Question Number: 21595

Fitness 6/27/2009

RE: Competitive Under 18

Ron of Birmingham, AL USA asks...

I have been refereeing since '02 and in mid July, I'll be taking charge of my first game during the summer months (I take summers off because of my full-time job).

Since it's probably going to be so hot (around 100 degrees), I was thinking about what I can do to make sure everyone is safe and hydrated. I was planning on taking a 2-3 minute water break at the midway point of each half and add more time to the end of each half to compensate. This way the teams and I can get water and stay hydrated.

What are your thoughts? How should I address this with the teams?

Thanks, and I really enjoy the site.

Answer provided by Referee Dennis Wickham

The USSF recently included a fantastic discussion on hydration and the dangers from the heat in this week's 'Lesson's Learned' available on the ussoccer.com website. I've quoted it below:



'Hydration: Preparation and Warning Signs

Forget about every other question that you have about nutrition until you've figured out how to stay hydrated. Being smart about hydration can separate good performance from great performance.

You are mostly water. In fact, if you took the water out of a 180-pound lean body, there would be about 55 pounds left. Because your muscles, your brain, your blood and sweat are mostly water, your body doesn't work like it should when it is not properly hydrated. You don't think as clearly, your endurance is compromised and your heart works harder.

When you're severely dehydrated, sweating stops and your body overheats. The result is fatigue, weakness, dizziness, and collapse, or worse. In fact, every year, deaths in young healthy athletes are linked to severe dehydration.

Sweat It Out

Sometimes you don't even see sweat, like when you swim. But you sweat whenever your body heats up from working out. Sweat is your body's cooling system. Evaporation of sweat from your skin cools you down.

When you sweat, you lose fluid from your body. That fluid must be replaced, and replacing fluids takes a plan.

Dehydration: A shortage of fluids in the body.

Don't Rely on Thirst

You might be thinking, "What's the big deal? Won't drinking when I'm thirsty guarantee that I'm hydrated?" Surprisingly, no. During exercise, for reasons not totally understood, humans don't drink enough to prevent dehydration. You need to drink before you're thirsty and keep drinking after you no longer feel thirsty.

Drink It In

Forget about the old rule of drinking 8 glasses of water per day. You probably need more than that on most days. Counting how many glasses you drink is only one way of keeping track of what you need. A better way of making sure you're hydrated is to check your body weight before and after practice. For accuracy, weigh yourself in minimal clothing if there's privacy, and afterwards, change out of the sweaty clothing before you weigh. The weight lost during practice or competition is not fat, it's fluid loss.

One pint of fluid weighs one pound. To replace the fluid, drink one pint of fluid (Gatorade or water) for every pound you lost. (One pint = 16 ounces = 500 ml = ? liter). It is critical to replace this as quickly as possible. Before your next workout, your weight should be back up to normal.

If you can't check your weight, pay attention to your body for signs of dehydration. Your mouth should not be dry. Your urine should be lemon-colored most of the time.

More than one episode of dark yellow urine is a warning sign that you don't have much reserve. (Exception: Vitamin supplements can turn your urine yellow-orange, even if you are hydrated.) Loss of appetite, stomach aches, and muscle cramps can be other warning signals of dehydration.

When?

Drink before, during and after working out. Drink a pint or so of fluid a few hours before exercise. This will help make sure you are hydrated and give you enough time to urinate if you need to beforehand.

Keep drinking during exercise. And don't worry about getting too much fluid. If you're sweating, your body needs a constant supply. Your stomach might gurgle, but your body will absorb and use the fluid. Feeling sick and cramping have been blamed on too much water when in fact, stomachaches and muscle cramps are usually signs of not drinking enough fluid.

Drinking fluids after workouts is extremely important. Even when drinking fluids during a workout, many athletes become dehydrated. Athletes working out in the heat for several hours can lose 10 pounds. That's more than a gallon of water.

Hydration Tip: Keep your hydration source full and in plain sight so you remember to drink it.

What Should I Drink?

Your body needs water. But remember water comes in all sizes, shapes and colors. Milk is 90% water. Juice and most soft drinks are 89% water, sport drinks are 94% water, and even pizza is 50% water. And it all counts. Nearly everything that passes your lips provides water for your body, and in fact, research shows that most hydration happens at meals from the combination of food and beverages.

Research also shows that we tend to drink more if the fluid is flavored and if a variety of fluids are available. Gatorade and water are two excellent sources for hydration.

Keys to Hydration

When you have figured out how to stay hydrated, especially when you sweat heavily, you have accomplished the single most important performance-enhancing aspect of nutrition.

Water is your most important nutrient.

Outline for Heat Illnesses

Source: USOC Sports Medicine Division

Heat illnesses are common problems for both athletes and non-athletes in hot, humid weather. Heat Cramps, Heat Exhaustion, and Heat Stroke start from similar circumstances: poor adjustment to hot weather and relative dehydration. These conditions can be severe and need emergency medical attention. All are preventable if certain procedures, such as time to adjust to heat, adequate fluids, and normal dietary electrolyte intake, are followed.

Heat Cramps

Cause
Inadequate adjustment to hot weather, heavy sweating; decreased blood levels of electrolytes; fluids and electrolytes not adequately replaced; unreplaced weight loss from previous workout/day.

Clinical signs and symptoms
Muscles in arms, legs, and/or abdomen spasm uncontrollably, accompanied by heavy sweating.

Treatment
Drink fluids; gently stretch and massage cramped muscles; rest in cool environment; apply ice to cramped area; watch for breathing or heart problems.

Prevention
Maintain adequate fluid intake by replacing sweat losses: 15-30 minutes before exercise, drink 16 oz. of fluid; during exercise, drink 8oz. every 15 minutes; and after exercise drink 16 oz. of water/electrolyte drink (i.e., PowerAde, Gatorade) for every pound of body weight loss; increase fitness; wear light colored and/or lightweight (i.e. mesh) clothing; do not use alcohol, coffee, caffienated drinks, or soda pop for fluid replacement.

Heat Exhaustion

Cause
Long exposure to hot and/or humid environment; heavy sweating; fluids and electrolytes not replaced adequately; unreplaced weight loss from previous workout/day.

Clinical signs and symptoms
Skin cool, pale and moist; heavy sweating; headache; dizziness; poor coordination; mental dullness; enlarged pupils; nausea; vomiting; fatigue; weakness; thirsty; small urine volume (bright yellow color); possibility of unconsciousness.

Treatment
Stop activity; rest in a cool area; sponge with cool water; drink water if conscious (replace weight loss with 16 oz of fluid for each pound of body weight); watch for breathing or heart problems; refer to physician attention if recovery does not occur quickly.

Prevention
Maintain adequate fluid intake by replacing sweat losses; 15-30 minutes before exercise drink 16 ounces of fluid, during exercise drink 8 ounces every 15 minutes, and after exercise drink 16 ounces of water-electrolyte drink (i.e. Powerade, Gatorade for every pound of body weight lost; increase fitness; wear light colored and/or lightweight (i.e. mesh) clothing; do not use alcohol, coffee, caffeinated drinks, or soda pop for fluid replacement; allow time for rest and cool down.

Heatstroke

Cause
Body's temperature control system stops working.

Clinical signs and symptoms
Hot, dry and red skin; no sweating; rapid pulse; confusion; dizziness; unconsciousness; rectal temperature as high as 104?-106? Fahrenheit.

Treatment: Medical Emergency!
Immediate emergency cooling (e.g. cool room, put body in tub of ice water, ice cloths with a fan blowing on skin) and transport immediately to hospital; check temperature; watch for breathing or heart problems (may need CPR)

Prevention
Maintain adequate fluid intake by replacing sweat losses; 15-30 minutes before exercise drink 16 ounces of fluid, during exercise drink 8 ounces every 15 minutes, and after exercise drink 16 ounces of water/electrolyte drink (i.e. mesh) clothing; do not use alcohol, coffee, caffeinated drinks, or soda pop for fluid replacement; allow time for rest and cool down.

Sources: ICSN, International Center for Sports Nutrition
USOC, United States Olympic Committee ? Sports Medicine Division
USSF, United States Soccer Federation ? Sports Medicine Committee

(Thanks to Mark Stein, ATC, for his help with this project.)
1991 United States Olympic Committee (revised November 1999) '

Answer provided by Referee Ben Mueller

Wow! 100 degrees. I complained about 85 the other day in WI. This to me falls under common sense. Just let captains/coaches know and I am sure theyll agree. I would take the break at a stoppage, after the halfway point of each half to avoid the drop ball. Good luck!

Answer provided by Referee Keith Contarino

Well, we have the same situation over here in Georgia. I talk to the coaches before the game especially for them to watch their players for signs of heat illness and to get my attention asap if they even suspect heat problems. When doing U12 and under in this heat I carry a cooler with ice, towels and water. I never cease to be amazed at parents who send their kids to a game in this heat with a 20 ounce sports drink and that's all! I suggest we have a water break at a stoppage around the halfway point of each half for a few minutes and I tell the players if they need liquid during play they are free to go to the sidelines and drink. I also tell them if they feel the need to leave the field during play if they feel ill, that they do NOT have to get my permission but to please get whatever treatment they need. I try to pay attention to the players and watch for any symptoms like staggering around, cramping, or stopping and staring off in space. You're doing a higher level game and, hopefully, the players and coaches are smart enough to bring plenty of liquid. But even at this level, your primary responsibility is the safety of the players so don't hesitate to stop the game if you suspect someone is having heat problems. One can die in the opressive heat and humidity we have here in the Deep South. Always err on the side of caution.

Answer provided by Referee Gene Nagy

Ron, at 100F any sensible coach would agree to a 2 minute water break half way through the half. Even in British Columbia we get those temperatures and we certainly allow for this common sense approach.
On top of setting this up at the start of the game (key) Ref Contarino's approach in watching for about to be fallen soldiers is great advice. In Hungarian a referee is called a 'game leader' (jatekvezeto) and that is what you are really doing out there. Lead them wisely.

Answer provided by Referee Jason Wright

Have a chat to the coaches/captains before the match, let them know. We have a few summer competitions in Australia - even our national competition is played over the summer, and we sometimes have drinks breaks in those games.

Health and safety is paramount.

Just remember to take the break in a stoppage, and don't forget which team has the restart! I would make sure the players stay on the field and the subs stay off (probably a good idea to point that out when you discuss it at the start of the match). They're only getting water, they don't need to go wandering.

I'd also bring a bottle of water or powerade to the touch line for yourself - players aren't the only ones who can suffer from dehydration or heat exhaustion.

For you personally, I would also strongly suggest a liberal application of sunscreen - I've found that once you start to burn it really amplifies the effects of heat and dehydration. Prevent this happening and you'll make your day a lot easier.

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