Heat Exhaustion vs. Heat Stroke in Athletes: Symptoms, Warning Signs, and What to Do
For athletes training and competing in the South Texas heat, recognizing the early signs of heat-related illness is critical. Muscle cramps, dizziness, headaches, weakness, and other symptoms can signal that the body is struggling to cool itself during physical activity.
Heat exhaustion and heat stroke are two of the most serious heat-related illnesses athletes may experience. Knowing the difference between heat exhaustion vs. heat stroke, recognizing the warning signs, and responding quickly can help protect athletes during practices, games, workouts, and outdoor training.
Why Heat-Related Illness Is a Serious Risk for Athletes
South Texas summers push athletes to their limit, and not just from the competition itself. Heat-related illness is one of the most preventable, and most dangerous, risks facing student athletes during practices and games. Exercise naturally increases body temperature. When athletes perform intense physical activity in hot or humid conditions, their bodies must work even harder to release that heat.
Dehydration, heavy equipment, prolonged practices, limited rest periods, and not being fully acclimated to hot weather can increase the risk of heat-related illness.
According to Dr. Samantha Baginski-Prewitt, DO, sports medicine doctor at Ortho SA, some sports carry a far higher risk than others.
"Football players are about 11 times more likely to develop exertional-related heat stroke than any other sport, and it's really important to pay attention to these heat-related illnesses. They're all more common in our summertime, of course, here in South Texas." - Dr. Samantha Baginski-Prewitt, DO
Recognizing these risks early can help athletes, parents, and coaches take action before heat-related symptoms become more serious.
Heat Cramps, Heat Exhaustion, and Heat Stroke: What's the Difference?
Heat-related illness in athletes generally falls into three stages, and each one is more serious than the last.
What Are Heat Cramps?
Heat cramps are painful muscle spasms that can occur during or after physical activity in hot conditions. They may be one of the first signs that an athlete is having difficulty managing heat and fluid loss. The CDC notes that muscle cramping can be an early warning sign of heat-related illness.
An athlete experiencing heat cramps should stop activity, move to a cooler environment, rest, and begin replacing fluids. Symptoms that continue, worsen, or are accompanied by dizziness, weakness, confusion, or other concerning changes should receive medical attention.
Heat cramps often cause painful muscle spasms or tightening during or after physical activity, especially in the legs, arms, or abdomen. Athletes may also experience heavy sweating, thirst, and general fatigue.
What Is Heat Exhaustion?
Heat exhaustion occurs when the body loses excessive amounts of water and salt, often through heavy sweating during activity in hot conditions.
Athletes with heat exhaustion need to stop participating and begin cooling down immediately. Continuing to practice or compete can put them at risk of developing a more serious heat-related illness.
Heat exhaustion can cause heavy sweating, headache, dizziness, weakness, nausea, muscle cramps, increased thirst, and decreased urine output. Athletes may also feel faint or unusually tired and should stop activity and begin cooling down right away.
What to Do for Heat Exhaustion
If an athlete is showing signs of heat exhaustion:
Stop Activity: Remove the athlete from practice, competition, or exercise immediately.
Move to a Cool Area: Move indoors to an air-conditioned space when possible or find a cool, shaded area away from direct sunlight.
Begin Cooling the Athlete: Remove unnecessary clothing or equipment. Cool compresses or ice packs can be placed around areas such as the neck, armpits, and groin to help cool the body.
Replace Fluids: If the athlete is alert and able to drink safely, encourage frequent sips of cool fluids.
Monitor Symptoms Closely: Do not send the athlete immediately back into activity because they begin feeling better. Heat exhaustion requires time to recover, and worsening symptoms can indicate a more dangerous condition.
The CDC recommends medical evaluation for heat exhaustion, particularly when symptoms are significant or do not improve with cooling and hydration.
What Is Heat Stroke?
Heat stroke is the most serious form of heat-related illness and occurs when the body can no longer regulate its temperature effectively. During exercise, body temperature can rise rapidly, especially in hot and humid conditions, putting athletes at risk for exertional heat stroke.
Unlike heat exhaustion, heat stroke is a medical emergency. Symptoms such as confusion, disorientation, slurred speech, loss of coordination, collapse, or seizures can signal that the condition has become life-threatening and requires immediate emergency care.
Heat stroke is a medical emergency. Warning signs can include confusion, disorientation, slurred speech, unusual behavior, loss of coordination, collapse, seizures, and a very high body temperature. Athletes experiencing heat stroke may still be sweating and need immediate emergency medical attention.
What to Do If You Suspect Heat Stroke
Call 911 immediately. Heat stroke is not something to monitor at home or wait to see if it improves.
While emergency medical services are being activated, cooling should begin as quickly as possible. Move the athlete out of the heat, remove excess clothing and equipment, and begin rapid cooling.
For exertional heat stroke, whole-body cold-water immersion is considered the most effective immediate cooling method when appropriately trained personnel and equipment are available. Athletic programs should have emergency plans in place for managing suspected heat stroke.
Do not give fluids by mouth to someone who is confused, unconscious, or unable to safely swallow.
Why Football Players Need to Be Especially Careful
Football season often begins while temperatures are still extremely hot in San Antonio and throughout South Texas.
Athletes may be practicing intensely while wearing helmets, shoulder pads, and other equipment that can make it more difficult for the body to release heat. Research consistently identifies football as one of the sports with the greatest risk for exertional heat illness.
Extra attention should be given during preseason practices and when athletes are returning to intense activity after time away from training.
How Can Athletes Help Prevent Heat Exhaustion and Heat Stroke?
Many heat-related illnesses can be prevented with preparation, monitoring, and appropriate modifications to activity.
Athletes, parents, coaches, and athletic programs can help reduce risk by:
Drinking fluids regularly instead of waiting until thirst develops
Gradually increasing exercise intensity
Allowing time to become acclimated to hot weather
Taking appropriate rest and hydration breaks
Scheduling intense outdoor activity during cooler parts of the day when possible
Monitoring weather and heat conditions
Watching teammates for signs of heat illness
Removing an athlete from activity as soon as concerning symptoms appear
The CDC specifically recommends pacing activity, drinking more water than usual during hot-weather exercise, taking precautions during the hottest parts of the day, and watching teammates for symptoms.
When Should an Athlete See a Sports Medicine Doctor?
Not every problem that occurs during a hot practice requires emergency treatment, but recurring symptoms should not be ignored.
A sports medicine doctor can evaluate athletes who repeatedly experience cramping, dizziness, weakness, exercise intolerance, or other symptoms during physical activity. Sports medicine physicians can also help athletes determine when it is appropriate to safely return to practice or competition following an illness or injury.
However, symptoms of suspected heat stroke, including confusion, slurred speech, disorientation, collapse, or seizures, require emergency medical attention rather than a routine sports medicine appointment.
Athletes who also experience a muscle, joint, or orthopedic injury during practice can be evaluated by a sports medicine specialist once any immediate medical emergency has been addressed.
Helping San Antonio Athletes Stay Healthy and Active
Whether an athlete is dealing with a football injury, knee or shoulder pain, an overuse injury, or concerns about safely returning to sports, having access to experienced sports medicine in San Antonio can help athletes stay active while protecting their long-term health.
At Ortho San Antonio, our sports medicine team works with athletes of different ages and competition levels to evaluate injuries, develop personalized treatment plans, and help patients safely return to the activities they enjoy.
For families searching for sports doctors in San Antonio or a sports medicine orthopedic surgeon near me, Ortho San Antonio provides comprehensive orthopedic and sports medicine care for athletes across the San Antonio area.