Keeping a Cool Head: Getting Back to Sports in the Summer Post Covid-19

A Word From the National Athletic Trainers’ Association (

Summer 2021 is heating up with the excitement of returning to sports. While it can be a truly exhilarating time, it can also spell disaster for those who are not prepared for the summer heat and humidity.

As temperatures continue to rise in many regions, so does the chance of heat-related illnesses that can vary in severity from the inconvenience of heat cramps to heat stroke, which can be fatal. While not always preventable, even in the fairest of climates, exertional heat stroke can be 100% survivable if properly and quickly cooled down.

Here are five things you should be asking before your athlete’s team starts summer workouts:

1. What are your heat acclimatization guidelines?

All athletes need to become accustomed to exercising in the heat. This is even more critical if an athlete is returning
to a sport after an extended time away. Heat acclimatization involves phasing in activity (duration and intensity) over 7 to 14 days to help the body physically adapt and cope with the added stress caused by the heat.

If they have had extended time away from their sport, remind your athlete to be patient with themselves during this process as they may expect to be immediately back to where they were before their time away.

2. Who monitors the weather and environmental conditions and what tools are used?

A medical professional, such as an athletic trainer, should monitor heat-stress conditions with equipment such as a Wet-Bulb Globe Temperature (WBGT) device, which measures ambient temperature, relative humidity,  wind speed, and radiation from the sun. WBGT readings may  require immediate adjustments to the team’s practice such as changing work-to- rest ratios, increasing water breaks, modification to equipment (ie, removing excess clothing), change in length and/or intensity of activity, and moving practice times to a cooler part of the day.

Important to note, it doesn’t have to be sunny for there to be conditions which require practice/game modifications.

3. What hydration is available for the athletes and how are hydration breaks determined?

Water should be freely available during any sports activities. As a rule of thumb, most athletes should consume 200 to 300 milliliters (7 – 10 ounces) of fluid every 15 minutes of exercise.

Hydrating before and after practice is important. If an athlete goes to practice dehydrated, they are already putting themselves at risk for heat-related issues. Tracking urine color can be a good indication of hydration. Pale yellow usually indicates proper hydration.

4. What is the emergency action plan in case exertional heat stroke is suspected? Do you have a cold-water immersion tub available?

Appropriate personnel (medical staff, coaching staff, and athletic administrators) should be familiar with and practice the emergency action plan for exertional heat illnesses. As every minute counts, they should be prepared to immediately activate the plan if an emergency occurs.

Once exertional heat stroke is suspected, decreasing the athlete’s core body temperature to a normal range via cold-water immersion (approximately $150 investment) within the first 30 minutes is critical. The risk of long-term or permanent complications, and even death, is directly related to the number of minutes an individual remains hyperthermic.
A cold-water immersion tub should be onsite and filled with water prior to the start of activity and ideally located in the shade or under a medical tent.

5. What medical personnel will be with the team during practices and games to ensure the safety of the athletes?

It is critical that a medical professional, such as an athletic trainer, is present at practices and games to monitor and inform coaching staff of potentially harmful conditions, prepare for emergencies, assess heat-related signs, and activate the emergency action plan if needed.

Visit National Athletic Trainers’ Association (NATA) for a printable PDF on heat illness at

Most athletes should consume 7-10 ounces of fluid every 15 minutes of exercise.

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