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

Disclaimer: I was a Tailwind Trailblazer, which meant I received 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?