Injury Q&A

This injury Q&A section contains questions from our readers with subsequent answers. The section will expand as we receive more reader questions.

Question: What should I do for an acute injury?

Answer: If you feel that you have “pulled a muscle” or have an inexplicable pain after exercising, the immediate treatment is RICE (rest, ice, compression, elevation). Icing for 48 hours, every 2 hours for about 10-15 minutes, should help the injured area. You can pair the RICE treatment with taking an over the counter ibuprofen medication to decrease inflammation. However, if you’ve got an injury that doesn’t respond to RICE in a couple of days, you should see your physician.

Question: What should I do for a chronic injury?

Answer: You must see your physician or other qualified person to find out what you should do if an injury persists.

Question: What should I do or look for when working out in extreme weather or exercise conditions?

Answer: Extremes of temperature and humidity pose special problems for the exerciser. In hot weather, care must be taken to wear clothing that is light, breathes well, and allows for the evaporation of sweat.

On extremely humid days care must be taken to exercise at an appropriately lowered intensity, out of the high heat/humidity, or even to postpone exercise until the heat/humidity diminish. As exercise intensity increases and more heat is and must be dissipated, evaporation of sweat becomes the principal means for cooling the body. In a high-humidity environment, evaporation becomes less effective at cooling, and the risk of heat-related injury is greater.

Adequate hydration is also key to safe exercise in hot weather, as the body will produce large quantities of sweat. Drinking 1-2 cups of water before exercise and 1/2-1 cup of water during exercise are recommended, though more can be ingested dependent on workout conditions.

It is important to remember that the thirst mechanism lags behind the body’s need for fluid, i.e., by the time you are thirsty you may already substantially dehydrated. Even small amounts of dehydration can affect performance, and severe dehydration can be life-threatening.

Contrary to popular belief, water consumed during exercise will not contribute to cramping, so rather than merely rinsing your mouth and discarding it, you should consume small amounts of water steadily during the exercise session, especially during periods of prolonged exercise.

In the cold, care must be taken as well. Dress in layers that will wick sweat away from the body such as Gore Tex and many other “high-tech” fabrics that are now available. Outer layers can be used to keep the body warm during warm-up, and removed as exercise progresses to allow the body to cool. If you get too cold, replace layers during cool-down to avoid excessive chill.

Garments made of fabrics such as wool, which will insulate even when wet, are superior to garments made of materials such as cotton that will absorb sweat and can contribute to heat lost by evaporation and conduction as physical activity level decreases.

Heat and Cold Related Illnesses and Injuries:

Question: Who is at risk for heat-related illness?

Answer: People at risk for heat-related illnesses include those who work or exercise outdoors, elderly people, young children, and those with health problems. Also at risk are those who have had a heat-related illness in the past people with medical conditions that cause poor blood circulation, and those taking medications to get rid of water (diuretics).

Question: What are heat related illnesses?

Answer: Heat cramps, heat exhaustion, and heat stroke are conditions caused by overexposure to heat. Heat cramps are the least severe, and often are the first signals that the body is having trouble with the heat. Heat cramps are painful muscle spasms. The usually occur in the legs and abdomen. These constitute a possible heat- related emergency.

HEAT EXHAUSTION is a more severe condition than heat cramps. It often affects athletes, fire fighters, construction workers, and factory workers, as well as those who wear heavy clothing in hot, humid environments. It manifests itself as cool, moist, pale or flushed skin, headache, nausea, dizziness, weakness, and exhaustion. HEAT STROKE is the least common but most severe heat emergency and most often occurs when people ignore the signals of heat exhaustion. HEAT STROKE develops when the body systems are overwhelmed by heat and begin to stop functioning. HEAT STROKE is a critical medical emergency. The signals of heat stroke include red, hot, dry skin; changes in consciousness; rapid, weak pulse; and rapid, shallow breathing.

Question: How do you treat heat cramps?

Answer: If you believe you or someone else has heat cramps, place the victim in a cool resting place. Give him or her cool water or an electrolyte drink, i.e., a sports drink. Generally, rest and fluids are all one needs to recover. The victim should NOT take salt tablets or salt water. This can make the situation worse. Also, gently massaging the cramp area can sometimes help relieve symptoms.

When cramps stop, you can usually start activity again if there are no other danger signals of illness. The person should keep drinking plenty of fluids and be watched carefully for further signals of heat-related illness. Perhaps the best treatment is to cease exercise and proceed at a later date and time.

Question: How do you treat other heat-related illnesses?

Answer: First, get the victim out of the heat. Second, loosen any tight clothing. Third, apply cool, wet cloths. If the victim is conscious, give him or her cool water to sip, do not let the person gulp it.

Give about 4 ounces of water every 15 minutes. Let the victim rest in a comfortable position and watch carefully for changes in condition. The victim should not resume normal activities the same day.

Question: Is it an Emergency? Should I call 911?

Answer: Refusing water, vomiting, and changes in consciousness mean that the victim’s condition is worsening. In this case, call 911 (or other emergency services). If the victim vomits, stop giving fluids and position him or her on their side. Watch for signals of breathing problems.

Keep the victim lying prone and continue to cool the body any way you can. If ice packs or cold packs are available, place them on each of the victim’s wrists, ankles, groin, armpit, and neck (these are considered the pulse points). Do NOT apply rubbing alcohol or other possible coolants.

Question: At what temperatures and humidity are heat-related illnesses likely?

Answer: These are the basic temperature ranges you should monitor.

  • HOT: {93F (34 C), 20% humidity}, {87 F(31 C), 50%}, {82 F(28 C),100%}. Sunstroke, heat cramps, or heat exhaustion possible with prolonged exposure/exercise
  • VERY HOT: {105F(41C), 20%}, {92F(34C), 60%}, {87F(31C), 100%}. Heat cramps or heat exhaustion likely
  • EXTREMELY HOT: {120F (49C), 20%}, {108F(43C), 40%}, {91F(33C), 100%}. Heat Stroke or sun stroke imminent (Reference, American Red Cross Standard First Aid Manual)

Question: What is frostbite?

Answer: Frostbite involves the freezing of tissue, and can range from mild to severe. The skin will generally look yellowish, and be cold to the touch. First aid involves warming the affected area using moderately warm water. However, remember that sensation will be reduced in the affected area thus, the temperature of the water should be checked by running it on unaffected skin! Do NOT rub the area; This can cause further tissue damage!

Frostbite should be examined by a doctor to assess the extent of skin damage. Frostbite is best prevented by proper clothing and limited exposure to cold.

Question: What is hypothermia?

Answer: Hypothermia is a life-threatening condition in which the core body temperature has become dangerously low. Many of the same symptoms as heat exhaustion, including dizziness, nausea, loss of appetite, vision problems, etc., can be present. For hypothermia, it is important to call 911 immediately. Use any means possible to warm the victim, such as removing excess clothing and putting them in a sleeping bag with an unaffected person who can provide body warmth until help arrives.