Guest Blogger: Aaron Vaughan, MD
MAHEC Family Medicine Physician, Sports Medicine Director
The winter months are upon us and all athletes need to be aware of the risks and benefits of exercising in the cold. The body attempts to maintain its temperature through a variety of means to permit exercise, though when unable to match its needs, it runs the risk of developing hyper- or hypothermia, or more specific tissue injury known as frostbite.
Frostbite can occur following prolonged exposure, usually of the nose, ears, cheeks, fingers, and toes, to below freezing temperatures (<0C or 32F) or significant wind chill. Risk factors for cold-related injury include poor blood flow to the extremities, prior cold-related injury, diabetes, and chronic respiratory diseases such as asthma and emphysema.
Common Mild Cold Signs/Symptoms:
- “Burning pain,” stinging sensation, or numbness of the affected body part
- Pale-appearing skin
- Blistering of skin
Moderate/Severe Cold Signs/Symptoms:
- Dry Gangrene
- Mental status changes (confusion, lack of coordination, irritability)
Cold illness treatments are determined by how deep the freezing has occurred. Superficial frostbite involves the outer layers of the skin and can be treated by local thawing and re-acclimation of tissues.
Superficial Cold Treatments:
- Duration: up to 1 hour
- Immersion in warm (NOT hot) water or exposure to warm body areas (armpit or groin)
- Once warmed, keep affected areas dry and warm with towels or blankets
- Avoid rubbing affected areas as may cause sloughing or loss of outer layers of skin
- DO NOT attempt warming if there is risk of immediate re-exposure to cold
More severe frostbite involves deeper layers of the skin, muscle or bone. Due to the severity of damage, rapid re-warming is essential and may require hospitalization.
Severe Deep Cold Treatments:
- Duration: up to 1 hour
- Immersion in hot bath (39-41C or 102-106F)
- Treat wounds/blisters; consider aloe for skin hydration, consider removing blisters
- Avoid re-warming by a fire or radiator as skin burns may occur
- Update tetanus immunization
The key to management of frostbite and cold injuries is prevention. Ensure adequate planning and coverage for outdoor activity in the cold. Well-fitted and layered clothing including insulated base (in contact with skin) and protective outer layers (wind and moisture) are important. Extremities including the head, face, and hands should be covered at all times. Wool or synthetic socks are preferred over cotton to wick away moisture from sweat accumulation. Of note, Vaseline and other topical lubricants facilitate cold and are not protective. Consult your medical provider before returning to sport or activity following an episode of cold injury, as there is higher risk for re-injury in the immediately following weeks to months.
Don’t forget that it’s not unsafe to play or exercise in cold weather, but know the risks and make sure to prepare!
About Glory Hound Events
Glory Hound Events was started in 2006, initially managing the historic Bele Chere 5K. Shortly after that first year the Lake Logan Triathlon was introduced and eventually became a part of the Lake Logan Multisport Festival. Glory Hound Events is now the largest endurance event management company in the Western North Carolina region, producing an average of eighteen events annually. In addition to producing its own events and those for a variety of clients, Glory Hound Events offers consulting services for events outside of Western North Carolina looking to take theirs to the next level.