Dangers of Running in the Heat

By Jason Hodde, MS, ATC/L

Originally published in Ultrarunning Magazine, September 2002. Reprinted with permission.

Running in hot weather can pose many dangers to ultrarunners. Although most runners are aware of the dangers of running for prolonged distances in hot and humid weather, many are also inadequately prepared for the intense stress placed on the body during these hot weather runs.

This past July, I participated in the 25th anniversary of the Badwater Ultramarathon, a 135-mile trek from the lowest place in the continental United States (Badwater Basin), through Death Valley National Park, and to the foot of Mount Whitney, the Whitney Portals, at an altitude of 8,360 feet (2,548 meters). The run was held in the middle of one of the most severe heat waves southern California has ever seen. In preparation for the run, I made sure my crew was aware of the signs and symptoms of heat illness, as well as how to treat me should problems occur. Here are some of the dangers of ultrarunning in the heat, and preventative measures that can be taken to avoid potential problems.

The Heat Index

The heat index is the apparent temperature felt by the body due to the combined effects of actual temperature and humidity. Most people understand that as the air temperature goes up, so does the heat index, but humidity also plays a role. As the humidity rises, the body is unable to efficiently evaporate the sweat it produces. Therefore, the perceived temperature is much higher than the actual air temperature. The loss of cooling efficiency thus makes exercise extremely dangerous.

Although it is convenient to use a single number to describe the apparent temperature your body feels, keep in mind that heat and humidity affect everybody differently. Several assumptions are made to calculate the heat index measurements in the table below. Specifically, the heat index assumes the body to be:

  • 5' 7" (170 cm) in height
  • 147 pounds (67 kg) in weight
  • Caucasian
  • A 98.6° F (37° C) body temperature
  • Clothed in long pants and a short-sleeved shirt
  • In shade
  • Walking at a speed of 3.1 mph (5 kph)
  • In a breeze of 6 mph (10 kph)
  • Not dripping with sweat

Changing any of these factors can either increase or decrease the heat index from those shown in the table. Be aware that heat index values of over 100 significantly increase your risk of heat-related illness.

Air Temperature (degrees Fahrenheit)
Relative
Humidity
70 75 80 85 90 95 100 105 110 115 120
Heat Index
0% 64 68 73 78 83 87 91 95 99 103 107
10% 65 70 75 80 85 90 95 100 105 111 116
20% 66 72 77 82 87 93 99 105 112 120 130
30% 67 73 78 84 90 96 104 113 123 135 148
40% 68 74 79 86 93 101 110 123 137 151 -
50% 69 75 81 88 96 107 120 135 150 - -
60% 70 76 82 90 100 114 132 149 - - -
70% 70 77 85 93 106 124 144 - - - -
80% 71 78 86 97 113 136 157 - - - -
90% 71 79 88 102 122 150 170 - - - -
100% 72 80 91 108 133 166 - - - - -
Data from the US National Weather Service

Heat Illnesses

There are three major heat illnesses—and all of them can be exacerbated by ultra distance running and prematurely end an ultrarunner’s race. In all cases, the main reason that runners experience heat illness is dehydration. If you replace lost fluids and electrolytes and are able to train your body to process a high volume of fluid in a short period of time, you significantly decrease the risk of experiencing these race-ending medical emergencies.

Heat cramps: Exercising in hot weather can lead to muscle cramps, especially in the legs. This is usually caused by imbalances or deficiencies in your body’s electrolyte stores. A cramp is characterized by sharp, stabbing pain in the muscle and rarely works itself out on its own. On a training run earlier this year in Death Valley, many runners complained of cramps in their legs; I suffered from cramps in my diaphragm and had difficulty breathing for more than an hour! Cramps become less frequent with heat training, but for those of us unaccustomed to such extreme conditions, maintaining adequate hydration and electrolyte balance is critical to avoiding them. To eradicate cramps, you should stop running, drink fluids containing electrolytes, cool your body with wet towels, and immediately get out of the sun.

Heat exhaustion: Losing fluid and electrolytes through sweat leads to dizziness and weakness if the lost fluids are not replaced. Heat exhaustion is characterized by a moderate rise in body temperature, dizziness, nausea and vomiting, and a headache. You might also experience weakness, lack of coordination, heat cramps, heavier than usual sweating accompanied by moist and cold skin, and “goose bumps.” Your heart rate may rise and you won’t be able to run as fast due to fatigue. Many runners – even those who are well trained – will suffer from mild heat exhaustion after running for several hours in hot and humid conditions. If you experience the signs of heat exhaustion, stop running immediately and drink fluids containing electrolytes, cool your body with wet towels, lie down and elevate your feet a few inches above your heart, and immediately get out of the sun. Since heat exhaustion can lead to the most severe form of heat-related illness, heat stroke, seeking prompt medical attention for heat exhaustion is also highly recommended.

Heatstroke: In extreme cases heat can upset the body's thermostat, causing body temperature to rise to105 degrees F or higher. This is a life-threatening situation that requires immediate medical attention. While it is common for untreated heat exhaustion to rapidly progress to heatstroke, heatstroke can (and does) occur without the signs of heat exhaustion being apparent. Symptoms of heatstroke include lethargy and extreme weakness, confusion and odd or bizarre behavior, disorientation and unconsciousness. Because heatstroke is a complete failure of the body’s temperature regulation system, sweating ceases and the skin becomes hot and dry. Convulsions or seizures can occur as the brain begins to shut down. Coma and death are also possible in extreme cases. Heatstroke is a medical emergency that requires immediate medical attention. Call the emergency response system immediately! Get the runner out of the sun, remove all clothing, and immediately rub their body with ice or immerse the runner in cold water.

By staying properly hydrated and recognizing the early warning signs of heat illness, as a runner you can prevent a heat-related problem from becoming a life-threatening situation. As a volunteer, recognizing these heat-related dangers may one day help you save the life of a runner who has underestimated the intensity of the surroundings.

Jay is a nationally Certified Athletic Trainer (ATC) licensed to practice in Indiana. He holds Master’s degrees in Exercise Physiology and the Basic Medical Sciences, both from Purdue, with an emphasis on tissue repair and healing. Jay works full-time as the Clinical Affairs Manager for Cook Biotech Incorporated, a medical device company in Indiana. He has completed over 60 ultramarathons, including the Grand Slam of Ultrarunning and the 2006 Badwater Ultramarathon.

More Heat Training and Preparation Articles:

"The Dangers of Hot Weather Running: Dehydration, Heat Cramps, Heat Exhaustion, Heatstroke & Hyponatremia" by Claudio Piepenburg, Road Runner Sports
"Heat training in the Sauna" by Arthur Webb, six time finisher
"A Perspective on Pre-Race Heat Training" by Stephen Simmons, 1999 finisher
"Heat Training Anaylzed" by Stephen Simmons, 1999 finisher
"Heat Training and Conditioning" by Ben Jones, M.D., three time finisher
"Training for Badwater" by Angela Brunson, a rookie finisher in 2002
"Medical Risks in the Badwater Ultramarathon"