Recognizing And Preventing

Dehydration and over

exertion in Physical Activity
   Fluid replacement is an important part of any athletic regimen, but proper
hydration is one of the most neglected aspects of the athlete’s diet. Now that podiatrists
are active members of the medical teams servicing many types of athletic events (and
often act as medical directors and co-directors), it is vital to have a working knowledge of
the signs and symptoms of dehydration. Active sports medicine podiatrists should also be
able to develop a plan for establishing hydration protocols at sporting events.
   When athletes engage in sport, they will lose a percentage of body weight through
water loss. When their sweat loss exceeds fluid intake, athletes become dehydrated
during activity. Dehydration of 1 to 2 percent of body weight begins to compromise
physiologic function and negatively influences performance. Dehydration of greater than
3 percent of body weight further disturbs physiologic function and increases the athlete’s
risk of developing heat cramps or heat exhaustion. Loss of 5 percent or more body weight
can result in heatstroke.
   These levels of dehydration are common in sports and can occur in just an hour of
exercise or even more rapidly if the athlete is dehydrated before exercising or
participating in a sports activity.
   When supervising the medical care of athletes, it is important to recognize the basic
signs of dehydration. These include thirst, irritability and general discomfort followed by
headache, weakness, dizziness, cramps, chills, heartburn, vomiting, nausea, head or neck
heat sensations and decreased performance. Thirst is a notoriously poor indicator of
dehydration because it is a delayed response. An athlete can lose over 1.5 liters of body
water before becoming thirsty.
The athlete’s level of hydration is influenced by many factors. The energy level or
intensity of the sport (e.g., badminton vs. football) is a major factor in how much fluid is
lost. If the sport requires helmets and padding, this will increase the amount of
perspiration and result in greater fluid loss. Rest breaks and fluid access are important
factors that affect hydration. If hydration opportunities are frequent, as in baseball,
football and track and field, the athlete can consume smaller volumes of liquid at a
convenient pace. In sports such as soccer, lacrosse and distance running, athletes must
consume fluids at specific times, making it more difficult to rehydrate.
   Another important factor in dehydration is the environment of play. Hot, humid
areas and high-pressure altitudes will also influence physiologic response and increase
fluid loss. Children involved in sports activities are more susceptible to dehydration and
heat illness in hot weather than adult athletes. Therefore, it is necessary to consider the
athlete’s age, sport and climate conditions when developing a plan to prevent
dehydration.

How To Determine Hydration Status

    One should evaluate the hydration status of athletes before starting any rigorous sports
activity. Athletes should begin all exercise sessions well hydrated. A recent study found two-
thirds of the pediatric athletes evaluated were dehydrated before practice.    There are several
ways to approximate hydration status. Assuming the athlete is properly hydrated, pre-exercise
body weight should be relatively consistent throughout the entire exercise session. One should
determine the percentage difference between the post-exercise body weight and also determine
the baseline hydrated body weight. The post-exercise weight should be no more than 2 percent
less than the pre-exercise weight.
A simple method to determine hydration status is to compare urine color (from a sample
container) with a urine color chart. A light “straw” color (1 or 2) is indicative of being well
hydrated while a dark color (5 or 6) represents significant dehydration. Measuring urine specific
gravity with a refractometer is less subjective than comparing urine color and can also be used.
For color analysis or specific gravity, midstream urine should be collected for consistency and
accuracy. Since body weight changes during exercise give the best indication of hydration status,
one should determine an athlete’s weight and urine measurement before the exercise session and
then determine their weight after exercise to estimate fluid balance.

Pearls On Preventing Dehydration

    The best way to prevent dehydration is to establish a good hydration protocol for the
athletes. Fluid replacement beverages should be easily accessible in individual fluid containers.
Individual containers make it easier to monitor the athlete’s fluid intake. The containers should
also be marked in 100 ml or in 3- or 4 oz. increments, providing visual reminders to athletes to
drink beyond thirst satiation. When it is practical to do so, carrying fluid bottles during exercise
encourages greater fluid ingestion.
 To ensure proper pre-exercise hydration, the adult athlete should consume approximately
16 to 20 fl. oz. of water or sports drink two to three hours before exercise and 8 to 10 oz. of
water or sports drink 10 to 20 minutes before exercise. Adjust fluid intake for children for
differences in body weight and physiology (see “Recommendations For Fluid Intake For
Children” below). Fluid replacement should approximate sweat and urine losses, and at least
maintain hydration at less than 2 percent body weight reduction. This generally requires 8 to 10
fl. oz. every 15 to 20 minutes of rigorous exercise.
 Post-exercise hydration should aim to correct any fluid loss resulting from the practice or
event. One should ideally complete rehydration within two hours with a fluid that contains water
to restore hydration status, carbohydrates to replenish glycogen stores and electrolytes to speed
rehydration. The primary goal is the immediate return of physiologic function. When rehydration
must be rapid, as in cases where an exercise bout will follow, an athlete should drink about 25 to
50 percent more than sweat losses to assure optimal hydration four to six hours after the event.  

The type and temperature of the fluids used in a sporting event are important in the
promotion of the rehydration process. This is especially true in events that involve children and
adolescents. One should ensure the most palatable beverage possible is available.
 Sports drinks appear to outperform water in preventing dehydration, especially in young
athletes. A study that offered water, flavored water and a sports drink to active children ages 9 to
12 showed they drank 90 percent more of the sports drink and stayed better hydrated than when
drinking plain water. Sports drinks served cold (50º to 59ºF is recommended) have flavor
(sweetness) and sodium that encourage athletes to drink more.
  When fluids have the correct mixture of carbohydrates and electrolytes, athletes absorb
them quicker into the bloodstream and the fluids help refuel muscles and speed rehydration.
Carbohydrates also aid in performance by facilitating an increased feel of energy for power and
endurance enhancement. Though carbohydrate concentrations greater than 8 percent increase the
rate of carbohydrate delivered to the body, they compromise the rate of fluid emptying from the
stomach and absorbed from the intestine.

What Drinks Should Athletes Avoid?

   Fruit juices, carbohydrate gels, soda and sports drinks that have carbohydrate
concentrations greater than 8 percent are therefore not recommended during an exercise session
as the sole beverage. Most carbohydrate forms such as glucose, sucrose and glucose polymers
are suitable and the absorption rate is maximized when multiple forms are consumed
simultaneously. Fructose ingestion should be limited since it may cause gastrointestinal distress.
  Substances to be avoided include caffeine and alcohol, which increase urine output and
reduce fluid retention, and carbonated beverages, which reduce voluntary fluid intake due to
stomach fullness.  Consider adding sodium chloride to fluid replacement beverages for physical
activity exceeding four hours or during the initial days of hot weather. This can offset the salt
loss in sweat and minimize the medical problems associated with electrolyte imbalances such as
muscle cramps and hyponatremia. Hyponatremia has been associated in sporting events with
overhydration, both orally and IV, with hypotonic (relative to sweat) solutions. There have been
reported cases in which individuals had been overhydrated with as much as 6 to 7 liters of free
water. Given this, providing hydration beverages that contain a small amount of salt would be
desirable and should cause no harm.
 
https://www.hmpgloballearningnetwork.com/site/podiatry/article/3331

As you may have written from the list above, most Fitness exercises were created for
cardio-vascular maneuvers.it comprises the heart and blood vessels and carries nutrients
and oxygen to the tissues of the body and removes carbon dioxide and other wastes. While
cardio - vascular is operating not in a normal effort the body needs water. So, what is the
purpose of water to your body anyway?

Water is an inorganic, transparent, tasteless, odorless, and nearly colorless chemical

substance. Your body uses water in all its cells, organs, and tissues to help regulate its
temperature and maintain other bodily functions. Because your body loses water through
breathing, sweating, and digestion, it is important to rehydrate by drinking fluids and eating
foods that contain water.

(https://familydoctor.org/hydration-why-its-so-important/)
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If fluid is not replaced, the dancer will become dehydrated. Muscle cramps,
electrolyte deficits and muscle fatigue may be associated with dehydration and heat
cramps.

It occurs when you use or lose more fluid than you take in, and your body does not have
enough water and other fluids to carry out its normal functions.
Water makes up approximately 60% of body weight and is the largest component of the human
body.  The muscles we work so hard to develop as dancers (skeletal muscles) are about 73%
water, your blood is about 93% water and even bones and teeth contain some water.

It is important for dancers to know that being properly hydrated helps keep the body from
overheating. Helping the body promote heat loss when dancing full out will improve athletic
performance and aid in recovery. 
This is especially important for dancers wearing hot costumes and performing under stage lights.
Sweat losses during performance can be significantly more than during rehearsal of the same
piece. Therefore, drinking regularly (even small, regular sips) is an important habit during a
show.
 It occurs when people push themselves too hard during physical activities like Dancing
causes injury when a person works beyond his or her physical capacity and tolerances of his or
her body’s soft tissues. Factors related to overexertion are age, physical condition, body
flexibility, obesity, strength, and tolerance.

Overexertion injuries are generally of two types:

Sprains - stretching or tearing of ligaments
Strains - stretching or tearing tendons or muscles

It refers to a group of heat-related conditions characterized by an abnormally high body

temperature in other words, the opposite of hypothermia. The condition occurs when the body's
heat-regulation system becomes overwhelmed by outside factors, causing a person's internal
temperature to rise.

Hypothermia is a medical emergency that occurs when your body loses heat faster than it
can produce heat, causing a dangerously low body temperature. Normal body temperature is
around 98.6 F (37 C). Hypothermia (hi-poe-THUR-me-uh) occurs as your body temperature falls
below 95 F (35 C).

To give you more of this concept, you may answer the activity below.
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