So the summer heat in Qatar is an issue. Whether or not it is just sour grapes and a political ploy by competing countries that lost against this Middle East hot spot, or if they are sincerely concerned about the risk to footballers, is debatable. It is probably both. Indeed, no one will dispute the risk the summer temperatures pose to the footballers competing in the 2022 World Cup. The real question is, "How will the powers that be manage that risk?" "All of us can take a lesson from the weather, it pays no attention to criticism." Similarly, Fifa has already slammed its controversial foot down in response to requests to hold World Cup 2022 in the winter months rather than in the blistering heat and sweltering humidity of Qatar's summer. So that's one door of risk management possibilities closed. We must now move to open and explore others. Qatar already seems to be doing their part, planning on establishing massive state-of-the art cooling systems in the stadiums. Whether or not these will be successful is yet to be seen, on the total cost of this technology, I wait with bated breath.
That is heat management from the top level.
But the 41 degrees Celsius temperatures will pose a significant challenge for all levels of involvement in this tournament, each of which must now develop unique strategies to deal with the risk to the athletes. Games may have to be scheduled in the cooler hours of the day. Matches may have to be structured to allow extra time for hydration and recovery in order to stabilise core body temperature. Teams may have to arrive earlier in order to acclimatise, costing their countries significantly more money to support a longer time in Qatar. Sports medicine officials will be of significant importance and should be particularly astute in diagnosing and treating heat-related illnesses. Every athlete will have to be schooled in heat management and adequate hydration plans to prevent performance decrements and heat illnesses. Heat illness is a rise in core body temperature to harmful levels and can manifest itself as anything from heat cramps to heat exhaustion to heat stroke and even death.
When nutrients are broken down during exercise, energy is released in the form of heat. In a cooling environment, convection allows this heat to be moved from the working muscles in to the blood. From here, the heat travels to the skin where it is transformed into sweat that then evaporates, cooling the blood, which then returns to the muscles.
On a hot day, the ability of the body to dissipate heat from the blood through the skin is significantly reduced and heat can be stored in the muscles, leading to a rise in core body temperature. This poses a serious concern for athlete performance and safety, and it is imperative that the athlete, coaching staff, and tournament organisers understand this risk and take precautions to reduce the probability of its development. Given our hot and humid climate in Trinidad, one would think that we would be adept at managing the risk of heat illness. However, experience has shown me otherwise. Just look at our recreational athletes. I hash with a water bottle attached to my side. A friend with a "hard core" philosophy laughs at me, insisting that "the body adapts!" and I should train my body to endure better by exercising under harsher conditions, using less water. While I appreciate his "acclimatisation" perspective, I fear he misunderstands its true meaning as well as the detrimental effects of dehydration. This is the same "hard core" yet risky philosophy used by many coaches who feel that they need to train their athletes to be tough.
Acclimatisation to a hot environment occurs when the individual is able to adjust (increase) his sweat rates to become more efficient at cooling himself. He also is able to "sweat out" less electrolytes from his body than someone who is not acclimatised. Getting acclimatised is the reason World Cup teams should arrive in Qatar about two weeks before the start of the tournament. This is quite different to dehydration, which is a shortage of water in the body, affecting its ability to execute vital processes and thermoregulation. Like the World Cup organisers, local coaches must develop hydration plans and structure their practices and tournaments to allow sufficient time for recovery and rehydration, particularly in hot temperatures. If you are dehydrated, you become more susceptible to heat illness. One can argue that those avid exercisers, plodding determinedly up Chancellor Hill in their sweatsuits, are attempting to "acclimatise" to Trinidad's hot, humid environment. But one knows better, and it is obvious that this is more of a weight loss strategy, albeit an ineffective one.
Wearing a sweatsuit during exercise to "sweat out the calories" is a myth and can be a dangerous practice. It does nothing more than reduce the ability of the sweat to evaporate. It wraps your body in a layer of stagnant hot air, significantly decreasing the body's cooling mechanism, putting you at risk for developing heat illness, not to mention making exercise a very unpleasant experience. Clothes should be lightweight and porous to maximise the cooling benefits of sweat evaporation. Then we have our Carnival exercise bandwagonists, who begin regular, intense exercise six weeks before the festival to "tone up" and "look bes" in their one-size-too-small bikinis. The biggest risk factor for heat illness is an exercise intensity that is too high for the individual's level of fitness. So trainers and Carnival exercise freaks beware! Exercising year round will not only make you fitter, smaller and able to get an even smaller one-size-too-small bikini, it will decrease your risk of developing heat illness. Heat illness is a condition we in Trinbago often fail to consider, and can result in fatalities. The good thing about the controversy in Qatar is that it highlights the importance of proper planning to stay safe. We must take note and exercise ourselves and train our athletes with greater consideration for heat illness. After all, if you saw a heat wave, would you wave back?
Carla Rauseo, P.T., M.S., C.S.C.S.
is a State Registered and Licensed Physiotherapist Certified Strength and Conditioning Specialist