It’s no shock that you get hot and sweaty playing baseball in North Carolina during the summer. As Kyle Davis wrote about feeling for baseball players playing the game during the heat, “…they do it while wearing like, full-length pants. In uniforms made out of polyester, and dark hats made of wool covering their heads. MLB players walk around in sweltering, unforgiving heat, basically wearing a heavy sun and warmth absorption costume. And they still run around and swing bats and throw baseballs just fine. They stand out in the middle of a grass and dirt field with literally nowhere else to go and no escape. They just have to stay there, flesh afire. It makes no effing sense!“

There are some things to watch out for to make sure that you have fun and stay safe though. Let’s talk about heat exhaustion and even heat stroke?  Most importantly, find out why every baseball player should care.

Heat exhaustion happens when a person exercises or works in hot weather and becomes dehydrated. Untreated heat exhaustion can lead to heat stroke. You may ask, “Why should we care about this as baseball players?”

The answer is because it can KILL you!

Heat Exhaustion

On June 30, 2012 the Washinton Senator’s 24-year-old All-Star pitcher – Stephen Strasburg – found out the hard way.

Strasburg had prepared by drinking lots of water the night before. He retreated back into the air-conditioned clubhouse between innings. It wasn’t enough. The temperature at the start of the game was 104 degrees (sound familiar?), the official high that day was 106 degrees – the hottest in Atlanta’s history – and by the fourth inning, the temperature on the field was around 120 degrees.

Obviously, the heat wore Strasburg down. By the second inning, his uniform was soaked through with sweat. He was dizzy, his face was pale, his breathing was labored. He could barely respond to the questions from his pitching coach. He later told reporters that he “didn’t know what was going on.”

After he left the game, the trainers gave him three intravenous saline transfusions! Fortunately, he was back to normal the next day.

Baseball players are very prone to heat exhaustion, especially when they are playing outside during the hottest part of the day. On the field, the temperature can sometimes get over 100° and the heat index, which is calculated by combining the air temperature and relative humidity, can be even higher. 

Sweating is your body trying to stay cool. But, you are losing fluid as you sweat and can become dehydrated. Studies have shown that baseball players should be drinking roughly 32 ounces of fluids each hour to stay hydrated. 

Here are the symptoms of heat exhaustion in the order that they are usually experienced:

• Profuse sweating
• Feeling overheated
• Dizziness and confusion
• Fatigue
• Faintness
• Weakness
• Headache
• Nausea
• Muscle cramps
• Dark colored urine

During heat exhaustion, you will have a weak rapid pulse and your blood pressure will drop, especially upon standing.  The most serious danger comes when your body temperature elevates to 104° and stays there for a prolonged period of time. Since we don’t usually have thermometers and blood pressure cuffs available at games, so, as soon as a player (or fan) begins to experience the symptoms, it’s time to take action.

Heat Stroke

When the heat index is high, the sweat can’t evaporate from your skin quickly, so your body temperature starts to climb. This produces the double whammy of dehydration and a dangerous increase in body temperature. It’s like having a high fever when you’re sick and no way to cool down. If your temperature becomes too elevated and you don’t get immediate treatment, you can get heat stroke. When this happens, you can go into shock, have a seizure, have organ failure and brain damage. If the condition is not addressed quickly, it can result in death, yes you read that correctly – death.

In a great article by Katherine Tallmadge, she writes about being in the medical tent at the finish line of the Marine Corps Marathon, “what is seared in my brain forever are the exhausted runners stumbling into the emergency tent on the verge of death: Forced into ice-water baths, several doctors surrounding each tub struggling to get IVs into the runners to save their lives. It was heat stroke.“

Heat stroke becomes obvious when you see the following signs:

• Lack of sweating
• Flushed or red skin
• Trouble breathing
• Fainting
• Seizures

Now the situation requires immediate medical attention, so don’t wait! Call 911 and get professional medical help.

Preventing Heat Exhaustion

Now that you know what it is and how it appears, let’s figure out how to keep from getting heat exhaustion and heat stroke.

Prevention is the best medicine. Even young athletes who are in great shape can get heat exhaustion and heat stroke. The best thing to do is to avoid playing baseball in the heat of the day.

After sunset, when temperatures begin to cool down is the best time to play. Early in the morning, before it gets too hot is also good, but this time has two things working against it. It can get hot very quickly in the morning around here and you are playing into the heat of the day. In the evening, that would never happen.

Other preventative measures include:

• Drink plenty of water or sports drinks (even if you don’t feel thirsty)
• Take frequent breaks in the shade (rotate out players every couple of innings)
• Use cooling devices such as fans, cooling cloths, ice packs, etc.

Here’s what to do if a person is showing signs and symptoms of heat exhaustion:

• Tell someone! That person can help assess your condition and keep an eye on you.
• Get out of the heat into some shade or preferably into a much cooler place like and air-conditioned car.
• Lie down and elevate your legs to get the blood flowing to the heart.
• Put cooling towels or cold packs on your skin (don’t put ice directly on skin).
• Drink water or sports drinks in sips.
• Take off any extra clothing, especially if it’s tight-fitting. Remove your hat and let heat escape from your head.
• Rest until you feel better.
• Do not go back to physical activity for the rest of the day.
• Get help if your symptoms don’t subside or get worse.

Here are some things to avoid in order to give yourself a better chance of not getting heat exhaustion or heat stroke:

• Avoid heat and direct sun and stay in the shade, in the dugout or under something as much as possible when you’re not on the field.
• Avoid overexertion (save yourself for when it counts).
• Avoid drinks with alcohol or caffeine in them.
• Avoid smoking.

The chart below shows the problem with us playing baseball in Central North Carolina during the summer months – the heat of July and August are especially dangerous months. The average humidity levels around Raleigh is between 70% – 80% from May through October!

Remember, if you are older, are out of shape or have a medical condition, you are at an increased risk for heat exhaustion or heat stroke. Additionally, there are some medications that can either make you more vulnerable or make the condition worse.

• Acne medications
• Amphetamines (speed/meth)
• Antibiotics (infection meds)
• Anticonvulsants (seizure meds)
• Antidepressants & Antipsychotics (mental health meds)
• Antihistamines (allergy meds)
• Blood Pressure medications
• Cholesterol medications
• Cocaine
• Diet & weight loss medications
• Diuretic medications (water pills)
• Heart disease meds like beta-blockers and vasoconstrictors

Most illegal drugs that alter your mental consciousness also alter your physiology in a way that is not a good mix with exercise. This includes the excess use of alcoholic beverages like beer and wine drinks that cause both dehydration and the inability to recognize the difference between feeling inebriated and the symptoms of heat exhaustion and heat stroke.

There were some players in our league that got heat exhaustion this season. Ask anyone who’s had it what it was like.  I’m sure they will tell you that it was scary and no fun. Play it safe as much as you can and you’ll be able to enjoy baseball for a long time without having to experience this miserable condition.