Sports Injuries

Primary Industry: Health, Wellness and Fitness
Sports injuries are injuries that occur in athletic activities. In many cases, these types of injuries are often due to overuse or acute trauma of a part of the body when participating in a certain activity. For example, runner's knee is a painful condition generally associated with running, while tennis elbow is a form of repetitive stress injury at the elbow.…
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Sports Injuries
Chiropractic care has received much attention in regards to its successful management of sporting injuries. Since the majority of sports injuries are soft tissue in nature and because many of injuries arise from improper body biomechanics and improper sporting techniques, chiropractic doctors have become the doctors of choice - from the weekend warrior to the professional athlete.

According to an article in the June '98 issue of The Physician and Sports Medicine, "Interest in alternative or complementary medicine 'especially chiropractic' is booming... active patients are running to unconventional providers to treat their aches and pains... from chiropractors and acupuncture to magnets and meditation."

It's really quite simple. Chiropractic care - through the use of safe and natural spinal adjustive techniques, physical therapy applications, soft tissue mobilization, stretching and exercise programs, diet and nutritional counseling, and extensive biomechanical training - focuses on all causes which have lead to the symptoms of pain and tissue injury and do not focus on solely eliminating pain.

Successful treatments must focus not only on pain relief, but must address the underlying causes such as muscular imbalances, biomechanical deficiencies, improper sporting techniques, and improper conditioning, to name a few.

Injuries In Competitive Athletes
Many professional and competitive athletes already know the value of regular chiropractic care. Increased flexibility, increased energy, increased speed, and increased performance as well as a decrease in injuries are all benefits of chiropractic care.

In fact, it's becoming rare to find a professional or amateur sports team that does not have a "team" chiropractor. Take for instance the bay area in Northern California. The San Francisco 49ers, San Francisco Giants and the San Jose Sharks have their own team chiropractor.
  • Increasing Athletic Performance
  • Minimizing The Risk Of Injury
  • Testimonials From Professional Athletes
Increasing Athletic Performance
Chiropractic is an excellent adjunct to any sports regimen. Through the use of highly specific and safe spinal and extremity adjustive techniques, physical therapies, therapeutic exercises and stretches, dietary and nutritional counseling and correction of biomechanical faults - athletes can experience increased performance and reduced risk of injury.

Chiropractic care can increase range of motion, flexibility, balance, coordination, joint proprioception, body symmetry, agility, reaction times, speed, and kinesthetic awareness - all essential to the serious athlete.

In a recent study a group of asymptomatic university baseball players were split into 2 group; one group received spinal manipulation while their counterparts acted as controls - receiving no care. Vertical jump, broad jump, standing broad jump, muscle strength, blood pressure, pulse rate, microcirculation (nail bed capillary counts) and stress test were evaluated in all athletes prior to the study, and 5 & 14 weeks follow up. Those receiving spinal manipulation experienced significant improvements in muscle strength and long jump distance at 14 weeks. The spinal manipulation group also experienced improvement in capillary counts at 5 and 14 weeks follow-up. Additionally, the spinal manipulation group had decreases in resting blood pressure and pulse rate following tread mill activity.

Another study conducted by Nansel, PhD., found cervical adjustments dramatically improved neck range of motion in a group of asymptomatic individuals who had differences of more than 10 degrees in lateral flexion of the head (ear to shoulder).
  1. Nansel, PhD. JMPT 1989; 12(6):419-27. 
  2. Schwartzbauer J, DC, Schwartzbauer M, DC, Hart J, DC, Zhang J, MD, PhD. J Vert Sublux Res 1997,1(4):33-39. 

Minimizing the Risk of Injury
Chiropractic care is not only exceptional in the treatment of acute and chronic injuries but is equally successful in preventing future injuries when regular care is received. Why is chiropractic care so effective in sports? Simply, chiropractic focuses on the cause of the deficiency or injury and not just the symptoms. All sports experts agree that pain relief alone in the management of sports injuries is not enough. Only treatments like chiropractic which deal with all aspects of the athlete - sufficient warm-up, proper technique, correct biomechanics, proper conditioning, optimizing balance and coordination, optimizing reaction times, correct management of existing injuries, optimal diet and nutrition, adequate rest, positive mental attitude, etc. - will allow the athlete to excel and avoid detrimental injury. According to an article in a 1997 issue of the Backletter, "Athletes are going to breakdown if they put high physical demands on a system that has function deficits & adaptive changes. 80% of reinjuries in sport occur within one month of going back-"

A study published in the Journal of Sports Medicine and Physical Fitness demonstrates the necessity of correct spinal biomechanics. Examiners followed 52 high level soccer and rugby players for 2 years to assess the relationship between injuries and body mechanics. Using photographs along with grids they were able to document the most common body mechanic deficiencies. The following lists the top 5 deficiencies:
  • scoliosis 
  • excessive lumbar curve 
  • excessive thoracic curve 
  • sway back 
  • shoulder asymmetry
At the end of the 2 years, the most common injuries were back injuries, affecting 24 of the 52 athletes. The incidence of injury was linked to the body mechanic defects associated with the site of injury. The researchers concluded that their results strongly suggest that treating biomechanical deviations would dramatically reduce the risk of high level athletic injuries.

In addition to correcting biomechanical faults, chiropractic care has been scientifically shown to stimulate and correct the functioning of joint proprioceptors. The proper firing and functioning of these joint proprioceptors are essential for eliciting subconscious spinal reflexes that alter muscle action to control posture and complex movements. This provides functional stability which is essential for the prevention of injuries in the athlete. According to Dickinson, MD, "Loss of feedback control 'from improper functioning joint proprioceptors' may be the cause of reinjury to the same joint."
  1. Watson. J Sports Med & Physical Fitness 1995;35(4):289-294 
  2. Wiesel MD.Backletterl997;12(5):57.Herring, MD quotation. 
  3. Lachman, MA, MD. Soft tissue injuries in sport 2nd ed London, Blackwell Scientific Publications 1994:12-31 
  4. Dickinson, MD. Clinics in sports med 1985; 4(3):417-429: 

Professional Athlete Testimonials
Professional athletes and sporting teams are discovering the many benefits of regular chiropractic care. Just read what the following professional athletes have said about chiropractic care:
  • According to Arnold Schwarznegger, "We are a perfect team. The world of fitness and the world of chiropractic." 
  • Barry Bonds of the San Francisco Giant remarked, "I go to Dr. Athens (doctor of chiropractic) on a regular basis. By getting adjusted once a week, I feel I can sustain my career a lot longer. Athens adjusts 3/4 of the team. I'm happy we can have chiropractic services at the park, I don't think we would ever go without it." 
  • Female tennis star Martina Navratilova stated, "A chiropractor was instrumental in putting my body back together. Since then I've visited the chiropractor many times for a variety of problems and solutions. As Americans become more aware of the need for preventive medicine, alternative therapies will play a bigger role in our lives. After all, people like what works." 
  1. Deters, DC. (Ed). Muscle & Fitness 1995- Nov. 
  2. Panter. Barry Bonds: The Most Valuable Player. Today's Chiro 1997; May/June: 60-66. 
  3. Navratilova Martina's Column: Natural Health. Conde Nast Woman's Sports 1998; March 1998: 60-61.

Injuries in Child and Teen Athletes
Sports and regular physical activities not only serve as fun-time for children and teens, but more importantly, it improves their overall health and wellness status while promoting a healthy lifestyle which they can carry on into their adulthood years.
  • Exercise and Health Education Cut Kids' Risk of Heart Disease
  • Experts Urge Children Need More Exercise
  • Results of Strength Training in Obese Prepubertal Girls
Exercise and Health Education Cut Kids' Risk of Heart Disease
According to recent findings, vigorous exercise and health education classes in the adolescents can cut their blood cholesterol levels and reduce their risk of developing heart disease later in life.

This comes from a study which is part of the larger continuing Cardiovascular Health in Children study, a unique effort in North Carolina to learn about improving children's - and later adults' - heart and lung health. This study used 600 middle-school students, ages 11 to 14, from five rural North Carolina schools in three counties.

According to one of the researchers, "I don't think most parents realize how little actual physical activity their children get at school nowadays. Most middle-aged and older people in this country were far more active when they were children than kids are now."

In this study, subjects were divided into four groups. During the 1995-96 school year they received both physical activity and classroom training, either one or the other intervention, or neither. Physical activity was vigorous and sustained three times a week but did not require special sports skills. Classroom teaching focused on nutrition, fitness, not smoking, blood pressure and other topics.

Researchers measured fat levels in the blood of children before and after completing the program. Among middle-schoolers in the combined group, total cholesterol dropped an average of 10.6 milligrams per deciliter and LDL dropped 8.7 milligrams per deciliter.

"We conclude that the combination of both a knowledge and attitude program and a physical activity program was highly effective in improving lipid [fat in the blood] profiles in this group of adolescents, Our work is important because the few studies that have been done before on this looked at younger children and none has tested older children the way we did."
  1. American Heart Association Conference, Santa Fe, New Mexico - March 19, 1998. 

Experts Urge Children Need More Exercise

New guidelines from the National Association for Sport and Physical Education (NASPE) recommend that children be physically active for at least 60 minutes per day - and longer if possible.

According to the NASPE, a nonprofit organization for fitness and physical activity professionals, "extended periods of inactivity are not appropriate for normal, healthy children... inactive children and youth are much more likely to be sedentary as adults than children and youth who are active."

The NASPE also stated, "children and youth who have active parents and family members and who do physical activities with them are more likely to be active than those who are not active with family members... 'children' develop skills through involvement in physical activity... only through devoting time to these skills will they become a regular part of a healthy lifestyle."

Other recommendations of the NASPE include:
  • schools need to make time for physical activity in a child's day. 
  • youngsters should be exposed to a variety of activities. 
  • continue to encourage motor skill development. 
  • some of a child's physical activity each day "should be in periods lasting 10 to 15 minutes or more and include moderate to vigorous activity." 
  • activities that can be done throughout a lifetime should be encouraged.
  1. National Association for Sport and Physical Education (NASPE) in Reston, Virginia.

Results of Strength Training in Obese Prepubertal Girls
A group of researchers set out to determine the effects of a school-based, low-volume strength training program on energy expenditure, strength, and physical fitness in obese prepubertal girls.

The researchers designed a longitudinal, 5-month strength training exercise program in which 11 healthy, obese girls aged 7-10 years participated.

The girls increased their upper and lower extremity strength, on average, by 20%. However, similar results were not noted when energy expenditure was evaluated.

The researchers concluded, "This long-term, school-based, low-volume strength training program favorably increases strength in obese prepubertal girls but does not increase their daily energy expenditure." 
  1. Med. Sci. Sports Exerc., Vol. 30, No. 7, pp. 1130-1136, 1998. 

Injuries in Aging Athletes
A record number of maturing adults and elderly individuals are initiating exercise regimens or continuing exercise and sports regimens.
  • New Exercise Guidelines For The Elderly
  • It's Never Too Late To Exercise
  • Exercise Benefits In The Aging Population
  • Sports Injuries On The Rise In The Elderly

New Exercise Guidelines for the Elderly
Adults should add flexibility exercises to their fitness regimens, and those over age 65 should follow a regular exercise program to prevent some of the functional decline associated with aging, according to updated exercise guidelines released this week by the American College of Sports Medicine (ACSM). The last ACSM guidelines were released in 1990.

"The recommendations are for 3 to 5 days per week of aerobic exercise, walking, jogging, (or) different types of activities that use the major muscle groups, at moderate to moderately high intensities," said Dr. Michael Pollock, director of the Center for Exercise Science at the University of Florida. "The main thing is that you get out there and burn calories to get the fitness benefits."

The new recommendations place greater emphasis on the total amount of time spent exercising for the elderly and for the first time, they call for flexibility training as a way to maintain joint range and fitness for adults in general. The ACSM recommends stretching of major muscle groups 2 to 3 times a week, exercise that becomes even more important with aging.

Elderly adults need to focus on strength and balance training first, and may work up to moderate intensity aerobic exercise, according to the College.

"When you are older, you may choose different, lower impact activities, such as walking versus running, because of the injury factor," said Pollock. "The higher the impact, the more injuries."

The need for greater physical activity among the elderly was also the subject of a position statement released by the World Health Organization (WHO) this week.

The WHO's "Guidelines for the Promotion of Physical Activity for Older Persons" is based on evidence that suggests that most elderly persons can benefit from a physically active lifestyle, according to Dr. Wojtek J. Chodzko-Zajko, a professor of exercise science at Kent State University in Kent, Ohio. The type of physical activity is less important than simply being active, he noted.

"There are many different kinds of physical activity which are beneficial for older persons," he said. "We know that traditional forms of cardiovascular exercise are very beneficial. Strength training is beneficial, flexibility exercises are helpful, but also physical activity as part of everyday living is useful in the prevention of diseases that are associated with inactivity and sedentary lifestyles."

Exercise should be tailored to meet the needs of individuals, taking into account any ailments or risk factors.

"There is no single physical activity that is optimal," says Chodzko-Zajko. "Most scientists would agree that a balanced program of physical activity would include stretching, calisthenics, strength training, and cardiovascular exercise. The specific combination would depend on the individual case."

It's Never Too Late To Exercise
New research shows that if you've reached middle age or have long since passed it, it's still not too late to exercise. According to researchers from the Royal Free Hospital School of Medicine in London, maintaining exercise habits or initiating light to moderate physical activity later in life reduces overall mortality risk as well as lowers the risk of heart attack in older men - including those with existing cardiovascular disease.

The researchers reviewed data collected from middle-aged men who were part of a large study looking at cardiovascular disease. The men answered questionnaires about their health and exercise habits, first in the late 1970s and again in the early 1990s. The 7,735 men who answered the first questionnaire were 40 to 59 years old. Nearly 6,000 participated in the second questionnaire. Their average age at that time was 63. These men were followed for an additional 4 years

Men who described themselves as inactive or occasionally active in the first questionnaire but who had begun "at least light activity" by the time of the second questionnaire reduced their risk of death by about 45%. Even men with preexisting cardiovascular disease appeared to benefit from exercising. Regular moderate exercise seems to confer the greatest benefit. Light physical activities included walking, gardening, swimming, and cycling.

More vigorous activities, such as participating in sports, "do not appear to give any additional benefit to health for older men, and our findings suggest that frequent light physical activity may be more appropriate," the authors write.

For older men, and, presumably, older women as well, "encouragement... to increase their physical activity gradually and regularly would help to maintain mobility, to prolong independence, and to reduce the risk of heart attacks and mortality," say the researchers.
  1. The Lancet 1998;351:1603-1608.


Exercise Benefits in the Elderly

Exercise has a number of vital benefits in the aging population. Studies substantiating these benefits are published weekly. Some of the interesting recent studies on exercise and physical activities benefit in the aging include:
  • Exercise Lowers Death Risk in the Elderly
  • Moderate Exercise Lowers Fracture Risk in the Elderly
  • Exercise Cuts Diabetes Risk in Older Adults
  • Low Intensity Exercise Lowers Blood Pressure in Elderly Hypertensive Patients
  • Exercise Protects Against Alzheimer's Disease

Exercise Lowers Death Risk in the Elderly
Regularly walking or cycling for at least 20 minutes 3 times weekly was associated with reduced (death risks from) cardiovascular diseases and all cause(s) in men over the age of 64, according to Dutch and American researchers. The 10-year investigation (1985-1995) examined the death rates of a group of 802 Dutch men, all of whom were at least 64 years of age at the beginning of the study. The authors divided the men into three groups - those who engaged in physical activity for an average of 15 minutes per day, 1 hour per day, or 3 hours per day.

The authors report that nearly half of the men (46.5%) had died by the study's end. However, they found that after adjusting for various lifestyle factors (smoking and drinking, for example) and the presence of cardiovascular disease, "men in the highest activity (group) had a 30% lower risk compared with men in the lowest activity (group)."

Overall, they estimate that among the men who died during the study, 15% of the deaths due to heart disease and 12% of the deaths as a whole "could have been avoided by a physically active lifestyle."

Reductions in death risk seemed to rise along with increases in exercise intensity. For example, the authors found that overall risks for fatal stroke were 60% lower among men who regularly engaged in high-energy workouts, compared with men who opted for less strenuous exercise routines. The authors stress that "these heavy-intensity activities did not necessarily include strenuous activities, which is illustrated by the fact that gardening and bicycling at normal speed ...were classified into this category."

They conclude that the same life-prolonging exercise guidelines already recommended for other adult age groups - exercise for at least 20 minutes three times per week - "may also be applicable to elderly men." The authors believe their "findings may also be extrapolated to elderly women."

  1. Archives of Internal Medicine 1998;158:1499-1505.

Moderate Exercise Lowers Fracture Risk in the Elderly
Older women who exercise even moderately, and for as little as 1 hour a week, reduce their risk of hip fractures. According to the recent Annals of Internal Medicine study, "Moderately to vigorously active women had statistically significant reductions of 42% and 33% in risk for hip and vertebral fractures, respectively, compared with inactive women."

The 9,704 women aged 65 years and older were contacted by researchers from the Centers for Disease Control and Prevention every 4 months over an average of 7.6 years. Women were questioned on the frequency and duration of their participation in 33 social and recreational activities, plus walking and stair climbing and were also asked whether they had experienced any fractures.

According to the study, "Women who did moderately intense or vigorous activities, such as aerobic and other forms of dance, tennis, and weight training, had greater reductions in hip and vertebral fracture risk than did women who did lighter activities, such as walking and gardening, particularly if they were active for at least 2 hours per week." The study also stated, "women who did lower-intensity activities, such as walking, gardening, or social dancing, for at least 1 hour per week also had significant reductions in risk for hip fracture."

Relatively inactive women - sat for at least 9 hours per day -had a 43% higher risk of hip fracture than those who were sedentary for less than 6 hours per day.

The researchers concluded that exercise "may enable a protective response in the event of a fall through enhanced balance, reaction time, coordination, mobility, and muscle strength."

  1. Annals of Internal Medicine 1998;129:81-88, 133-134.

Exercise Cuts Diabetes Risk in Older Adults
Regular exercise can lead to improved glucose (blood-sugar) tolerance in older adults - which can reduce their risk of developing diabetes, according to researchers.

The effects of moderate levels of aerobic exercise are even more important in older people with high blood glucose levels (hyperglycemia) and insulin resistance, they report.

"Moderate-intensity aerobic training has a favorable effect on glucose tolerance," conclude investigators at Yale University School of Medicine in New Haven, Connecticut.

Glucose tolerance - the ability of the body to regulate blood sugar levels - decreases with age, but excess weight gain and decreased physical activity also play a role. Decreased glucose tolerance is believed to be a step in the development of type 2 (adult onset) diabetes. Since obesity has been linked to impaired glucose tolerance, many experts have assumed that only those exercise regimens which resulted in weight loss could bring the condition under control.

That may not always be the case, however. In the Yale study, published in the July issue of The Journal of the American Geriatrics Society, researchers placed 16 elderly men and women on a four month regimen of either aerobic exercise or non-aerobic yoga and stretching. Those in the aerobic exercise group were encouraged to walk and run on mini-trampolines equipped with handrails.

Those who participated in the non-aerobic regimen, four months of stretching and yoga, saw no changes in fitness level or glucose metabolism, according to a statement issued by the journal.

The four month aerobic regimen produced no "appreciable weight or fat loss" in elderly participants. However, blood tests revealed that people in the aerobic exercise group who had impaired glucose tolerance at the beginning of the study showed a 25% improvement in the way their body handled glucose.

The researchers also noted that blood levels of free fatty acids fell by 24% in the aerobic exercise group, leading the researchers to suggest that "training-related improvements in glucose regulation... may be modulated by decreases in (free fatty acid) concentrations."

The study team also conclude that "use of the mini-trampoline allows a safe, enjoyable, and effective mode of exercise for older people, who may otherwise be at risk for musculoskeletal injury from more traditional forms of weight-bearing aerobic exercise."

  1. The Journal of the American Geriatrics Society 1998;46:875-879.

Low Intensity Exercise Lowers Blood Pressure in the Elderly Hypertensive Patients
According to a recent study, low intensity aerobic training significantly reduced blood pressure in elderly hypertensive (high blood pressure) patients who were receiving antihypertensive (high blood pressure) medication.

A group of elderly patients performed 30 minutes of low intensity exercise on a treadmill 3-6 times per week for 9 months while another group acted as controls - receiving no exercise. The average age of the groups was 75 and 73, respectively.

According to the study, "... blood pressures decreased significantly after 3 months of training and the blood pressure of all participants stabilized at a significantly lower level by the end of the 9 months in the training group, whereas no significant changes in blood pressure were found in the control group."

  1. Med. Sci. Sports Exerc., Vol. 30, No. 6, pp. 818-823, 1998.

Exercise Protects Against Alzheimer's Disease
Participating in regular exercise throughout the adult years appears to reduce the chances of developing Alzheimer's Disease later in life, according to researcher Robert Friedland, M.D.

Alzheimer's disease is a progressive, degenerative disease of the brain affecting one in 10 persons over the age of 65 and nearly half of those over the age of 85.

Friedland and colleague Arthur Smith, M.D., neurologists with Case Western Reserve University, compared the adulthood exercise habits of 126 elderly Alzheimer's patients with 315 elderly individuals without Alzheimer's Disease. Their results indicated that overall the Alzheimer's patients led far greater sedentary lifestyles and scored much lower on an activity rating scale than did their healthy counterparts. Some of the activities associated with the reduced Alzheimer's risk included regular participation in biking, swimming, golf, tennis, racquetball, running, ice skating and weight training. The activity periods studied were those between the ages of 20 and 59.
  1. 50th Annual Meeting of the American Academy of Neurology, Minneapolis, Minnesota. April 1998.

Sports Injuries Rising in the Elderly
According to a recent report from the US Consumer Product Safety Commission, sports injuries rose by 54% in Americans age 65 years and older between 1990 and 1996.

The rise in elder sports injuries outstrips the 8% increase in the number of Americans in this age group over the same period, notes the agency. "The increase in injuries is most likely attributable to increasingly active lifestyles and to increased participation in sports activities by older Americans," according to the report.

The Commission also notes that Americans are remaining physically active into their 70s, 80s, and even 90s. And more elderly people are participating in "more active" sports such as bicycling, weightlifting, and skiing.

The report is based on data from the National Electronic Injury Surveillance System, which samples 101 hospitals nationwide drawn from 5,000 hospitals with 24-hour emergency departments.

The study showed that between 1990 and 1996, sports-related injuries increased much more among older active people than among younger age groups. In contrast to the 54% increase noted in those over age 65, sports-related injuries increased by 18% in the 25 to 64 age group.

In actual numbers, there were 34,000 sports injuries in the 65 and older age group in 1990, rising to 53,000 in 1996. "The increased incidence of injury occurred not only among the youngest of the 65 and older population, but also among those 75 years and older," according to the report. "Sports-related injuries to persons 75 and older increased by 29%."

But the Commission report also notes that the average cost for treating sport-related injury in the emergency room fell between 1990 and 1996. "While more injuries are occurring, they appear, on the average, to be less costly and severe," the report authors write.

While injuries from "less active" sports such as fishing, golf, bowling, and shuffleboard increased only slightly or not at all between 1990-1996, injuries sustained while participating in "more active" sports increased significantly in those 65 and older. Bicycling injuries were most common in this age group, and bike-related injuries increased by 75% in this age group. Most (60%) of these injuries resulted from falls, and 21% were head injuries. More injuries were also noted among older people using weights or other exercise equipment, and in older skiers.

"It is interesting to note that there were a small number of injuries (in those age 65 and older) seen for the first time in 1996 involving 'extreme' or more physically challenging sports such as snowboarding and in-line skating," note the study authors.

The report also notes that in both 1990 and 1996, about 60% of sports injuries in the geriatric age group occurred in men.

The hospitalization rate for sports injuries in the 65 and older age group is 10%, less than the 18% rate for injuries with all consumer products in this age group. "The lower hospitalization rate for sport-related injuries suggests that the population participating in sport activities is healthier overall than those who are not participating in sports," comments the Commission.

The study authors recommend that individuals participating in sports "use safety gear and take appropriate safety precautions, especially in active sports such as in-line skating and use of exercise equipment and weights."

They also note that "virtually none" of the elderly people with a head injury following a cycling accident were wearing a helmet at the time of the incident. "Bicycle helmets reduce the risk of serious head injury," advise the Commission.

"By getting regular exercise - and doing it safely - older Americans can enjoy a healthier life," they conclude.

Injury Prevention Tips and How To's

A number of factors lead to sporting injuries or suboptimal performance. The following links provide in-depth information on how to optimize your performance while minimizing your risk of injury:
  • Improving Athletic Performance Through Nutritional Supplements
  • Preventing Dehydration
  • Ultraviolet Radiation Protection
  • Heat Fatigue/Exhaustion/Stroke Prevention 

Improving Athletic Performance Through Nutritional Supplements
Athletes looking to optimize their ability to cope with the warmer temperatures during strenuous physical activity can benefit from supplementation. Electrolyte loss, free radical formation and the need for biochemical participants like vitamins and minerals is heavily increased. At minimum, athletes should consume a complete multi-vitamin/mineral supplement containing generous amounts of basic antioxidants like beta-carotene, vitamin C and vitamin E. This should also contain adequate amounts of electrolytes such as sodium, potassium and chloride. Active athletes finding it difficult to maintain their body weight during the summertime will find a weight gainer indispensable. Those in need of an energy boost should give energy bars and carbohydrate powders/drinks a whirl. When it comes to protein, there is no question that demands are increased under the extra stress of exercising in the heat. A recent study published in Medicine & Science in Sports & Exercise found branched-chain amino acid supplementation could prolong moderate exercise performance in the heat. Branched-chain amino acids (leucine, isoleucine, and valine) are anti-catabolic essential aminos which are in high demand anytime the body undergoes physical stress. Alternatively, a high quality protein powder with added branched-chain amino acids can be taken. 

Heat Acclimatization
Many experienced athletes have also utilized heat acclimatization in order to minimize heat-related illnesses. Similar to your body adjusting to a change in altitude, heat acclimatization depends on the adaptive powers of the body. Over a period of 10-14 days, the athlete gradually increases the intensity and duration of the workout while in the new environment. This allows the body to respond and successfully adjust to the increased demands placed on the body by the heat.