Heat stroke can happen to any runner

How to prevent and treat heatstroke

Taking part in a running event is a unique experience, but at the same time you are asking a lot of your body! You exert yourself, which causes your body temperature to rise. This is normal, but sometimes your body can no longer get rid of the heat. In that case, overheating lurks, which can eventually lead to a life-threatening heatstroke. Fortunately, you can do a lot yourself to prevent heatstroke and help other runners. The advices on this page and in the information video below will help you do so. Watch the advice carefully (and share it with your fellow runners and supporters). That way, you will be well prepared for the start.

Overheating: even if it's not hot 

To immediately clear up a misunderstanding: it does not have to be very hot to overheat. It is more common in warm weather, but even at a temperature of, say, 14 degrees you can overheat, or even have heatstroke. Heat stroke is when your body gets so hot during exercise that organs can fail, sometimes even resulting in death. Older and less fit people are officially more at risk of heatstroke, but in practice we see that young and experienced runners are also affected. Fortunately, there is a lot you can do to prevent heatstroke. If you follow the following five pieces of advice, you will reduce your risk of overheating (or heat stroke)!

5 golden tips to prevent heatstroke during your run:

1. Make sure you show up fit at the start.
By ‘fit’, we of course mean well-trained — but also in tune with your body. If you've been dealing with stress or (mild) flu symptoms in the days leading up to the race, it’s important to listen to what your body is telling you. Even if you feel okay on race day, your body might not be fully recovered. Adjust your pace and goal time accordingly — or don’t start at all if you’re unsure about your fitness. Smart runners put their health first!
2. Help your body adapt to running in warm and/or humid conditions.
Try scheduling a training session on a warm or humid day during your event preparation. This helps you understand how your body responds to heat and what signals it gives. It also allows your body to acclimate to exercising in warm conditions, making it better prepared for possible heat during the race.
It’s important to start this process well in advance — not just in the week of the event. In addition to training in the heat, you could consider visiting a sauna, using warm baths, or wearing extra layers during some of your runs (as long as the weather isn’t already too hot).
3. Choose breathable, light-colored clothing and protect yourself extra when the sun is out.
It might feel chilly at the start, but once you begin running, you’ll warm up quickly. Temperatures can also rise unexpectedly during the race, and the heat can feel even more intense in a crowded event. That’s why it’s smart to wear lightweight, breathable clothing in light colors — you’ll rarely be underdressed!

Is the sun shining? Protect your head and neck with a breathable cap, and wear sunglasses to shield your eyes from the bright sunlight. Don’t forget your skin — apply sunscreen specially designed for sports, with a high protection factor.
4. Stay well hydrated before and during the race (tip: make use of the water stations).
Fluids — especially water — are key, especially in warm weather. These tips will help you stay properly hydrated:

  • At your last meal (about two hours before the event), drink two large glasses of water (around 500 ml), and make sure to drink enough in the days leading up to the race (about 2 liters per day);
  • Stay hydrated during the race. Use the water stations — you’ll also find sponges there to cool yourself down;
  • If possible, bring your own water so you can drink whenever you need to;
  • Avoid alcohol before the race (even the night before);
  • In addition to drinking enough fluids, make sure you're getting enough salt. Alternate water with sports drinks, which contain sodium, or eat some salty snacks (but avoid salt tablets);
  • Monitor your urine: it should be light yellow and you should produce at least 1.5 liters per day. Dark yellow urine means you’re not drinking enough;

Struggle with drinking during the run? Practice beforehand using paper cups — test how to grab them from volunteers and how to drink efficiently while running.
5. Watch your pace
Run with control and keep your pace steady; don’t get swept up by the adrenaline at the start or the pressure to perform. In the end, your health is what truly matters.

If race day turns out to be hot or humid, or if you’ve recently had the flu, been under stress, or don’t feel 100% fit at the start, we strongly advise you to slow down your pace if you decide to run anyway. Even if you’re “young” or “super fit”! That personal record isn’t worth putting your health at risk.

Run in control and keep an eye on your pace — don’t get swept up by the adrenaline at the start or the pressure to perform. In the end, your health is what matters most.

If the day turns out to be hot or humid, if you’ve recently had the flu, been under stress, or don’t feel at your best at the start, we strongly recommend adjusting your pace if you decide to run anyway. Even if you’re “young” or “super fit”! That personal best is never worth risking your health.

Still overheated? How to recognise and treat overheating

The advices above will go a long way in reducing the risk of (serious) overheating, but what do you do if you or another runner does become (seriously) overheated? Recognising and treating overheating in yourself and your fellow runners can be life-saving. Use the signs below to recognise (severe) overheating.
Headache
Confusion
Dizziness, blurred vision
Nausea
Dull or strange behaviour
Convulsions
Red skin (but no sweat)
Sometimes the skin is actually pale and clammy 
Loss of coordination and walking with a limp
A high body temperature (but someone may be cold at the same time!)
A fast or highly variable heart rate
Do you recognise (any of) the above signs in yourself or another runner? Take action immediately.

What should you do if you think a participant is overheating?

2. Seek help at a Red Cross care centre (or call 112)
On the course of the Dam tot Damloop, you will find a Red Cross care station every 500 metres. This is the place to go if you don't feel well or are bothered by something else. If you see that a fellow runner is not well, call the emergency services immediately.
3. Cool direct
In case of heatstroke, immediate cooling is vital. When in doubt, start cooling immediately while calling the emergency services.  

Cooling can be done in the following ways, for example:
  • Fully immersing someone in cold water works fastest to cool them down. At the Dam tot Damloop, there are cooling devices on the course and after the finish line, including cooling baths after the finish line. You can take the runner there. If the runner is far from here, you can cool with the resources that are nearby and can be provided by mobile medical teams.
  • For example, spray the runner with cold water (such as bottled water, or a watering can with (ditch) water)
  • Put cold packs in the neck, armpits, groin and possibly knee hollows.
  • Point a fan at wet skin
  • Cover the runner with wet, ice-cold towels

By acting quickly and cooling properly, most runners who overheat recover quickly. Quickly recognising and acting saves lives!
Learn more?
  • The Red Cross conducted a survey among sporting Dutch people and here the conclusion was that to avoid possible overheating, signals from the body should not be ignored. Read some of the advice and results of this survey on their website. 

  • Thermo clinics
    Joost Fonville started several initiatives to prevent heat stroke in runners after losing his son to heat stroke. For instance, he started a website where a lot of information about hyperthermia in running has been brought together and runners who have had it happen to them can share their story with others, to better understand how it happens and what it does to you. Click here to visit this website.
    Another initiative is the organisation of thermo clinics, in which you can measure the (fluctuations in) your own body temperature during exercise. A thermo clinic also gives you lots of advice on how to prevent overheating or hypothermia. If you want to know more, or take part in a thermo clinic, click here.  

Do you know runners who are going to take part in a running event or people who are coming along to support? Share these tips and advice with them! Together, we will make sure that all runners can participate in a healthy way. Have fun!