Water is the Best Medicine for the Heat

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To most people, football player Korey Stringer’s heat-stroke death a decade ago was a tragic curiosity.  For young Dr. Michael Leddy, it was a defining moment early in his orthopaedic medicine career.  Leddy was one of the team doctors for the Minnesota Vikings while working through a sports medicine fellowship at The Orthopaedic Center in Minneapolis when Stringer, the immense and popular rookie offensive lineman collapsed on the practice field.  “It was a hallmark case of dehydration at its worst, and it was completely preventable,” Leddy said.  “These horrible things don’t have to happen.”

Leddy, now an orthopaedic surgeon with Mid State Orthopaedic and Sports Medicine Center, is passionate about nutrition and hydration, especially in the more dangerous days of hot-weather training and exercise.  Already, Central Louisiana summer temperatures have been well above average, and the July – August boiling point is still to come.  “Water — plenty of it — is the best defense against dehydration,” Leddy says.  “There is a time when sports drinks and other electrolyte-providing concoctions are necessary, but if you drink enough water they probably won’t ever be needed.”

Contributing to Stringer’s death was his use of several weight-loss supplements as he tried to meet pre-season training camp goals.  “Supplements should not be taken because they act as natural diuretics.  Supplements actually promote dehydration, the very condition we’re trying to avoid,” Leddy advises.  Leddy also cautions against energy booster drinks (Red Bull, Full Throttle and the like), caffeine, alcohol, carbonated drinks and fatty foods.  “All of these things work against the body that needs maximum hydration in hot weather scenarios.”

This orthopaedic surgeon, who serves as the Head Team Physician for Northwestern State University, Alexandria Aces Baseball, and several local high schools, says athletes and anyone else exercising or working in high temperatures should eat foods with high potassium content.  Bananas and pickles are good.  He also suggests a “sensible breakfast” and a carbohydrate-loaded diet the day prior to strenuous activity.

It’s also not good enough to drink water only just prior to exertion.  Hydration should start at least 24 hours before the event so that muscles and other tissue can absorb fluid.  And, of course, drinking water at regular intervals during exercise — even if there’s not an immediate burning thirst — is extremely important.

Several years ago, the Louisiana High School Athletic Association mandated that water breaks be taken each quarter in hot-weather high school football games.  It’s a rule with which Leddy wholeheartedly agrees.  “It’s not possible to determine how many potential dehydration problems that required water breaks have prevented, but there’s no doubt that this is a medically sound practice,” he says.  “The idea is always to stop trouble before it starts.”  Furthermore, each of the athletic trainers supervised by the doctors at Mid State Orthopaedic and Sports Medicine Center are thoroughly educated on hydration issues, and they utilize best-practice protocol for maximum safety.  The sports medicine program includes many Cenla schools, NSU and Louisiana College, and the Alexandria Aces.

What comes out of the body is as important as what goes in.  Perspiration is nature’s way of heat dissipation and maintaining a workable body temperature.  “The worst-case scenario is when a person stops sweating,” Leddy cautions.  “There can be irreversible, deadly consequences when that occurs.  Overheating can lead to stoppage of the heart.  In layman’s terms, it causes an electrolyte imbalance which short-circuits the wiring in the heart.”  Another “outflow” to monitor is the color of your urine — the clearer the better.  Dark yellow, or even worse, rust or brown urine, is a sign that there is a need for hydration.  “This is something that’s monitored regularly at NSU.  Dark urine is a warning sign,” Leddy says.  “Pay attention to it.”

Although people who exercise or work in hot weather should never let their guard down, the body usually becomes somewhat acclimated to its environment.  “I think one of the reasons we didn’t have more problems in the days before we started applying science to exercise was people were outdoors in the heat much more, and our bodies became more tolerant,” Leddy says.  “In those days, we did a lot of things wrong in sports practice protocol.  Coaches thought it was a sign of weakness to take water breaks, and players were actually forced to take salt tablets before practice.  This was absolutely opposite of what he now know.”  On the flip side, there is far less exposure in everyday life to the outdoors these days.  Therefore, there is a much greater “shock” to the human system when extreme conditions are encountered.

There are three major types of heat-related illness: heat cramps (cramps in the legs and abdomen, faintness or dizziness, weakness, profuse sweating); heat exhaustion (nausea, dizziness, headache, pale and moist skin, weak pulse, disorientation); and heat stroke (a life-threatening condition that strikes suddenly or with little warning and includes very high body temperature, lack of sweating, rapid pulse, confusion, possible loss of consciousness).  Many experts recommend drinking eight ounces of water every 20 minutes during exercise that lasts less than 45 minutes.  Sport drinks containing sugar or salt are recommended during periods of longer workouts.

It’s hot out there.  You may not be able to stay cool, but you can stay hydrated for health.