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Background <p>Heat-related illnesses (HRIs) pose a significant and escalating threat to athlete health and performance, driven by rising global temperatures and strenuous training demands. The body’s ability to maintain thermal balance during intense exercise in hot environments is frequently challenged, potentially leading to compromise of core thermoregulatory mechanisms like sweating and cutaneous vasodilation.</p> Aims <p>This review explores the underlying physiological mechanisms of thermoregulation, characterizes the clinical spectrum of HRIs (from mild cramps to life-threatening exertional heat stroke [EHS]), and summarizes current evidence-based strategies for prevention and management in athletic populations.</p> Methods <p>We analyzed the progression of HRIs, which culminate in EHS, defined by a core temperature exceeding 40&#xa0;°C and central nervous system (CNS) dysfunction. We identified key risk factors, including dehydration, inadequate heat acclimatization, and high body mass. The necessity of core temperature measurement for accurate field diagnosis and laboratory testing for complications such as rhabdomyolysis was also assessed.</p> Results <p>The analysis of the 89 included studies comprising a mix of randomized trials, observational cohorts, and mechanistic evaluations demonstrates a strong consensus on evidence-based management and prevention of EHS. Data synthesis confirms that cold water immersion provides the most rapid cooling rates across diverse clinical presentations, outperforming alternative modalities in the reviewed literature.</p> <p>Preventive findings across the study pool emphasize the efficacy of multi-layered strategies, specifically noting that the integration of acclimatization, hydration, and environmental monitoring significantly reduces heat-related incidents. The reviewed data also highlight distinct physiological responses in specific demographics, such as youth and para-athletes, necessitating the specialized protocols identified in the synthesis.</p> Conclusion <p>A multidisciplinary, adaptive approach focusing on proactive prevention and immediate, definitive treatment is crucial for protecting athletes. Continued research and adoption of new technologies are necessary to safeguard athlete well-being in an increasingly warm climate.</p>

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Thermoregulation and heat-related illnesses in athletes: prevention and medical management

  • 期刊论文

  • 发表日期：

    2026年3月22日

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  • Natalia Kawka,
  • Paulina Tymińska,
  • Julia Frączek,
  • Natalia Laskowska,
  • Karolina Borówka

摘要

Background

Heat-related illnesses (HRIs) pose a significant and escalating threat to athlete health and performance, driven by rising global temperatures and strenuous training demands. The body’s ability to maintain thermal balance during intense exercise in hot environments is frequently challenged, potentially leading to compromise of core thermoregulatory mechanisms like sweating and cutaneous vasodilation.

Aims

This review explores the underlying physiological mechanisms of thermoregulation, characterizes the clinical spectrum of HRIs (from mild cramps to life-threatening exertional heat stroke [EHS]), and summarizes current evidence-based strategies for prevention and management in athletic populations.

Methods

We analyzed the progression of HRIs, which culminate in EHS, defined by a core temperature exceeding 40 °C and central nervous system (CNS) dysfunction. We identified key risk factors, including dehydration, inadequate heat acclimatization, and high body mass. The necessity of core temperature measurement for accurate field diagnosis and laboratory testing for complications such as rhabdomyolysis was also assessed.

Results

The analysis of the 89 included studies comprising a mix of randomized trials, observational cohorts, and mechanistic evaluations demonstrates a strong consensus on evidence-based management and prevention of EHS. Data synthesis confirms that cold water immersion provides the most rapid cooling rates across diverse clinical presentations, outperforming alternative modalities in the reviewed literature.

Preventive findings across the study pool emphasize the efficacy of multi-layered strategies, specifically noting that the integration of acclimatization, hydration, and environmental monitoring significantly reduces heat-related incidents. The reviewed data also highlight distinct physiological responses in specific demographics, such as youth and para-athletes, necessitating the specialized protocols identified in the synthesis.

Conclusion

A multidisciplinary, adaptive approach focusing on proactive prevention and immediate, definitive treatment is crucial for protecting athletes. Continued research and adoption of new technologies are necessary to safeguard athlete well-being in an increasingly warm climate.