Gulp: As emergency rooms can attest, staying hydrated while training is serious business

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By JOSE ESPARZA
Cronkite News

PHOENIX  — Weak muscles. Fuzzy vision. Increased thirst. Decreased sweat.

All are symptoms of dehydration, a common and often dangerous physiological occurrence frequently experienced by those who train in the Arizona heat.

“Once you start becoming dehydrated, your mind is altered,” said Randon Hall, a Phoenix pediatrician and specialist in sports medicine. “You don’t know where you are, you’re not sure how to get help, you don’t know what to do and that’s how people die.”

In 2014, 12,743 Arizonans who visited emergency rooms were diagnosed with dehydration, according to a study by the Center for Population Health and Discovery at the University of Arizona. Preparation and education are key to prevention, experts say.

“Hydration and dehydration refer to the amount of water that is in the body,” said Suzie Squires, an outreach athletic trainer at Dignity Health in Mesa. “Dehydration is excessive fluid loss and specifically to athletes in their participation. Dehydration is excess sweat rate in relation to the amount of fluids they are intaking.”

Staying hydrated in a hot and dry climate is challenging. Guidelines are available “that allow you to look at a heat index and give you recommendations on the activities on what you can and can’t do,” Squires said. “How many water breaks you should have, the duration, etc. Arizona is consistently off the heat index charts.”

Approximately 60 percent of the human body is made up of water. For the brain and heart, it’s 73 percent.

Dehydration can cause dizziness, headaches, a difficulty to quench thirst, weakness and worse.

“The first stage is that they are thirsty,” said Matt Lucht, a head athletic trainer at Glendale Community College. “They take a drink of water and it still doesn’t quench their thirst. The second sign is during a workout their sweat rate will decrease. They begin to stop sweating because they have run out of fluids and your body is trying to conserve fluid.

“That’s how dehydration plays into heat-related illnesses because if you’re not sweating, your body can’t cool. Then after that, you start to get light-headed, dizzy and headaches.”

Lucht encourages his athletes to drink their body weight in ounces throughout the day but does warn, too, about taking in an excessive amount.

“Drinking too much water can dilute the minerals within your body,” Lucht said. “It actually promotes dehydration or heat-related illnesses, because our body doesn’t have that proper electrolyte balance.”

Another mistake that trainers see is athletes underestimating Arizona’s extreme heat.

“When they get out here they realize that it’s dry heat and humidity is not much of a factor,” said Marty Parel, head athletic trainer at Mesa Community College. “They will think that, ‘OK, well, it’s hot, but I’m not sweating.’ ”

MCC makes it a point to practice during early mornings or in evenings on days when temperatures hit triple digits, even in September and October. The school has taken other precautions with its football team, too.

“We no longer do two-a-day practices,” Parel said. “That’s helped us out as far as preventing any sort of heat illness or heat stroke type of injuries. I don’t know of any other teams in Maricopa that are doing two-a-day practices.”

A growing problem with athletes, trainers say, is the decision to chug an energy drink before practice. This can be detrimental to their health and performance.

“Caffeine could make your dehydration worse,” Parel said. “I would highly suggest that athletes not consume energy drinks or caffeine beverages before practice because caffeine does draw water out and make athletes more prone to dehydration.”

MCC does not allow energy drinks in its locker rooms.

Athletes aren’t the only ones that have to make smarter decisions. One of the bigger issues in Arizona involving dehydration is individuals hiking and not taking hot temperatures seriously.

“Common mistakes we see is biting off more than you chew,” said Rob McDade of the Phoenix Fire Department. “So you haven’t hiked this mountain ever in your life and you are going to try to go to the top.”

McDade and his team have rescued many hikers who don’t have enough water to reach the top and return down. He has a message for visitors.

“Do not underestimate this heat,” McDade said. “You have never lived in this climate and you are not prepared for it.”

Besides fluids that can assist in hydration, food and nutrition choices are important, too.

“I tell people pretzels are a good option,” Hall said. “Some people like beef jerky. It’s a high-salt food and it’s got some protein in it. Any kind of little snack that has a little bit more sodium than the average may be helpful.”

Hall also suggests using carbohydrates to one’s advantage, approximately 60 carbohydrates in one hour.

“Carbohydrates is your main fuel source during a workout or competition,” Hall said. “Taking a big protein shake is not going to be that helpful for you.”

How is one’s hydration level measured? One of the simplest ways is, well, the “pee test.”

Many sports teams have a poster in their locker rooms to help athletes judge the color of their urine. A darker yellow suggests poor hydration.

More accurate ways of testing hydration including measuring sweat rate and the density of the urine, and tracking weight loss before and after a workout.

Staying hydrated in an extreme heat state like Arizona can be challenging.

But for the health of athletes, it’s necessary.

Suzie Squire, athletic trainer with Dignity Health in Mesa, believes education is key to staying hydrated. (Photo by Jose Esparza/Cronkite News)