Heatstroke can happen to any runner

Here's how to prevent and treat heatstroke

Taking part in a running event is a unique experience; at the same time, however, you ask a lot of your body! You exert yourself considerably, which causes your body temperature to rise. This is normal, but sometimes your body is no longer able to disperse this heat. In such circumstances, you're at risk of overheating, which can eventually lead to life-threatening heatstroke. Fortunately, you can do a lot yourself to prevent heatstroke and also help other runners. The advice on this page and in the information video below will help you do so. Pay close attention to the advice (and share it with your fellow runners and supporters). That way, you'll be well prepared when that starter's gun goes off.

Overheating: even if it isn't 'stiflingly hot'

Just to clear up one misunderstanding from the outset: it doesn't have to be very hot to overheat. Although it is more common in warm weather, you can overheat, or even get heatstroke, at temperatures as low as, for example, 14 degrees. Heatstroke is when your body gets so hot during exercise that organs are at risk of failure, which occasionally even results in death. Even though older and less fit individuals are officially more at risk of heatstroke, in real life we are also seeing young and experienced runners being affected. Fortunately, there's a lot you can do to prevent heatstroke. If you follow the following five pieces of advice, you'll be greatly reducing your risk of overheating (or heatstroke)!

5 golden pieces of advice to prevent heatstroke

1. Make sure you come to the start fit

By ‘fit’ we obviously mean well trained, but also listening to your body if you've been experiencing a lot of stress or flu symptoms, mild or otherwise, in the days before the race. Even if you again feel up for it on race day, your body may not have recovered properly. Which is why you should adjust your planned running pace and finishing time, or even pull out if you're in doubt about your fitness. After all, good runners put their health first!

2. Get your body used to running in hot and/ore muggy weather

When preparing for an event, try training on a hot or muggy day. This will help you learn how your body reacts to heat and what signs it gives. It also allows your body to get used to exercising in warm conditions (acclimatisation), so that it is better prepared for potential heat during a run. However, it is important to start doing this early and not in the week of the event. Besides training in the heat, you could also think about visiting a sauna, using hot baths or putting on extra layers of clothing during some of your training sessions (if it isn't too hot).

3. Opt for light-coloured ventilated clothing, and take additional precautions when it's sunny

It may be chilly at the start, but you'll soon get hot during the run. In addition, temperatures can rise unexpectedly fast during a race. Heat lingers even longer if you're running at a well-attended event, which often makes it feel even hotter. So opt for light-coloured, light clothing. Don't underestimate the warmth and comfort that lighter clothing can provide!

What if it's sunny? Then protect your head and neck with breathable headgear, and use sunglasses to protect your eyes from bright sunlight. Protect your skin with a sunscreen that has a good protection factor.

4. Drink plenty of water before and during the race (tip: use the drinking stations)

Moisture and water are the main concerns, especially when it's hot. The following advice will help you hydrate 'properly':

Have two large glasses of water (500 ml) with your last meal - about 2 hours before the event -, and also drink enough (about 2 litres per day) in the days leading up to the event;
Drink enough during the run as well. Use the water stations. These will also have sponges you can use to cool down;
Preferably bring your own water as well, so you can always have a drink if you need to;
Don't drink alcohol before the run (not even the day before);
Besides drinking enough, make sure you get enough salt. This can be done by alternating water with sports drinks, as these contain salt. Or consume some extra salty food (but no salt tablets);
Check the quantity and colour of your urine: your urine output should be sufficient (at least 1.5 litres per day). By looking at the colour of your urine, you can check whether you've drunk enough. Before the event, your urine should preferably be light yellow. If your urine is dark yellow, you haven't drunk enough.

Do you find it difficult to drink during events? In the lead up to the race, experiment with cardboard cups on how best to grab them from volunteers and drink from them while running.

5. Keep an eye on your running pace

Run in a controlled manner, and control your pace; don't be fooled by the adrenaline you feel at the start, or the pressure you're under to perform. All that matters in the end is your health. And what if turns out to be a hot or muggy day, or you've had the flu or been under stress, or even if you're not feeling in tiptop shape at the start? Then we strongly advise you - if you do participate - to adjust your running pace downwards. Even if you're ‘young’ or ‘super fit’! That PB isn't worth risking your health.

Still overheating? How to recognise and treat overheating

The above advice will go a long way towards reducing the risk of any type of overheating, but what do you do if you or another runner still overheats, be it serious or otherwise? The recognition and timely treatment of overheating in both yourself and fellow runners can be life-saving. Use the signs below to recognise any form of overheating.

Headache

Confusion

Dizziness, blurred vision

Nausea

Drowsy or strange behaviour

Convulsions

Red skin (but no sweat)

In same cases, the skin is actually pale and clammy

Loss of coordination and walking with a limp

High body temperature (but someone might feel cold at the same time!)

A fast or strongly fluctuating heart rate

Do you recognise any of the above signs in yourself or another runner? If so, take immediate action.

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

1. Walk to the side and look for shade, or bring your fellow runner to a shady, cool spot

2. Seek help at a Red Cross aid station (or call 112)

You will find a Red Cross aid station every 500 metres along the route of the TCS Amsterdam Marathon. You should go here if you don't feel well or are suffering from some other ailment. If you notice that a fellow runner is really not well, call the emergency services immediately.

3. Immediate cooling

Immediate cooling is vital in the event of heatstroke. 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 if you're looking to cool them down. However, if the runner is too far away from such an amenity, you can cool them with materials in the immediate vicinity and that can be provided by mobile medical teams;
For example, spray the runner with cold water (such as bottled water, or a watering can, if needs be filled with ditchwater);
Place cold packs in the neck, armpits, groin and, if necessary, knee cavities;
Direct a fan at wet skin;
Cover the runner with wet, ice-cold towels.

Acting quickly and cooling properly will see most runners who overheat recovering quickly. Quick recognition and action saves lives!

Want to find out more?

The Red Cross recently conducted a survey among Dutch athletes, with the conclusion being that the signs the body gives shouldn't be ignored. Read some of the advice and results of this survey on their website here.

Thermo clinics

Measuring is knowing. Joost Fonville has started several initiatives to prevent heatstroke in runners after losing his own son to the condition. For example, he has created a website where - in order to better understand how the condition can occur and how it can affect you - extensive information in relation to hyperthermia in running has been compiled and where runners who have experienced it in the past can share their experiences with others. Click here to visit the website.
Another initiative is the organisation of thermo clinics, at which you can measure your body temperature, or the fluctuations in it, during exercise. A thermo clinic also gives you ample 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 be taking part in a running event or people who will be coming along to watch? If so, share these tips and advice with them! Together, we can ensure the healthy participation of all runners in our race! Lots of fun in advance!