Tuesday, May 23, 2017

How to Prevent 8 of the Most Common Heat-Related Running Issues

Disclaimer: I am a Tailwind Trailblazer, which means I receive Tailwind Nutrition in exchange for sharing my experience and opinions, which are of course, my own. This is NOT a sponsored post.

You've done the work, training for 12-20 weeks for your marathon. Completed every run on your plan. Ran at least one 18-20 miler and lived to tell about it. Tested out GU and hydration. Survived the taper crazies. You're injury free and ready to run. As part of your prep, you've been weather-stalking, checking and comparing at least 3 different weather apps so that you can be prepared for race day. While the forecast initially looked promising, as the week went on, the predicted high temperature keeps going up. Initially, yellow flag conditions are now red flag.Your confidence begins to take a nosedive. How can you run a strong race in the heat? What are the risks? And how can you prevent problems?



Overhydration and hyponatremia: When it comes to running in the heat, the first issue that comes to mind is dehydration. But have you ever considered that overhydrating could be a thing? A few years ago there were stories in the news of runners dying from having low blood sodium levels aka hyponatremia. What was happening was that these runners were taking in too much water. Believe it or not, salt tablets and sports drinks will not prevent this. Taking NSAIDS, such as ibuprofen, which a lot of runners use for pain, has been associated with this problem as well. The best thing an endurance athlete can do to prevent overhydration is to drink to thirst. In other words, only drink when you are thirsty. You also might want to consider a complete fuel, such as Tailwind, which contains carbohydrates, electrolytes, and hydration, that you continually sip on throughout the race. I've had great success using Tailwind. There are other fuels that work similarly. Of course, you should trial these fuels prior to race day to make sure you can tolerate them.

I like to carry my Tailwind in a handheld bottle. I sip every time a song changes on my iPod.
I drink 240 ml (8 ounces) per hour and if it's hot, I'll drink extra water at the aid station.
Heat cramps are the worst. I can say this because I had them in my first marathon. My friend made me take salt capsules, which didn't do a thing to help relieve my pain. Bananas won't help either. That's because most heat and/or running related cramps are not due to sodium or potassium depletion, but are simply muscle spasms from exertion. Dehydration won't cause cramps either, but it can make cramps worse if your muscles are already tired from all that running. Hydration has not been proven to help with muscle cramps, but it's one of those things that won't hurt in this situation. Prevention is the best strategy and that comes with good training. Run those long runs and do your strength training.

Heat cramps from that infamous 2011 Chicago Marathon
Better preparation would have helped me, I think.
Heat Rash: There's chafing and there's heat rash. I can't say one is worse than the other, but heat rash can pop up at any time during a race. Heat rash is itchy and bumpy. Most people get it on the back of their neck, chest, armpits, or between their thighs--any place where you get extra sweaty. If you are prone to heat rash, you will want to do the same things you might do to prevent chafing, including body glide or vaseline in areas that are prone to rubbing. You can also try applying antiperspirant to those areas instead. If you know you're likely to break out in heat rash, taking an antihistamine like Claritin or Zyrtec prior to running can be helpful.

This is not a picture of heat rash. It could have been, though.
It was an incredibly hot day!
Heat Edema: I can't say that I've ever experienced this, but there's an article on heat edema in Runner's World, so apparently it's more common than I thought! Heat edema is swelling and redness in the hands and feet while running. It has less to do with dehydration and more to do with circulation. Wearing compression socks is a good strategy if you are prone to swollen feet while running. I've never seen compression gloves but if your hands swell when you run make sure you aren't clenching your hands tightly, open and close your hands at times, and avoid wearing rings and jewelry.

I don't often wear compression but when I do, they feel good!
Heat Syncope: Have you ever seen a runner collapse after crossing the finish line? Finish line syncope aka fainting occurs because once a runner comes to a complete stop, their blood pressure drops rapidly. It isn't life threating but it is scary. The best way to prevent this is by NOT coming to a stop once you cross the finish line. I'm guilty of this after a hard push to the finish as I often stop with my hands on my knees to catch my breath. Slow down to a walk to keep the blood flowing and the heart pumping. This is why races have such long finish line chutes. That walk to the Goose Island beer truck at the Chicago Marathon seems like cruel and unusual punishment after running a marathon, but there's a reason for that.

Don't do THIS at the finish line.
Keep on moving.
Heat Exhaustion and Heat Stroke are the most severe forms of heat-related illness. Symptoms of heat exhaustion include excessive sweating, goosebumps, fatigue, nausea, and confusion. Heat exhaustion isn't life threatening, but if untreated, can lead to heat stroke. Heat stroke is a medical emergency. The best way to prevent heat stroke is to recognize the signs that you're having heat related issues. Stop and walk if you're feeling bad. Stay hydrated throughout the race. If it is really hot, pouring water over your head throughout the race to keep yourself cool can be helpful. When I ran some hot Chicago Marathons, several aid stations provided wet sponges, which I found to be wonderful.


Even though you can't plan for the weather on race day, you can practice fueling and hydration on your runs to prepare yourself for any conditions. The rule of thumb is always NOTHING NEW ON RACE DAY. Don't panic and resort to desperate measures just because it's predicted to be record heat. Even if you haven't trained in the heat, stick to your race plan. Don't be a hero, because if you end up in the medical tent before you cross the finish line, it's a DNF for you. Cooler heads prevail--literally and figuratively.

Have you ever run in red or black flag conditions? What did you do to stay cool? Have you experienced any heat-related running issues? What do you use to stay hydrated during an endurance event?

I'm linking up with Marcia, Patti, and Erika for Tuesdays on the Run as well as Debbie, Susie, Rachel, and Lora for Coaches' Corner.




76 comments :

  1. This brings back so many memories of the apocalypse that was the 2007 Chicago Marathon, my first. People were literally going down all around me. I was drinking but yes, conscious about not drinking too much. The one thing I'd say is DO NOT run your plan. Listen to your body carefully and make peace with backing off your pace if you need to. So much energy is diverted to the cooling effort. Energy and digestion are compromised. My feet don't swell (that I've noticed) but my fingers do when my electrolytes are off. It's good to train in heat if you can and figure out what's right for you. Good info!

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    1. I couldn't help but think of you when I wrote this! That marathon! I still can't believe you finished!

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  2. I just noticed my blog in your sidebar...thank you for including me!

    And - wish I'd had these tips last summer when I was doing a triathlon in 95 degree 98% humidity weather!

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    1. Experience is the best teacher--I wish I'd known this a few years ago too!

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  3. I notice that I can suffer from Heat edema when running in the summer. My fingers will swell up but my feet tend to be fine. It just reminds me that I need to drink more of my water + Nuun. I always run with a handheld but I need to do a better job of sipping from it more often.

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    1. I like the sip with every new song method--It's about the only way I can remember to sip!

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  4. Only one time have I had weird heat-related problems. It was on a hot summer night (go figure!), and I had run a few miles and stopped back at the house for water before continuing on for a few more miles. About a mile into the second part of the run, I felt dizzy and all of a sudden had the chills....let's just say the "hero" mode came to a crashing halt and I walked back home LOL I don't mind the heat, but it does need to be respected.

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    1. You are right, the heat needs to be respected! I cannot tell you how many times I've had heat issues. But part of me thinks it's all that getting comfortable with being uncomfortable thing too. I deal with it so much better now.

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  5. My fingers swell all the time in the heat when I run, no matter how much I drink. Maybe it IS circulation vs dehydration? My feet/ankles don't swell. The best thing you can do when running in extreme heat it to slow down...the second best thing would be to not run, LOL.

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    1. I have never had heat related swelling--I'm surprised to know how many people do!

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  6. Such good info for athletes at all levels! Several years ago while on a long training run I started to get dizzy...definitely due to the heat. I sat in some shade to cool down and then kept going...I probably should have stopped but I'm such a numbers person and my training schedule said 10, not 8 miles that day! My fingers get swollen at the ends of marathons regardless of the temperatures so I always take off my jewelry before the longer races.

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    1. I've had a tough time with the heat over the years, but I've learned how to manage it much better. I'm thinking my run/walk intervals are going to serve me well this summer! Will I see you at RnR Chicago?

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    2. Unfortunately, I won't be there...I'm doing the Napa to Sonoma Half again this year, which falls on the same weekend.

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  7. I ran the Vermont City marathon relay that was cancelled due to the heat. I just took it slow and rain under a lot of sprinklers.

    Lsst Thursday evening, it was over 90 degrees. Again, you have to adjust your pace and stop at every water station whether you are thirsty or not.

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  8. Great tips! I think overdrinking (no, not alcohol HA HA) is a common mistake since the natural response to heat is to drink water. I do take Salt Capsules. I don't think they completely prevent cramps, but mine have been so much better since using them. Living in Dixie, it is not uncommon for me to lose up to 7 pounds on a long run. I think they help with recovery as well.

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    1. I'm glad to hear the salt capsules help you! You should be an expert on the heat, not me!

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  9. I'm really glad you cleared up the muscle cramps bit about how bananas and salt tablets won't do a thing. It's such a common misconception and it's driven me nuts for years.

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  10. I typically use Hammer Nutrition products, especially Endurolytes (electrolyte formula.) I experienced heat exhaustion in Hawaii, it was pretty scary! I got nauseated/dizzy and was afraid I was going to pass out. I've learned to really watch my heart rate, when it starts sky rocketing on hot days I know it's time to slow down.

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    1. I used to do HR training, just to help me monitor myself in the heat. Now I know when to slow down.

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  11. I didn't know that's why race chutes can be that long. I do try to keep walking anyway to keep my muscles loose. I know once I stop, they'll start to tighten up.

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  12. I just started using Tailwind and I can tell a huge improvement on these hot and humid days! I love that stuff. When it's really hot outside, I have been know to get headaches so I slow my already slow pace down even more. :) Great info Wendy!

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    1. I have gotten headaches on those long hot runs too. I never really connected it to the heat, but it makes sense! Glad to hear you like the Tailwind!

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  13. Thankfully never experienced anything worse than cramping & chafing (which can be totally random for me).

    I've been using Saltstick chews, which is more than just sodium -- but I still haven't quite cracked the post race/run cramping. They do seem to help during the race (I had terrible cramping the last 3 miles in PCB & it wasn't even that hot -- but it was a big PR for me).

    But sometimes immediately afterwards or hours later I'll cramp up so badly I can't move for a few minutes. I often do find that eating something salty can help with it, though. Maybe it's a placebo, but it works for me, what can I say.

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    1. I still am a little mystified about the post race cramping--besides that horrible first marathon, I had my calves freeze up post marathon#2 when I ended up in a wheelchair because my legs stopped functioning. I don't know what that was all about, but I recovered quickly!

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  14. Great tips! As much as I love running in the heat than in cold weather, your pace really does slow down. I like to bring Nuun during the really hot runs!

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    1. The heat really affects my pace. I get so humbled when I race in Florida!

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  15. I sometimes have issues with heat edema in my hands - I can't wear my wedding ring during summer runs.

    By the way I have to tell you that I started using Tailwind after reading about how much you like it and it's been great! Finally found something that agrees with my stomach!

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    1. I'm so glad to hear you like the Tailwind! Let me know if you want me to send you some! I have tons.

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  16. I think spring marathons can be so challenging because often times you train in the cold weather and then have to deal with the heat on race day. It makes it tough to be able to practice fueling and also acclimate to the weather!

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    1. That's one of the reasons I picked Grandma's marathon for this year--I thought that I'd have decent weather to train in, and since the race is in northern Minnesota, I thought it would be perfect race conditions. I'm so sad that I don't get to do it!

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  17. I get heat rash on pretty much every summer long run - it stinks!

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  18. I sometimes get a heat rash on long bike rides under my shorts it's the worst really. As much as we complain about the winter it's the extreme heat that is so much harder to train in

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    1. That is the truth! I always say that it's so much easier to run in the cold. It doesn't mean I like it tho!

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  19. I ran the 2012 Green Bay Marathon where they cancelled the race about 2.5 hours in. They received a lot of backlash for it and that's about the time the flag guidelines became more common at marathons. That year, I had family give me frozen sponges at a couple spots on the course. My hands swell when it's warm, so if a race gives out ice on the course, I'll shove some into my bra but also carry some in my hands to help cool me off. The best thing I do is adjust the pace based on effort. Even this year's Boston forced me to adjust a bit even though it wasn't that hot. Sometimes, it's all about making it to the finish line in one piece. A race is never supposed to end in the hospital. :)

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    1. I think you just have to be smart about running in the heat and listen to your body. There's no sense in trying to be a hero!

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  20. I have several packets of Tailwind to try. I'll be using them this summer as I train for Marine Corps Marathon again. I'm not sure I've ever run a race that was quite that bad, but living in VA, I've gone for runs in some pretty hot and awful weather.

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    1. You've got so much experience under your belt that I'm pretty sure you do a good job of listening to your body.

      Let me know how you like the Tailwind!

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  21. My hands often swell in the heat - especially if it's humid. Didn't know there was a name for it, and just kinda thought it happened to everyone. lol.

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    1. Apparently it's way more common than I knew!

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  22. GREAT great post. Super helpful for everyone, and I"m glad that we have a medical professional to explain them!

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    1. It was kind of fun putting on my nurse practitioner hat for this one! :)

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  23. Heat is SERIOUS!!! Such a great way to lay out all the problems for everyone right before summer!

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  24. You always have the most informative posts. I've experienced heat edema and it's a b****! I didn't use to have that until I had my thyroid removed. And yes circulation has everything to do with it. And also yes there are compression gloves for edema but I find them cumbersome. So unless it's an above normal heat, I don't wear them.

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    1. I had no idea about compression gloves, but it seemed like it would work like the socks. I'm sure they get really hot in the heat of summer. I figured heat edema would be unpleasant. I just didn't know it was so common amongst runners!

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  25. Really great tips. Heat stress is a real concern! Runners need to take it seriously and make sure they have the right water/electrolytes to stay hydrated. Knowing the warning signs can save your life!

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    1. I think that's the key--to pay attention to the signs.

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  26. Amazingly, since I live in such heat, I've never had any of the problems you mentioned. Or maybe it is because I live and train in the heat. Though now that you mention the heat syncope I have had times after a bike ride in the heat that I feel faint when I get off my bike. Never fainted, but I'll bet that is what happened. Thanks for the info!

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    1. I think living and training in the heat is an advantage--you're already acclimated. For those of us who live in more temperate climates, the ups and downs make it tough for us to get used to the heat!

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  27. I live in Florida so I have total body edema 10 months out of the year! It's brutal to run in the humidity....,sigh. I am so careful to not get over heated. I try to run either early morning or evening time. I have never tried Tailwind. Wanna send me some?

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    1. I'd love to send you some Tailwind! PM me at wendy(at)takingthelongwayhome.com

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  28. This is a really, really great post. I feel like there is SO MUCH MISINFORMATION out there ESPECIALLY pertaining to hydration, being a salty sweater / runner, and all the salt tabs, etc. I'm going to use this post as a reference for those that question...

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    1. There is so much misinformation in general--as a medical person, it drives me crazy!

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  29. I have experienced a few of these and they are never fun! That blood pressure drop at the end of a run is the one that I actually dislike the most, but fins myself still doing the cause all the time. I'm pretty sure I get a heat rash on my torso, so I'm going to try your tips the next time I run. It's either that or maybe I'm allergic to the material of my tops?? Great post!

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    1. Those heat cramps have been my nemesis more than once. I dropped at the finish line once but it wasn't syncope, my calves froze up and I couldn't walk!

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  30. My hottest and most humid race was the Chicago Half two years ago. I wasn't used to the humidity at all but what helped me was I stayed at a comfortable pace to run with a friend. I think if I had ran faster - I would have experienced some type of heat related stress.

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    1. That slower pacing is the key to keeping cool in the heat!

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  31. Oh man, thankfully I haven't had to deal with any of these. I would much rather run in warm weather than cold weather, but I do find the heat very oppressive. I just stick to early mornings and avoid racing in hot weather.

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    1. I do my runs in the early morning too, but racing in hot weather is unavoidable around here!

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  32. Ive had chafing and heat stroke during a race (and soccer tournaments growing up)...horrible things to experience. I find when my sports bras hit their expired date, that's where I get chafing, so that's when I know it's time for new ones!

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    1. I'm not good about that! I won a sports bra from Title Nine awhile ago and they gave me all kinds of education about that.

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  33. Here in Florida I am always running in the heat. And my hands swell like crazy....I had never attributed it to hydration issues.

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    1. It could be heat or hydration. It's got to be tough, running in that heat all the time!

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  34. Yikes, what a great (or scary, rather) reminder of everything that can go awry when you add heat into the mix!

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    1. I wonder if we are going to get any heat this summer?

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  35. I haven't run for a long time bcause my job is so busy

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  36. Man, I need to get ready to train during the summer. But maybe I should wait since maybe it won't be too hot this summer. The weather so far has been CRAZY. Mother Nature for sure is confused.

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    1. At the rate we are going, I don't think we're going to have summer! Either that or we will go right to the blast furnace.

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  37. I've never thought about overhydrating being a potential issue, but I understand where you're coming from. I usually hydrate based on my thirst, not because I'm "supposed" to drink anything at a certain point on a run, and this approach works really well for me.

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    1. Then you are already ahead of the game!

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