One sports injury that doesn’t get a lot of attention is hypothermia. Winter is here and like most people in St. Louis, we like our sports and we still like to go outdoors to run or ice skate or hike, even if it’s 4 below zero.
Then there are the people who have to work in the weather. And if you’ve lived in this area long enough you know how quickly the weather can change.
For instance, I once knew a guy who ran in the Kansas City marathon. The race started early in the morning at 40 degrees. Since you should dress for weather about 20 degrees than the current temprature, meaning at this race runners were dressed for 60 degree weather, most runners were wearing shorts and a sleeveless t-shirt. The guy I knew wasn’t as brave so wore long pants and long sleeved shirt.
Well, halfway through the race the weather changed.
The temperature dropped from 40 to 30…and then it started to rain. That rain turned into slush, sleet and finally huge junks of snow. Under-dressed runners were carted off and rushed to the hospital. At the end of the race an entire tent was devoted to medical assistance as people suffered from frostbite and hypothermia. The guy I knew finished the race and was cold, but didn’t suffer any further harm.
Suffering from Hypothermia
Running, exercising or even working out in cold weather will expose you to hypothermia. What is hypothermia? Your body temperature at the core is 98.6 degrees. Hypothermia occurs when your core body temperature drops and your body responds by shipping blood away from your arms and legs to your core trying to keep that temperature up.
When that starts happening, no matter what you are doing, you will experience a drop in performance. That drop will further complicate the issue if you don’t do something to bring your entire body temperature up.
It’s important to recognize that it doesn’t have to be extremely cold to suffer from hypothermia. Running or working in the rain when it is chilly or excessive sweating in chilly weather can induce hypothermia.
There are typically three phases of hypothermia, which each level getting worse and more serve. You need to recognize the symptoms to avoid severe medical issues.
- Mild hypothermia occurs when the body is at around 95 to 97 degrees and you generally have a cold sensation that include moderate shivering, goose bump and possibly numb hands.
- Moderate hypothermia occurs when the core body temperature drops to around 90 to 95 degrees. At this stage you are stumbling, probably shivering uncontrollably and even speaking with great difficulty.
- Severe hypothermia occurs when your body core temperature plummets below 90 degrees. At this stage you do not have good muscle control or coordination and you will stop shivering. At this stage you will appear confused and if left untreated can die.
It’s best to recognize the early symptoms of hypothermia and cut a workout short to avoid descending into the second and deadly third stage. Live to run or work another day.
The Other Cold Weather Threat: Frostbite
If having to worry about hypothermia was not enough, you also have to worry about frostbite. There are four stages to frostbite:
- Cold response. This looks like a red, severe color on the skin. You’ve probably seen this if you’ve been out in the cold and had to take your gloves off for any reason for a long period of time. The cold response is usually painful, too, and is indication you need to go inside.
- Frostnip begins when a part of your body goes numb and turns white. This stage is reversible. The next two are more than likely not.
- Superficial frostbite is where your skin is completely soft and white without any feeling at all.
- Deep frostbite occurs when you do not end the exposure to your skin to the cold. Your skin at this point becomes firm.
Anyone working or running outside also needs to be aware of the wind chill factor, which can speed up the process off hypothermia or frostbite. What can further cause problems is your own wind chill you can create, whether you are running or cycling. If you are running into a 5 mile per hour wind and running at 6 miles per hour, then you are creating a 11 mile per hour wind chill factor.
Always consider the wind chill factor when dressing for the cold. Remember, a runner’s body is a heat producing machine, so add 20 degrees to the temperature, but always dress appropriately. Keep your skin, fingers and face covered. And I would say run in the cold as long as you are comfortable…it’s really a personal preference. You can always run on a treadmill or just bundle up.
Also make sure someone always knows where you are going and carry a phone with you.
Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer. He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.