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Other Medical Conditions of Concern During Hot Weather Exercise

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Sport and Physical Activity in the Heat

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Abstract

Certain medical conditions can compromise many aspects of human thermoregulatory adaptations, leading to heat intolerance. There are varying disorders of skin and perspiration, and depending on extent of the disease or injury, it can significantly impair heat dissipation. Common examples include sunburn and type 1 diabetes (i.e., impaired vasomotor and sudomotor control). Conditions affecting central thermoregulation (e.g., febrile illness, sleep deprivation) and metabolism (e.g., malignant hyperthermia susceptibility [MHS], hyperthyroidism) may also increase the risk of heat illness. The similarities between malignant hyperthermia and exertional heat stroke (EHS) have long been speculated, and many cases of EHS in individuals with MHS have been reported. Cardiovascular disorders contribute to heat intolerance via blunted cardiac output response to exercise, impaired blood shunting to the skin, and side effects of medications used to treat heart disease. This is especially relevant with today’s increasing numbers of “masters” runners and athletes. Other medical conditions or intrinsic factors may impair thermoregulation through a variety of mechanisms, including obesity, dehydration, poor physical fitness (or deconditioning), lack of acclimatization, increasing age, and sickle cell trait. The pre-participation physical exam is a critical opportunity to identify these medical conditions and implement risk-mitigation strategies (e.g., ensuring good hydration practices are followed, and coaches are notified of any athletes with increased risk). In individuals with medical conditions that contribute to heat intolerance, risk can generally be mitigated by optimizing every other factor possible, such as hydration, nutrition, sleep, acclimatization, and proper cycles of exercise and rest.

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The opinions contained herein are those of the authors and do not represent the position or policy of the United States Air Force or the Department of Defense.

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Authors and Affiliations

  1. 559th Trainee Health Squadron, 559th Medical Group, Joint Base San Antonio - Lackland, TX, USA

    Nathaniel Nye MD, CAQSM (KSI Medical &Science Advisory Board Member)

  2. Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, CT, USA

    Rebecca L. Stearns PhD, ATC

  3. 559th Trainee Health Squadron, 559th Medical Group, Joint Base San Antonio - Lackland, TX, USA

    Francis Tran MD, MS

Authors
  1. Nathaniel Nye MD, CAQSM
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  2. Rebecca L. Stearns PhD, ATC
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  3. Francis Tran MD, MS
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Correspondence to Nathaniel Nye MD, CAQSM .

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Editors and Affiliations

  1. Department of Kinesiology Director, Athletic Training Education Research Associate, Human Performance Laboratory College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, Connecticut, USA

    Douglas J. Casa

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Nye, N., Stearns, R.L., Tran, F. (2018). Other Medical Conditions of Concern During Hot Weather Exercise. In: Casa, D. (eds) Sport and Physical Activity in the Heat. Springer, Cham. https://doi.org/10.1007/978-3-319-70217-9_18

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  • DOI: https://doi.org/10.1007/978-3-319-70217-9_18

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  • Publisher Name: Springer, Cham

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