Safe running as the temperatures rise

The early morning or post-work hours see Cayman’s roads littered with eager runners, some out for a short leisurely jog, and others pushing their limits in preparation for their next race.

Whether your route includes pounding the pavements of West Bay Road, dodging traffic along South Sound Road, or whizzing along the incredibly scenic option of Seaview Road in East End, it is unlikely you’ll escape the heat. Running in Cayman will always be a hot hobby, especially over summer, and it brings with it its own set of challenges.

Dr. Melissa Mascaro

Dr. Melissa Mascaro, who specializes in primary care sports medicine at Cayman Clinic and Novoclinic laid out the facts for Cayman Health when it comes to running in the heat.

Hot weather issues

“Those running in hot weather may experience heat rash, sunburn, heat cramps, heat exhaustion or heatstroke due to exertion in high temperatures, with the likelihood increasing as temperature rises,” explains Dr. Mascaro.

It’s likely that even sedentary Cayman residents are no stranger to a bout of heat rash, which develops when blocked pores (sweat ducts) trap perspiration under the skin. “Symptoms range from superficial blisters to deep, red lumps,” says Dr. Mascaro. “Some forms of heat rash feel prickly or intensely itchy but it usually clears on its own.”

Sunburn too is unfortunately common even among non-runners here, and usually appears within a few hours of over-exposure to ultraviolet light from sunshine. “Intense, repeated sun exposure that results in sunburn increases your risk of other skin damage and certain diseases such as melanoma. You can prevent sunburn and related conditions by protecting your skin.”

Heat cramps may be a hot weather issue reserved mainly for those exercising in the heat. Dr. Mascaro describes them as “painful, involuntary muscle spasms that usually occur during heavy exercise in hot environments. Fluid and electrolyte loss often contribute to heat cramps.

Heat exhaustion is a result of your body overheating and symptoms may include heavy sweating and rapid pulse. “It’s 1 of 3 heat-related syndromes, with heat cramps being the mildest and heatstroke being the most severe,” explains Dr. Mascaro. “Causes of heat exhaustion include exposure to high temperatures, particularly when combined with high humidity, and strenuous physical activity. It is a preventable condition but without rapid diagnosis and treatment, heat exhaustion can lead to heatstroke, a life-threatening condition.”

This life-threatening condition – heatstroke, is classed as an emergency condition, and is caused by your body overheating, usually as a result of prolonged exposure to or physical exertion in high temperatures. “The condition is most common in the summer months and can occur if your body temperature rises to 104 F or higher,” explains Dr. Mascaro.

“Heatstroke requires emergency treatment and if untreated can quickly damage your brain, heart, kidneys and muscles. The damage worsens the longer treatment is delayed, increasing your risk of serious complications or death.”

How to reduce adverse effects in the serious runner

In order to avoid these issues, or lessen their effects, Dr. Melissa Mascaro has some advice for those partaking in outdoor running events such as long races.

1. Know the signs of heat-related problems. If you feel faint, dizzy, disoriented, or have stopped sweating, or if your skin feels cool and clammy, slow down or stop running. If symptoms continue, seek medical attention.

2. Drink enough during the days leading up to the race so that your urine is plentiful and pale yellow. Water maintains hydration; sports drinks, which contain sugar and salt, transport fluid to cells more quickly than water alone.

3. Don’t drink too much. Over-hydration can cause a dangerous condition known as hyponatremia (water intoxication), resulting in nausea, fatigue, vomiting, weakness, and in the most severe cases, seizures, coma, and even death. To avoid hyponatremia, do not overdrink, include salty foods such as pretzels or a salt bagel in your pre-race meal, and use a sports drink that contains sodium.

4. During the race, drink for thirst … no more than a cup (8 ounces) of fluid every 15 to 20 minutes. Drink what you drank in training. If you come upon a fluid stop and are not thirsty, pour cups of water over your head to keep cool.

5. Take advantage of spray/misting stations along the course. Wet your head. Don’t be afraid of getting really wet. The water will evaporate, thereby helping your body maintain a normal temperature.

6. Avoid supplements containing caffeine, which increases the risk of heat-related problems by raising metabolism and inhibiting sweating. As always, limit caffeine to less than a total of 200mg race morning. Avoid cold medicines and anti-diarrhea agents that are dehydrating.

7. Wear synthetic fabrics, which wick moisture from your skin so cooling evaporation can occur.

Clocking slower times

Those running in the heat may find that their stopwatch is recording longer times for the same distance. This is due to the body having to work harder during hot weather exercising.

“The body cools itself with the evaporation of sweat — not the sweating itself,” explains Dr. Mascaro. “The more humid it is, the more saturated the air becomes with water, and the harder it becomes to evaporate sweat and with less evaporation of sweat, we don’t cool as well. Plus, that sweat remains on the skin, making it seem like you’re sweating more, but you’re not — that’s the lack of evaporation. As temperature increases exercise costs more energy and you’ll tire sooner which will slow your time. It is best not to fight your times but to work on other aspects of your training.”

However, bodies can adapt to this hot weather running. “Acclimatization can occur,” says Dr. Mascaro. “We recommend training in the environment for 2 weeks prior to a race.” Especially useful advice for those who travel from cooler climes to warmer to compete.

Sports drinks/gel packs

Current advice when it comes to the use of sports drinks or gels is that those doing short runs of under 60/90 minutes can consume water. Those running for longer periods of time, especially in the heat, may need to take more of a scientific interest in their replenishment needs.

“Sweat testing during your training is a way to determine your sweat loss, and by accurately measuring your sweat losses you can start replenishment,” says Dr. Mascaro.

“Please speak with your sports physician to set up pre-activity testing in order to determine the best electrolyte replacements. Often times regular table salt is adequate. This is recommended in all climates but is particularly important when exercising in the heat.”
Sweat testing consultations can be done at Novoclinic.

Dr. Mascaro’s advice for Cayman runners

1. Use sunblock to protect your skin.
2. Exercise with family and friends. It is never too early to teach healthy habits.
3. Consider sweat testing to determine your individual sweat losses.
4. Exercise during cooler times of day