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In only a few weeks, football players across the United States will return to the field for the start of another football season. Those early August days also signal the highest temperatures of summer. Without proper hydration, outdoor practices, games and physical activity can lead to heat illness and decreased performance. It is crucial that coaches, players and parents are aware of the signs and symptoms of heat illness and the proper hydration techniques necessary to combat its onset. Dr. Patrick Kersey, the USA Football medical director and a sports medicine physician at St. Vincent Sports Performance in Indianapolis, said

In only a few weeks, football players across the United States will return to the field for the start of another football season.

Those early August days also signal the highest temperatures of summer.

Without proper hydration, outdoor practices, games and physical activity can lead to heat illness and decreased performance. It is crucial that coaches, players and parents are aware of the signs and symptoms of heat illness and the proper hydration techniques necessary to combat its onset.

Dr. Patrick Kersey, the USA Football medical director and a sports medicine physician at St. Vincent Sports Performance in Indianapolis, said heat illness can cause tissue and muscle to break down. In advanced stages, it can even cause organ to start failing.

According to Kersey, a severely dehydrated player can no longer maintain normal body functions. Organs lose their ability to regulate temperature, eventually causing them to overheat and shut down.

“(In the most severe cases), it’s kind of like cooking your organs, so to speak,” he said. “They get too hot and, as they get hot and with improper hydration to cool and maintain function, they can’t maintain that environment.”

The most effective ways to prevent heat illness is to recognize the early signs and symptoms. If players are exhibiting any of the following symptoms, they should rest and rehydrate immediately.

Significant fatigue or feeling more tired than usual

Excessive sweating

Decrease in performance

Muscle cramps (often the earliest sign – not necessarily heat illness)

Feeling lightheaded or dizzy

Significant headache

Feelings of nausea or an upset stomach

Skin becomes cold or pale (in advanced cases of heat illness)

Not sweating (in advanced cases of heat illness)

It is important to remember that heat illness comes in many forms. Different athletes will exhibit different symptoms depending on the stage.

If a player exhibits any of these symptoms, remove them from the exercise, move them to a cool, shaded area, remove their equipment and loosen the clothing to lower core temperature.

Most importantly, make sure they continue to hydrate.

There are several easy ways to prevent heat illness and heat exhaustion. The following hydration tips and techniques can help protect players from heat illness, even on the hottest days.

Hydration tips and techniques

Consume 6 to 8 ounces of water eight times a day.

Use the urine test: The color of a player’s urine should be clear to slightly yellow (lemonade). If it’s darker in color, he or she is not properly hydrated.

Not all fluids serve as hydrating components. Soda, coffee and energy drinks should not be used to properly hydrate athletes.

Water (bottled or tap) and electrolyte replacement drinks (such as Gatorade) should be encouraged before, during and after games and practices.

Hydrate before physical activity. Most athletes are dehydrated before they even step on the field of play. It’s important to begin exercise fully hydrated.

Hydrate during physical activity. Sports drinks are most beneficial to replace the electrolytes lost in sweat.

After physical activity, athletes can continue sweating for up to an hour. They’re still losing fluids that need to be replenished, so continue to hydrate.

In addition to water – which provides fluid – it is important to provide athletes with electrolyte replacement drinks that can provide energy, carbohydrates and electrolytes.

Mark Kovacs, director of the Gatorade Sport Science Institute in Barrington, Ill., works with an extensive team of scientists and educators to improve athlete performance through sport nutrition research.

He said electrolytes help with processes in the body, and it is important to maintain ideal ranges of them.

“Once those electrolytes get out of balance, they get too high or too low, it affects processes in the body, which can potentially cause problems,” he said. “The main electrolyte that we usually are most concerned about in athletes is sodium. Sodium is lost the most in sweat, and that’s the one that really needs to be replenished in foods and fluids.”

According to Kovacs, electrolyte replacement drinks, such as Gatorade, provide several benefits that water does not.

Unlike water, sports drinks contain carbohydrates, an important component that is converted by the body into energy. Although water is best for hydrating, it does not provide any carbohydrates.

Kovacs suggests that athletes who have been performing for longer than 30 minutes consume a product with carbohydrates for energy and electrolytes to replace those lost in sweat.

Another key benefit is taste.

“It’s been shown that athletes and the general population will drink more fluid if they like the taste,” Kovacs said. “So providing flavor is beneficial.”

Hydration