Heat Stress and Thermal Strain Challenges in Running
Abstract
Synopsis: Running well and safely in the heat is challenging for all runners, from recreational to elite. As environmental heat stress (heat stress modulated or augmented by air temperature, humidity, wind speed, and solar radiation) and the intensity and duration of a training run or race increase, so are metabolic heat production, the parallel need for heat transfer from the body to maintain thermal equilibrium, the consequent increase in blood flow to the skin, and the concomitant sweating response progressively and proportionally amplified. An accumulating total body-water deficit from extensive sweating and escalating level of cardiovascular and thermal strain will, in due course, considerably challenge a runner's physiology, perception of effort, and on-course well-being and performance. However, with the appropriate preparation and modifications to planned running intensity and distance, runners can safely tolerate and effectively train and compete in a wide range of challenging environmental conditions. Clinicians play a key role in this regard as an effective resource for providing the most effective guidelines and making the best overall individual recommendations regarding training and competing in the heat. J Orthop Sports Phys Ther 2014;44(10):831–838. Epub 7 August 2014. doi:10.2519/jospt.2014.5500
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Dehydration is more of a risk during races in hot and/or humid conditions when sweat rates are increased.
“Although dehydration can result from running in cold conditions due to a blunting of the thirst response, dehydration is more of a risk during races in hot and/or humid conditions when sweat rates are increased [120].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [120]
Cites
American College of Sports Medicine position stand
Otis, C. L. (1997) · Medical Entomology and Zoology · Cited by 4,407 · see citing works
ACSM Position Stand: Exercise and Fluid Replacement
Convertino, V. A., Armstrong, L. E., Coyle, E. F., Mack, G. W., Sawka, M. N., Senay, L. C., & Sherman, W. M. (1996) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199610000-00045 · Cited by 1,977 · see citing works
Exertional Heat Illness during Training and Competition
Armstrong, L. E., Casa, D. J., Millard-Stafford, M. L., Moran, D. S., Pyne, S. W., & Roberts, W. O. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802fa199 · Cited by 1,024 · see citing works
Hyponatremia among runners in the Boston Marathon.
Almond, C. S. D., Shin, A. Y., Fortescue, E. B., Mannix, R. C., Wypij, D., Binstadt, B. A., Duncan, C. N., Olson, D. P., Salerno, A. E., Newburger, J. W., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043901 · Cited by 553 · see citing works
Tucker, R. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2008.050799 · Cited by 544 · see citing works
Mechanisms of aerobic performance impairment with heat stress and dehydration
Cheuvront, S. N., Kenefick, R. W., Montain, S. J., & Sawka, M. N. (2010) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00367.2010 · Cited by 477 · see citing works
Casa, D. J., McDermott, B. P., Lee, E. C., Yeargin, S. W., Armstrong, L. E., & Maresh, C. M. (2007) · Exercise and Sport Sciences Reviews · doi:10.1097/jes.0b013e3180a02bec · Cited by 340 · see citing works
The physiological regulation of pacing strategy during exercise: a critical review
Tucker, R., & Noakes, T. D. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2009.057562 · Cited by 321 · see citing works
Impact of Weather on Marathon-Running Performance
Ely, M. R., Cheuvront, S. N., Roberts, W. O., & Montain, S. J. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802d3aba · Cited by 305 · see citing works
Thermoregulation and Marathon Running
Cheuvront, S. N., & Haymes, E. M. (2001) · Sports Medicine · doi:10.2165/00007256-200131100-00004 · Cited by 285 · see citing works
Casa, D. J., Armstrong, L. E., Kenny, G. P., O’Connor, F. G., & Huggins, R. A. (2012) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e31825615cc · Cited by 229 · see citing works
Induction and Decay of Short-Term Heat Acclimation in Moderately and Highly Trained Athletes
Garrett, A. T., Rehrer, N. J., & Patterson, M. J. (2011) · Sports Medicine · doi:10.2165/11587320-000000000-00000 · Cited by 194 · see citing works
Multiple Triggers for Hyperthermic Fatigue and Exhaustion
Cheung, S. S., & Sleivert, G. G. (2004) · Exercise and Sport Sciences Reviews · doi:10.1097/00003677-200407000-00005 · Cited by 191 · see citing works
Inbar, O., Morris, N. R., Epstein, Y., & Gass, G. C. (2004) · Experimental Physiology · doi:10.1113/expphysiol.2004.027979 · Cited by 188 · see citing works
Shirreffs, S. M., & Maughan, R. J. (1998) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1998.274.5.f868 · Cited by 178 · see citing works
The Effects of Acute Dopamine Reuptake Inhibition on Performance
Roelands, B., Hasegawa, H., Watson, P., Piacentini, M. F., Buyse, L., Schutter, G. D., & MEEUSEN, R. R. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181659c4d · Cited by 174 · see citing works
Heat tolerance and acclimatization to work in the heat in relation to age.
Wagner, J. A., Robinson, S., Tzankoff, S. P., & Marino, R. P. (1972) · Journal of Applied Physiology · doi:10.1152/jappl.1972.33.5.616 · Cited by 163 · see citing works
Exertional Rhabdomyolysis and Acute Renal Failure in Marathon Runners
Clarkson, P. M. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00022 · Cited by 162 · see citing works
Aetiology of skeletal muscle ‘cramps’ during exercise: A novel hypothesis
Schwellnus, M. P., Derman, E. W., & Noakes, T. D. (1997) · Journal of Sports Sciences · doi:10.1080/026404197367281 · Cited by 161 · see citing works
Inoue, Y., Tanaka, Y., Omori, K., Kuwahara, T., Ogura, Y., & Ueda, H. (2005) · European Journal of Applied Physiology · doi:10.1007/s00421-004-1303-2 · Cited by 158 · see citing works
Sex differences in postsynaptic sweating and cutaneous vasodilation
Gagnon, D., Crandall, C. G., & Kenny, G. P. (2012) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00877.2012 · Cited by 156 · see citing works
Siegel, R. B., Maté, J., Watson, G., Nosaka, K., & Laursen, P. B. (2011) · Journal of Sports Sciences · doi:10.1080/02640414.2011.625968 · Cited by 154 · see citing works
Role of Gastrointestinal Permeability in Exertional Heatstroke
Lambert, G. P. (2004) · Exercise and Sport Sciences Reviews · doi:10.1097/00003677-200410000-00011 · Cited by 152 · see citing works
Exercise Performance over the Menstrual Cycle in Temperate and Hot, Humid Conditions
de Jonge, X. J., Thompson, M. W., Chuter, V., Silk, L., & Thom, J. M. (2012) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3182656f13 · Cited by 151 · see citing works
Hew‐Butler, T., Almond, C. S. D., Ayus, J. C., Dugas, J. P., Meeuwisse, W. H., Noakes, T. D., Reid, S., Siegel, A. J., Speedy, D. B., Stuempfle, K. J., et al. (2005) · Clinical Journal of Sport Medicine · doi:10.1097/01.jsm.0000174702.23983.41 · Cited by 145 · see citing works
Thermoregulation during exercise in the heat in children: old concepts revisited
Rowland, T. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01196.2007 · Cited by 136 · see citing works
Lambert, G. P. (2008) · Medicine and Sport Science · doi:10.1159/000151550 · Cited by 134 · see citing works
Climatic Heat Stress and Exercising Children and Adolescents
Bergeron, M. F., Devore, C. D., & Rice, S. G. (2011) · PEDIATRICS · doi:10.1542/peds.2011-1664 · Cited by 131 · see citing works
Self-citationThermoregulatory responses of middle-aged and young men during dry-heat acclimation
Pandolf, K. B., Cadarette, B. S., Sawka, M. N., Young, A. J., Francesconi, R. P., & Gonzalez, R. R. (1988) · Journal of Applied Physiology · doi:10.1152/jappl.1988.65.1.65 · Cited by 122 · see citing works
O’Connor, F. G., Casa, D. J., Bergeron, M. F., Carter, R., Deuster, P. A., Heled, Y., Kark, J. A., Leon, L. R., McDermott, B. P., O'Brien, K., et al. (2010) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e3181f1d183 · Cited by 119 · see citing works
Self-citationAmerican College of Sports Medicine position stand. Heat and cold illnesses during distance running.
Armstrong, L. E., Epstein, Y., GREENLEAF, J. E., Haymes, E. M., Hubbard, R. W., Roberts, W. O., & Thompson, P. D. (1996) · PubMed · Cited by 115 · see citing works
Junglee, N. A., Felice, U. D., Dolci, A., Fortes, M. B., Jibani, M. M., LEMMEY, A. B., Walsh, N. P., & Macdonald, J. H. (2013) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00091.2013 · Cited by 101 · see citing works
Muscle Cramps during Exercise-Is It Fatigue or Electrolyte Deficit?
Bergeron, M. F. (2008) · Current Sports Medicine Reports · doi:10.1249/jsr.0b013e31817f476a · Cited by 97 · see citing works
Self-citationSodium replacement and fluid shifts during prolonged exercise in humans
Sanders, B., Noakes, T. D., & Dennis, S. C. (2001) · European Journal of Applied Physiology · doi:10.1007/s004210000371 · Cited by 95 · see citing works
Noakes, T. D. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00050 · Cited by 82 · see citing works
Ice Slurry on Outdoor Running Performance in Heat
Yeo, Z., Fan, P. W., Nio, A. Q. X., Byrne, C., & LEE, J. K. W. (2012) · International Journal of Sports Medicine · doi:10.1055/s-0032-1304643 · Cited by 81 · see citing works
Drinkwater, B. L., & Horvath, S. M. (1979) · PubMed · Cited by 79 · see citing works
Aerobic training and cutaneous vasodilation in young and older men
THOMAS, C. M., Pierzga, J. M., & Kenney, W. L. (1999) · Journal of Applied Physiology · doi:10.1152/jappl.1999.86.5.1676 · Cited by 78 · see citing works
Hyperthermia Impairs Brain, Heart and Muscle Function in Exercising Humans
lez-Alonso, J. G. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00025 · Cited by 69 · see citing works
Exercise Tolerance and Thermoregulatory Responses during Cycling in Boys and Men
Rowland, T., Hagenbuch, S., POBER, D. M., & Garrison, A. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31815a95a7 · Cited by 66 · see citing works
Effect of Wearing Compression Stockings on Recovery After Mild Exercise-Induced Muscle Damage
Bieuzen, F., Brisswalter, J., Easthope, C. A., Vercruyssen, F., Bernard, T., & Hausswirth, C. (2014) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2013-0126 · Cited by 66 · see citing works
Caffeine during Exercise in the Heat
Coso, J. D., Estévez, E., & Mora‐Rodríguez, R. (2008) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318184f45e · Cited by 63 · see citing works
Exercise Tolerance in a Hot and Humid Climate in Heat-Acclimatized Girls and Women
Rivera‐Brown, A. M., Rowland, T., Ramírez-Marrero, F. A., et al. (2006) · International Journal of Sports Medicine · doi:10.1055/s-2006-923863 · Cited by 63 · see citing works
Vercruyssen, F., Easthope, C. A., Bernard, T., Hausswirth, C., Bieuzen, F., Gruet, M., & Brisswalter, J. (2012) · European Journal of Sport Science · doi:10.1080/17461391.2012.730062 · Cited by 58 · see citing works
Mitchell, J. B., Phillips, M. D., Mercer, S. P., Baylies, H. L., & Pizza, F. X. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.89.4.1302 · Cited by 58 · see citing works
Exercise-Associated Muscle Cramps
Miller, K. C., Stone, M. S., Huxel, K. C., & Edwards, J. E. (2010) · Sports Health A Multidisciplinary Approach · doi:10.1177/1941738109357299 · Cited by 56 · see citing works
Muscle Cramping in Athletes—Risk Factors, Clinical Assessment, and Management
Schwellnus, M. P., Drew, N., & Collins, M. (2008) · Clinics in Sports Medicine · doi:10.1016/j.csm.2007.09.006 · Cited by 54 · see citing works
Acute Renal Failure in Marathon Runners
MacSearraigh, E. T. M., Kallmeyer, J. C., & Schiff, H. B. (2008) · The Nephron journals/Nephron journals · doi:10.1159/000181723 · Cited by 51 · see citing works
Water and electrolyte shifts with partial fluid replacement during exercise
Sanders, B., Noakes, T. D., & Dennis, S. C. (1999) · European Journal of Applied Physiology and Occupational Physiology · doi:10.1007/s004210050598 · Cited by 49 · see citing works
Muscle-Damaging Exercise Increases Heat Strain during Subsequent Exercise Heat Stress
Fortes, M. B., Felice, U. D., DOLCI, A., Junglee, N. A., Crockford, M. J., West, L. R., Hillier-Smith, R., Macdonald, J. H., & Walsh, N. P. (2013) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318294b0f8 · Cited by 47 · see citing works
The Role of Sodium in ???Heat Cramping???
Eichner, E. R. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00024 · Cited by 47 · see citing works
Effect of Body Cooling on Subsequent Aerobic and Anaerobic Exercise Performance: A Systematic Review
Ranalli, G. F., DeMartini, J. K., Casa, D. J., McDermott, B. P., Armstrong, L. E., & Maresh, C. M. (2010) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0b013e3181fb3e15 · Cited by 45 · see citing works
Compression Sleeves Increase Tissue Oxygen Saturation But Not Running Performance
Ménétrier, A., Mourot, L., Bouhaddi, M., et al. (2011) · International Journal of Sports Medicine · doi:10.1055/s-0031-1283181 · Cited by 45 · see citing works
Roberts, W. O. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00033 · Cited by 43 · see citing works
Exercise-heat acclimation in young and older trained cyclists
Best, S. A., Thompson, M. W., Caillaud, C., Holvik, L., Fatseas, G., & Tammam, A. H. (2013) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2013.10.243 · Cited by 41 · see citing works
Graduated Compression Stockings for Runners: Friend, Foe, or Fake?
Bovenschen, H. J., Booij, M. T., & van der Vleuten, C. J. M. (2013) · Journal of Athletic Training · doi:10.4085/1062-6050-48.1.26 · Cited by 38 · see citing works
Dehydration, Cramping, and Exertional Rhabdomyolysis: A Case Report with Suggestions for Recovery
Cleary, M. A., Ruiz, D., Eberman, L. E., Mitchell, I. D., & Binkley, H. M. (2007) · Journal of Sport Rehabilitation · doi:10.1123/jsr.16.3.244 · Cited by 36 · see citing works
The Importance of Salt in the Athleteʼs Diet
Valentine, V. D. (2007) · Current Sports Medicine Reports · doi:10.1007/s11932-007-0038-3 · Cited by 34 · see citing works
Marginal effects of a large caffeine dose on heat balance during exercise‐heat stress
Ely, B. R., Ely, M. R., & Cheuvront, S. N. (2011) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.21.1.65 · Cited by 33 · see citing works
Aging and assessment of physiological strain during exercise-heat stress
Moran, D. S., Kenney, W. L., Pierzga, J. M., & PANDOLF, K. B. (2002) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00364.2001 · Cited by 31 · see citing works
Effect of Aspirin Dose on Gastrointestinal Permeability
Lambert, G. P., Schmidt, A., Schwarzkopf, K., & Lanspa, S. J. (2012) · International Journal of Sports Medicine · doi:10.1055/s-0032-1301892 · Cited by 29 · see citing works
Determinants of Endurance Exercise Capacity in the Heat in Prepubertal Boys
Rowland, T., Garrison, A., & POBER, D. M. (2007) · International Journal of Sports Medicine · doi:10.1055/s-2006-924142 · Cited by 29 · see citing works
Cholinergic sensitivity of the eccrine sweat gland in trained and untrained men
Buono, M. J., White, C., & Connolly, K. P. (1992) · Journal of Dermatological Science · doi:10.1016/0923-1811(92)90053-e · Cited by 27 · see citing works
Exertional Heat Stroke in the Marathon
Roberts, W. O. (2007) · Sports Medicine · doi:10.2165/00007256-200737040-00044 · Cited by 26 · see citing works
Menstrual cycle and oral contraceptive use do not modify postexercise heat loss responses
Kenny, G. P., Leclair, E., Sigal, R. J., Journeay, W. S., Kilby, D., Nettlefold, L., Reardon, F. D., & Jay, O. (2008) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00194.2008 · Cited by 22 · see citing works
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- Authors
- Bergeron, M. F.
- Corresponding author
- Bergeron, Michael F.
- ORCID
- Bergeron, Michael F.
- Venue
- Journal of Orthopaedic & Sports Physical Therapy
- Published
- 2014-10
- Volume
- 44
- Issue
- 10
- Pages
- 831-838
- ISSN
- 0190-6011 (ISSN-L)
- 1938-1344
- OpenAlex
- W2038920547
- Cited by
- 28
- References
- 65
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 6 · 2017: 1 · 2016: 2 · 2015: 1 · 2014: 2
- FWCI
- 0.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Orthopaedic and Sports Physical Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- heat stress, running, thermal strain, heat acclimatization, sweating, skin blood flow, metabolic heat production, fluid deficit, exercise in the heat, heat illness prevention
- MeSH terms
- Acclimatization, Aging, Fluid Therapy, Hot Temperature, Humans, Physical Education and Training, Physical Endurance, Risk Factors, Running, Sex Factors, Sweating, Cryotherapy, Heat Stress Disorders
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