or sports drinks..
DID YOU KNOW?
Antidepressant medications and antihistamines such as Benedryl (diphenhydramine) and Claritin (loratadine) increases the risk for heat-related illness..
Visit www.nemours.org to learn more.

Lebron James left the game during the Heat vs. Spurs NBA Finals after muscle cramp took over his body..
Memorial Fitness Center’s Rob Herzog explains what may have happened to LeBron and how you can prevent cramps from happening..
Muscle cramps.
Definition.
Muscle cramps are when a muscle gets tight (contracts) without you trying to do so. The muscle gets tight and does not relax. Cramps may involve all or part of one or more muscles..
The most commonly involved muscle groups are:
Back of the lower leg/calf.
Back of the thigh (hamstrings).
Front of the thigh (quadriceps).
Cramps in the feet, hands, arms, abdomen, and along the rib cage are also very common..
Muscle cramps are common and may be stopped by stretching the muscle. The cramping muscle may feel hard or bulging..
Alternative Names.
Cramps muscle.
Considerations.
Muscle spasms are different than muscle twitches, which are covered in a separate article..
Causes.
Muscle cramps are common and often occur when a muscle is overused or injured. Working out when you haven’t had enough fluids (dehydration) or when you have low levels of minerals such as potassium or calcium can also make you more likely to have a muscle spasm..
Muscle cramps can occur while you play tennis or golf, bowl, swim, or do any other exercise..
They can also be triggered by:
Alcoholism.
Hypothyroidism (underactive thyroid).
Kidney failure.
Medications.
Menstruation.
Pregnancy.
Home Care.
If you have a muscle cramp, stop your activity and try stretching and massaging the muscle..
Heat will relax the muscle when the spasm begins, but ice may be helpful when the pain has improved..
If the muscle is still sore, nonsteroidal anti-inflammatory medications can help with pain. If the muscle cramps are severe, your health care provider can prescribe other medicines..
The most common cause of muscle cramps during sports activity is not getting enough fluids. Often, drinking water will ease the cramping. However, water alone doesn’t always help. Salt tablets or sports drinks, which also replenish lost minerals, can be helpful..
Other tips for relieving muscle cramps:
Change your workouts so that you are exercising within your ability..
Drink plenty of fluids while exercising and increase your potassium intake (orange juice and bananas are great sources of potassium)..
Stretch to improve flexibility..
When to Contact a Medical Professional.
Call your doctor or nurse if your muscle cramps:
Are severe.
Do not go away with simple stretching.
Keep coming back.
Last a long time.
What to Expect at Your Office Visit.
Your doctor or nurse will examine you and ask questions about your symptoms and medical history, such as:
When did the spasms first begin?
How long do they last?
How often do you experience muscle spasms?
What muscles are affected?
Is it always the same location?
Are you pregnant?
Have you been vomiting, had diarrhea, excessive sweating, excessive urine volume, or any other possible cause of dehydration?
What medications do you take?
Have you been exercising heavily?
Have you been drinking alcohol heavily?
Blood tests may be done to check for the following:
Calcium, potassium, or magnesium metabolism.
Kidney function.
Thyroid function.
Pain medicines may be prescribed.