The blistering heat and the dog days of summer are finally winding down. For football players these weeks leading up to the kickoff of a new season can still be rough, but they aren’t what they used to be — and that’s a good thing.

A lot has changed in terms of what coaches are permitted to do during the summer. New rules adopted by the Ohio High School Athletic Association in 2015 are in place primarily to enhance player safety. While there is a focus on limited physical contact, the changes also regulate the overall intensity during the heat of summer that can lead to dehydration and heat-related illnesses.

Every athlete, regardless of sport, needs to think about heat and hydration together.

Hydration is about more than simply quenching one’s thirst during a hot practice or game. Hydration needs to be part of every pre-game, in-game and post-game routine. And that same mindset goes for practices, too.

When athletes sweat it out during practice or in the game, the body works hard to maintain its optimal temperature and fluids are lost. By replenishing those fluids, athletes are helping to prevent muscle cramping, heat stress and possible heat stroke, all of which can lead to an athlete’s inability to perform as desired — both mentally and physically.

By taking a measured approach to hydration instead of responding only to the obvious need for fluids, athletes add an important regimen to their strategic game-planning and overall wellness.

How much to hyrdrate

Just as a football game goes for four quarters, proper hydration also has four designated time periods — advance, pre-game, in-game, and post-game hydration — to ensure athletes are getting the fluids they need.

Here’s a simple approach that every athlete can apply to ramp up and replenish their needed fluids to help them be at their best and avoid heat illness.

• ADVANCE HYDRATION: start 24 hours in advance of an event by drinking fluids throughout the day.

• PRE-GAME HYDRATION: intake 16-24 ounces of fluid 2-3 hours before an event, and follow with another 8 ounces 10-20 minutes prior to the start time.

• IN-GAME HYDRATION: consume 8 ounces of water every 15-20 minutes during competition. After 60 minutes, drink 8 ounces of water or a sports drink.

• POST-GAME HYDRATION: drink 16-24 ounces of fluids for every pound of body weight lost during competition (this can include chocolate milk or recovery beverages with carbohydrates, electrolytes and/or protein). If urine is not clear or pale yellow, then more fluids are needed.

Dehydration can be debilitating, dangerous

Failure to hydrate can have serious, even life-threatening consequences. The three common heat-related illnesses that can be spurred on by high temperatures and a lack of hydration include:

CRAMPING is a painful tightening of the muscle or muscle spasm that can emerge during or after periods of physical activity along with a loss of fluids from perspiration. It is the mildest form of heat illness. Pain will eventually subside by carefully stretching affected muscles.

HEAT EXHAUSTION happens when an athlete is depleted of water and salt by high temperatures without maintaining proper hydration. Symptoms of heat exhaustion can include headache, dizziness, nausea, vomiting and excessive thirst. If heat exhaustion is suspected, seek medical attention as fluids might need to be replenished intravenously.

HEAT STROKE is a dangerous spike in body temperature. It must be taken seriously as it can cause brain damage, organ failure and even death. Earlier stages of heat illness are warning signs that can prevent heat stroke when detected and properly addressed. A noticeable sign of heat stroke is a change in mental state, which is not present with heat exhaustion. Other symptoms include warm, dry or even moist skin, body temperature of 104 degrees or more, vomiting, headache, confusion, loss of appetite, fatigue, lethargy and agitation. Immediate emergency medical attention is necessary and requires rapid cooling of the body in an ice water bath with a physician’s supervision.

While the heat can make an obvious demand for hydration, athletes can easily forget that they need hydrated during autumn’s cooler temperatures. Just because it isn’t hot doesn’t mean hydration becomes less important.

Muscle cramps might not be completely avoidable (pre- and post-game stretching along with keeping muscles loose and limber in-game are important measures to help prevent cramping), but heat exhaustion and heat stroke can and must be prevented.

Coaches aren’t just teaching the fundamentals of football, they are training athletes in the best ways to care for their bodies in a game that demands intense physical exertion. Hydration is part of that training. And few coaches will complain about missing an end-of-game Gatorade bath if it means their players are practicing proper hydration.

Questions or concerns about this topic or any other sports medicine issue? We want to hear from you. Contact Dr. Frederick Soliman, DO, a primary care sports medicine physician at OhioHealth Physician Group Heritage College and team physician for the Ohio University Athletics Department at

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