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Ask The Running Doc: How Can I Train & Race In The Heat?

Use these tips to stay cool this summer.


Use these tips to stay cool this summer.

Written by: Lewis G. Maharam, MD

The signs and symptoms of heat stroke and heat exhaustion are actually similar for runners, although heat stroke is far more severe. One will experience dizziness, nausea, warmth and even confusion as symptoms get worse. Some folks say that with heat stroke people will stop sweating, but that is hard to evaluate in runners because of spray stations on the course and water being thrown over one’s head at a water stop. Symptoms become heat stroke, and life threatening, when body temperature reaches 104 degrees or higher. If you get this hot, or cooling down with ice or a cold shower or rags does not reduce your symptoms, seek medical attention. I repeat, heat stroke can be life threatening.

But we don’t have to get to this level of heat illness. I have written heat tips in my book Running Doc’s Guide to Healthy Running, which I share on the following pages.


Always Respect Your Limits

Respect your limits. Increased heat and humidity increase the physical challenge of running, and can cause health problems like heat illness, breathing  or cardiac problems when you push beyond what your body and metabolism is ready to handle.. Do not try for a personal best on a warm, humid day, particularly if you are not used to these conditions. Back it down and enjoy a slower run.



It takes about  two weeks for the body to fully acclimate to keeping cool at higher temperatures. Give your body time to adjust. Until that time, run in early morning or evening hours when the sun is down and the environment is cooler. Choose shaded courses rather than in the hot sun.


Drink Enough, But Not Too Much

Drink throughout the day, so that your urine remains the color of lemonade: clear you are drinking too much, iced tea color you are drinking too little. Everyone has their own fluid needs based on their unique metabolism. Don’t rely of calculations which may be wrong for a number of reasons. Rely on your “thirst” and watch your urine color!

Sports drinks are better than water, especially in the heat, because the sugar and salt they contain form an “active pump” that transports fluid to cells more quickly than water alone. Any exercise longer than 30 minutes you should be consuming sports drinks exclusively, not watered down, for the most efficient, healthiest way to hydrate.


Use Water To Stay Cool

If you are overheating, a cool spray will cool you down quickly and have a lasting effect as the water evaporates from your skin. Keep in mind, though, that drenched clothing will cling to skin and prevent evaporation, and wet socks can cause blisters, so use this strategy carefully. Cups of water over the head, spray and sponge stations are all good use of cool water when running.


Do The Salt!

As long as your physician has not recommended that you limit salt, salt helps you maintain hydration and prevent cramps.Increase your consumption of salted foods like salt bagels, salted pretzels,and salted nuts. On an excersise day, consume one fast-food salt packet at the beginning and another salt packet halfway through the intended course. It would not hurt to increase your salt intake all week unless again if your physician has you limiting salt.


Protect Yourself From Sunburn

Use sunscreen on exposed skin, even on overcast days. Be sure to re-apply. Even “exercise proof” and “waterproof” brands last a max of 2 hours. Try to wear a cap or visor and sunglasses to shield you from the sun’s burning rays.

What fabrics you wear also make a difference. Unlike cotton, synthetic fabrics act in your benefit by  wicking moisture away from your skin so evaporation can cool you down. Synthetics will  also decrease chafing by not clinging to your skin. Try to wear loose-fitting clothes and sagain synthetic socks to keep feet dry.


Watch The Meds!

Do not take cold medicines, diet pills, ephedrine, pseudoephedrine, or anti-diarrhea medicines with dehydrating agents in them. They will increase your risk for heat illness. Caffeine products are only OK in doses you are used to taking on training day. Do not start taking a caffeine product on race day. And limit caffeine to less than 200mg before a run of 10k or more.

Succumbing to the heat can be cumulative. We all have heard of professional football players being hospitalized during summer training camps due to heat illness. The New York Football Giants in 1990, the the actions of their now retired team nutritionist Merle Best, RD, instituted a program that has limited this bad result. We should all follow it. On hot days weigh yourself before and after the workout. For every pound lost, even if you are drinking during the workout and your urine looks like lemonade, drink 1 pint of Sports drink. In that way you replenish what you lost in water weight and be ready for the next day. Otherwise, heat illness can creep up on you.


You can now order Running Doc’s new book: Running Doc’s™ Guide to HEALTHY RUNNING at Barnes and Noble, Borders and

Any questions you may want answered by Dr. Maharam in future columns should be e-mailed to Dr. Maharam at

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