An athlete faces stress in numerous ways. Whether physical, internal or coming from peers and coaches, stress can cause individuals to tire and wear down.

But there’s another factor that plays a large role in stressing the body and affecting performance – heat.

The good news is there are ways to counter heat’s effects through acclimatization and proper hydration.

Dr. Douglas Casa is chief operating officer for the Korey Stringer Institute and a member of the USA Football Medical Advisory Committee. Since 1999, Casa has worked toward his goal of preventing sudden death in sport at the University of Connecticut, Department of Kinesiology. During this time he has written and presented on subjects related to exertional heat stroke, heat-related illnesses, preventing sudden death in sport and hydration.

Casa recently spoke to USA Football about these topics.

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What can athletes do now to start acclimating to heat?

There is no question that you can get a good jump on heat training in June and July to make the transition to August practices easier. This way you can slowly increase the intensity and activity outside and be used to the environment by the time practices come around.

This has become rare, though, for today’s athletes. For college players and even some high school student-athletes, they do their offseason conditioning inside in air conditioned weight rooms and training facilities. Players may have been working hard all summer, but the first time they actually step outside is on Aug. 1.

Look at what happened to LeBron James in Game 1 of the NBA Finals. This is one of the greatest athletes in the world, but when do you think is the last time he had to play or practice without air conditioning? If this can happen to him, it can happen to any player.

What are some other benefits to exercising outside this time of year?

When kids exercise by themselves in the heat, you don’t need to take the precautions that you do in a structured practice. You are not worried about dehydration because they can back off or get a drink whenever they need.

At practices, athletes can feel pressure – whether it’s real or perceived – from coaches or peers to push through thirst or not be given proper access to rest and rehydrate.

How can parents be sure their children are hydrated properly before practice or games?

The simplest test is urine color. Tell your kids when they go to the bathroom: If it looks like lemonade, they are good to go. If it looks like apple juice, go drink some more.

For an early morning practice or game, drink a tall glass of water or two right after dinner. If an athlete is prepping for the late morning or early afternoon, drink water between breakfast and lunch.

Make sure they are hydrating right before the event and through the first half. Dehydration comes before thirst. By the time you feel it, the dehydration is already there.

Is there a difference for hydration based on what region you live in?

Yes. If it’s 95 degrees in Louisiana vs. Minnesota, for the kid in Minnesota, it will be one of the worst days he faces that year. Be cautious. Slow things down and make time for extra water breaks.

In Louisiana, the kids will be more used to it. You still need to schedule regular water breaks, though.

There’s also a difference between heat and heat index. Heat index combines the air temperature and relative humidity. It’s basically “how it feels.”

The human body cools itself by sweating. Heat is removed from the body through evaporation. When the heat index is high because of high humidity, the evaporation rate slows and athletes are more likely to get overheated.

Click here for the Korey Stringer Institute’s state-by-state heat index guidelines

Along with proper hydration, how do you prevent heat stroke?

The simplest things are preventative. Players can wear loose-fitting, light-colored clothing. During hot or humid conditions, coaches can minimize the amount of equipment a player is required to wear. Make sure to take the time to heat acclimatize, have work-to-rest ratios in practice based on the intensity and the Wet Bulb Globe Temperature, make cold fluids readily available during frequent breaks and educate the parents, athletes and coaches about prevention of heat illnesses.  Move practices to appropriate times of the day, usually before 10 a.m. or after 5 p.m.

Make sure all coaches and medical professionals on site can recognize the warning signs, including:

• Extreme fever (104 degrees or higher)
• Profuse sweating
• Irrational behavior, irritability or emotional instability
• Disorientation, dizziness or confusion
• Headache or rapid pulse
• Nausea and diarrhea
• Muscle cramps or loss of muscle function

Click here for more information on emergency conditions and heat illnesses

What do you recommend when asked about sports drinks vs. water?

Water is preferred before exercise because the calories are not necessary at this point. 

When people are doing intense exercise in the heat, however, it’s better to have a sports drink over water. With the sugars, you are getting energy and replacing sodium without food. Also, children like the taste of sports drinks better, so they are more likely to drink it. ‘

But whatever you bring, make sure it stays cold. Cold fluids bring down body temperature better than fluids that are allowed to sit and warm in the sun.

What else can parents do?

There are many things:

• Bring coolers with cold towels to games and practices. Twenty towels soaked in ice and water to put over an athlete’s head, neck and arms during break periods will help with cooling.
• Before your child starts playing a sport, he or she should have a physical examination that includes specific questions about any history of exertional heat illness, information that also should be shared with the coaches.
• Make sure that your league or team has an emergency action plan.

SEE ALSO: Korey Stringer Institute’s preseason heat acclimation guidelines for practices