As summer comes to an end, parents and students start preparing for school. By the time the students return to school, fall sports have begun and student athletes are well into the dreaded "hell weeks." Most sports will be working-out under the hot sun, while training in "double day" mode to prepare for the upcoming season.
This is an important time for athletes to be aware of not only what they are doing to their bodies during training, but also what they are putting into their bodies. Any extreme training conditions may make athletes susceptible to injury. One way athletes, coaches and parent can help prevent injuries is through a clear understanding of dehydration.
Why talk about dehydration?
Many athletes, coaches and parents underestimate the negative effects of dehydration. Preventing it is simple, yet it is one of the most common catalysts to sports injuries I see in my practice. It is, therefore, important for all athletes to be able to recognize key signs of dehydration and learn how prevention can decrease risk of injuries and help athletes perform at their peak.
What is dehydration?
Dehydration occurs when the amount of water in the body falls below normal. This disrupts the level of salts and sugars (electrolytes) in the body.
Water performs two important roles for the athlete. It maintains blood volume and cardiovascular function and ensures regulation of body temperature. Adequate hydration is therefore necessary for optimal training performance and recovery.
What are the signs of dehydration?
Thirst is a certain sign of dehydration, but someone who has waited until he/she feels thirsty before drinking has waited too long. In order for the body to perform at its peak, it must remain properly hydrated throughout the workout, rather than trying to hydrate after the body's water sources have been depleted. Other dehydration indicators include muscle cramps, dizziness, lethargy, muscle weakness and loss of one percent body weight during exercise.
Many athletes and coaches underestimate the dangers of dehydration. When an athlete becomes dehydrated, especially during hot and humid weather, the body instinctively chooses to preserve what water is left in the body for the vital organs. Dehydration can lead to a breakdown of the body's cooling system, which can cause severe electrolyte disturbance, widespread muscle breakdown, diarrhea, kidney damage and vomiting. The worst-case scenario of dehydration can lead to seizures, shock and even death.
My coaches many years ago use to "reward" us with a water break if we performed well. And sure enough, many of us were always in the training room rehabilitating our injuries. The aforementioned symptoms reiterate the importance of maintaining hydrated through the duration of exercise.
How can athletes avoid dehydration?
The best way to athletes can avoid dehydration is by drinking water before, during and after a workout, even if they don't feel thirsty.
We have all heard the research that says we need eight, eight-ounce glasses of water a day. This is true. This is the minimum our body needs for "normal" bodily functions and to sustain life. This is not enough for athletes. Athletes need to replace the fluids they have lost during exercise.
I recommend drinking eight, eight-ounce glasses of water each day with an additional eight ounces for every 20 minutes of exercise. A little side note: Many of my patients say they "think" they have eight glasses, but they get confused. This is not good enough.
How do I know if I'm drinking enough?
A good way make sure you drink enough water is to buy a 1.5 liter bottle of water. Fill it up in the morning and you know what you have to drink for that day. An athlete also needs to remember the 20-8 rule (eight ounces of water for every 20 minutes of exercise).
If you have even mild signs of dehydration -- start drinking water. A good indicator that you are hydrated (normal fluid levels) after suspected dehydration is that you are urinating every hour and are passing clear, dilute urine. Always consult the team physician at the first sign or symptoms of dehydration.
What is the best fluid when exercising?
The best fluid for an exercising body is cool water, for two reasons:
1. It rapidly leaves the digestive tract to be absorbed by the tissues needed
2. It cools the body. The quick absorption helps the athletes perform longer and avoid post-workout fatigue.
What about sports drinks?
Although you can't beat just plain water during exercise, sports drinks are good to replace the electrolytes lost with excessive sweating. Sports drinks have low carbohydrates (sugars), and the body absorbs liquids that are lower in carbohydrates more quickly.
In a competitive situation a sports drink can be vital to the athlete's performance. A sports drink will be absorbed quicker by the muscles than a fruit drink or soda, thus, decreasing muscle fatigue. Also, the sodium in sports drinks actually enhances thirst, which may actually make athletes drink more.
Fruit juices and soda are not a good choice during exercise because of their high sugar content. Coffee or any caffeinated drink is by far the worst drink an athlete can consume before, during and even after a workout. Caffeinated beverages are diuretics that deplete the body of fluids. This means the body literally sponges out excess water in the body, especially in the muscles. This is counter-productive to athletic performance and staying healthy and injury-free.
If you are going to drink a soda or cappuccino, replace the fluids that were lost with at least eight to 12 ounces of water; make sure to add this amount to the minimum daily requirement for fluid intake.
The chart below compares calories, carbohydrates and sodium of some of the popular sports drinks and other alternative thirst quenchers. Remember: the lower the carbohydrates, the quicker the absorption by the body.
| Drinks (8 oz) | Calories | Carbohydrates (g) | Sodium (mg) |
| Water | 0 | 0 | 0 |
| Gatorade | 50 | 14 | 110 |
| Allsport | 70 | 20 | 55 |
| Powerade | 70 | 19 | 55 |
| Apple Juice | 120 | 29 | 20 |
| Orange Juice | 110 | 27 | 25 |
| Soda | 140 | 39 | 50 |
How can coaches help?
Coaches should encourage their athletes to have frequent water breaks and be aware if some athletes aren't taking advantage of these "water breaks."
How can parents help?
Parents should remember their children will be training long hours and are going to come home fatigued, hungry and tired. If they are thirsty, they are already dehydrated. Parents should encourage their children to drink fluids that are beneficial to them by replacing the cola in the refrigerator with fresh cold water and/or sports drinks.
Also, serve water at dinner and parents can join in drinking the water as well to get their daily minimum. Instead of getting a latte before practice to give your children energy, buy a sports drink or water.
Lastly, the team physician should be consulted at the first sign of dehydration. And remember that the above information should not replace medical advice or diagnosis from a physician.
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