By: Kat Kussart, MSEd, ATC, LAT

As temperatures drop it seems appropriate to have a conversation about exercising in the cold. Frostbite and hypothermia are two cold injuries that everyone should be aware of. But, what exactly are they? Frostbite happens when body tissues freeze. This can happen to exposed skin or skin that is covered. Hypothermia occurs when the core body temperature drops below 95 degrees.

One of the first symptoms of frostbite is typically a numbness or ‘wooden’ feeling. When frostbite occurs on exposed skin of the face, individuals will sometimes report a burning feeling. As tissues rewarm, a sharp, aching pain and loss of sensation to light touch often occurs. With very low air temperatures, there is a greater risk of frostbite. Although, when the outside temperature is above 5 degrees, the risk of frostbite is less than five percent when properly prepared. In our region, it’s rare to have temperatures in the single digits, so frostbite isn’t a large concern for us.

An athlete suffering from mild hypothermia will feel cold, shiver, display lack of emotion, be withdrawn, and show impaired physical and mental abilities. The lower the body’s core temperature drops, the more confusion, sleepiness, slurred speech, and irrational thinking and behavior will occur. Severe hypothermia can even lead to cardiac arrhythmias (irregular heartbeat) and cardiac arrest (the heart stops beating).

Risk Factors for Cold Injuries

• Exercising in water, rain and wind
• An athlete with very little body fat or muscle mass
• Hypoglycemia (low blood sugar) caused by fatigue, energy depletion, sleep deprivation or an endocrine disorder such as diabetes
• Poor fitness levels
• Exercising at altitudes greater than 8,000 feet
• Stopping exercise and remaining in the cold environment

Preventing Cold Injuries

• Assess your environmental risks. Things to consider include temperature, wind, precipitation and altitude.
• Assess the underlying risk factors of each individual.
• Take appropriate precautions. Plan for adequate training, appropriate clothing, food and water, and a shelter for rewarming.
• When planning what to wear, layering is crucial. The innermost layer should include a material that wicks moisture away from the skin and toward the outer layers of clothing for evaporation. The middle layer should allow for moisture transfer, and the outer layer (if necessary) should repel wind and rain while still allowing for the evaporation of perspiration. Coverings on hands and feet should allow for movement of the fingers and toes. Arrangements should be made for the removal of wet clothing quickly, especially socks and gloves.
• Athletes should be encouraged to continuously hydrate and take in carbohydrate solutions, as exercising in the cold increases energy expenditures and fluid loss.

So, is it too cold to exercise outside? In Hampton Roads, probably not. As long as appropriate precautions are taken and athletes and coaches look out for each other, exercising in the cold can be done safely.

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CHKD's sports medicine program offers the most comprehensive care for your young athlete. From diagnosis and treatment to customized rehabilitation plans, we specialize in physical therapy and injury prevention programs for active children and teens. Our team is composed of pediatric orthopedic surgeons, sports medicine specialists, physician assistants, certified athletic trainers and pediatric sports medicine physical therapists.