Why Drinking Too Much May Kill You

For the longest time, athletes and other exercise enthusiasts have been encourage to take in enough water to compensate for the water loss as sweat. Nobody would have ever expected that there can a problem with taking too much water.

Hyponatremia has gained media attention in the last few years, but it is important for athletes to realize that dehydration is much more common and ‘overhydration’ is a risk mostly associated with ultra-endurance sports and not sports events lasting less than 2 hours such as hockey, basketball and soccer, or shorter hikes/runs. Hyponatremia, a low concentration of sodium in the blood, has become more prevalent in athletes as more people are participating in endurance sports lasting more than 3 hours such as marathons. Such prolonged activity and excessive sweat production increases the risk of an athlete having too little sodium in their blood stream during training and competition. The hyponatremia or ‘overhydration’ associated with prolonged exercise arises primarily from fluid overload, under replacement of sodium losses, or both. When blood sodium concentration falls to abnormally low levels, a rapid and dangerous swelling of the brain occurs, that can result in seizures, coma, and death.

Sourced from: https://sportmedbc.com/article/hyponatremia-or-overhydration%E2%80%94who-risk

The intake of too much water leads to a condition called hyponatremia/ overhydration that results from the low concentration of sodium ions in the body. The problem begins with having long periods of exercise that are characterized by large amounts of sweat and electrolyte loss.

Although rare, overhydration can occur during long bouts of exercise when electrolytes lost through sweat are not replaced, yet excessive amounts of water are consumed. Overhydration can lead to potentially dangerous imbalances of electrolytes, including hyponatremia, a serious condition in which the sodium level in the blood becomes too low. Hyponatremia can be a problem for athletes who experience excessive sodium loss through perspiration as part of prolonged exercise or heat exposure, such as running a marathon. The World Health Organization (WHO) has documented this condition in mountain climbers who have used melted snow to prepare their beverages, without supplementation with the necessary ions or electrolytes.

Sourced from: https://www.beverageinstitute.org/article/hydration-for-athletes-special-considerations/

Too much sweating causes excessive sodium loss especially in athletes due to prolonged heat exposure and exercise. The working of the body comes down to the basic unit called a cell, which is surrounded by extracellular fluids made up of electrolytes.

Cells in the body are surrounded by extra-cellular fluid, which contains significant amounts of the electrolyte sodium, dissolved in the water. If that extra-cellular fluid becomes diluted with excess water, the water will migrate into the cells to keep the osmotic forces inside the cells balanced with those outside the cell. Otherwise, the cell walls could rupture and the cell would die. That ingress of water can cause tissues to swell and become puffy. The common example of that is seen in the hands, wrists and feet. While that is annoying, the real problem is that the swelling also happens to the brain (encephalopathy). That leads to a number of problems, which can result first in poor performance, but also could lead to DNF and possibly death if not addressed.

Sourced from: http://www.succeedscaps.com/articles/over_hydration/

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The extracellular fluid around cells has to be more concentrated that the fluid inside the cell to prevent intake of excess water in to cells. The following is a more comprehensive list of signs and symptoms of overhydration;

1.What can you expect to see with over-hydration? There are many diagnostic signs that a physician would look for, but most runners are not physicians and can only go by what they can easily recognize. Digestion is impaired. With the excess water comes stomach sloshing, poor absorption of food (because you need an adequate sodium concentration for absorption), and vomiting. Salty foods taste unusually good if sodium is simultaneously low. Thirst is low.

2.Neurological signs appear: dizziness, confusion, irritability, and possibly headache. If neurological signs appear, the athlete is heading toward a medical emergency and steps need to be taken immediately to prevent serious injury or death. Unfortunately, the mental confusion may impair judgment, and corrective actions may not be taken. If you are not feeling right late in an ultra, it is important to ask at an aid station if medical help is available. Medical people may be able to spot a developing problem and help before things get really serious.

3.Physical signs can be: weight is up 3 or more pounds, hands and wrists get tight and puffy, urination may be absent early in a run but appear later with a high volume of crystal clear urine, and there may be shivering in temperatures that would otherwise be warm enough for no shivering. If it is actually cold, and other signs of over-hydration are not present, shivering may just be due to poor thermoregulation.

Sourced from: http://www.succeedscaps.com/articles/over_hydration/

The Relationship Between Football & Kidney Lacerations

We can all agree that any game that is intensive and full of adrenaline coupled with a lot of contact will lead to numerous injuries. American football as some call it is one of the most intensive and contact oriented sports activity. Recently, the number of players suffering from kidney lacerations has increased at a fast rate; causing researchers to research on the relationship between the two.

Football is a dangerous game. We all have heard about the head injuries players receive that can cause long-lasting damage. We also have seen players sidelined by serious orthopedic injuries. Now a different type of injury is taking players out of the game – kidney laceration. “A kidney laceration is usually caused by blunt force trauma,” says Jeffrey Campsen, M.D., a kidney surgeon with University of Utah Health Care. “It’s an injury that is commonly associated with car accidents.” Kidney lacerations cause pain, usually in the upper abdomen or in the hip flank. Both Allen and Luck sought medical care after feeling pain in their sides following their injuries. “In more severe cases, the patient may go into shock as well,” says Campsen. And, “blood in the urine is also a common symptom.” That was what led to a kidney laceration diagnosis for Miles Austin of the Cleveland Browns. The receiver thought he just had a post-game stomachache before he hit the urinal.

Sourced from: http://healthcare.utah.edu/healthfeed/postings/2015/11/111215_kidney.laceration.php

Kidney lacerations are painful injuries found in the upper abdomen and hip flank. The symptoms can vary and mild damage may initially show no symptoms. However, severe cases can lead to shock and death is a real eventuality.

  • Usually the abdomen will be painful on palpation.
  • Blood in the urine (hematuria).
  • Nausea or vomiting.
  • Changes in blood pressure and pulse.
  • Shock which may lead to unconsciousness.

Sourced from: http://www.sportsinjuryclinic.net/sport-injuries/chest-abdomen-pain/kidney-laceration

  • Right or left abdominal pain, mild or severe depending on rupture.
  • Muscle guarding
  • Low back pain
  • Abdominal bruising, swelling, and pain
  • Signs of internal bleeding: decreased alertness, dizziness, fatigue, blurred vision, low BP, nausea, vomiting
  • Decreased urine output or inability to urinate
  • Fever
  • In severe cases shock may result – Increased heart rate, pale, cool skin.

Sourced from: http://ksi.uconn.edu/emergency-conditions/internal-trauma/kidney-injury/

Some of the more common symptoms include; abdominal pain, low back pain, vomiting, and nausea. However, there are some predisposing factors that increase the probability of an individual suffering from lacerations.

  • Children are more susceptible to internal injury due to anatomic factors. Their decreased perirenal fat (decreased fat located around the kidneys), larger proportional size, and lack of complete rib protection due to lower position of the kidneys in the abdomen all increase risk of renal injury for children.
  • Hypertension
  • Chronic heart failure
  • Diabetes
  • Multiple myeloma
  • Chronic infection
  • Myeloproliferative disorder
  • Connective tissue disorders
  • Autoimmune diseases

Sourced from: http://ksi.uconn.edu/emergency-conditions/internal-trauma/kidney-injury/

  • Low fluid intake
  • Nephrotoxic drug ingestion
  • Trauma or exertion
  • Blood loss/transfusions
  • Exposure to toxic substances
  • Exposure to mercy vapors or heavy metals

Sourced from: http://ksi.uconn.edu/emergency-conditions/internal-trauma/kidney-injury/

Trauma or exertion is one of the main causes of lacerations. Football players have an increasing chance of experiencing exertion and trauma more than once in their career, which makes sense with the increasing numbers of lacerations. The following are some treatment options available to patients;

How do you treat an individual with a kidney rupture?

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Conservative management is widely accepted for all but the most severe blunt renal injuries in a stable patient. Surgical intervention in blunt renal trauma is required in less than 10% of cases. In a 7-year retrospective review study regarding patients with blunt renal trauma, 18.3% were grade III-V injuries.

  • Assess Vital Signs (Blood Pressure, Pulse, Respiratory Rate)
  • Call 9-1-1 (activate EMS)
  • When at the hospital procedures may include:

  • Surgery to repair organ, or remove it completely (Nephrectomy).
  • Aspiration to remove pooled blood and swelling
  • Urinalysis
  • CBC (complete blood count)
  • CT scan (Computed Tomography)
  • Diagnostic Ultrasound
  • Current practice recommendations state that all children with blunt trauma and hematuria should be imaged regardless of blood pressure or degree of blood in the urine.

Sourced from: http://ksi.uconn.edu/emergency-conditions/internal-trauma/kidney-injury/

  • An Aortogram. This is where a special dye is injected into the main artiery (the aorta). X-rays are then taken of the area as the blood containing the dye travels through the kidneys. A leak can be seen clearly here.

Sourced from: http://www.sportsinjuryclinic.net/sport-injuries/chest-abdomen-pain/kidney-laceration

Common Sport’s Injuries

In any sport, players are bound to suffer from injuries occasionally. Some sporting activities have greater injuries than others depending o the intensities and contact.

“Sports injuries” are injuries that happen when playing sports or exercising. Some are from accidents. Others can result from poor training practices or improper gear. Some people are injured when they are not in proper condition. Not warming up or stretching enough before you play or exercise can also lead to injuries.

Sourced from: http://www.niams.nih.gov/Health_Info/Sports_Injuries/sports_injuries_ff.asp

Most Sport’s training is a result of poor training or improper gears. The best prevention way would be to consider training program that agrees with your muscle capabilities and appropriate gear. The following is a list of the most common sport’s injuries;

1.Hip Flexor Strain

The hip flexor is a group of muscles that assist with the upward movement of your leg or knee. An injury occurs when these muscles are torn or stretched too far. This can occur from having weak muscles, forgetting to warm up, having stiff muscles, or from a fall. The athletes that have hip flexor problems play sports that include sudden upward movements or changes in direction. Those sports include martial arts, football, soccer, and hockey.

Pain, spasms, bruising and swelling can be expected where the hip meets the leg. A minor hip flexor injury can be healed at home with rest, ice and pain medication that includes an anti-inflammatory. A physical therapist may recommend specific hip-strengthening exercises. If the pain does not go away in two weeks, you should see a doctor for a possible torn hip flexor.

2.ACL Tear

The ACL or anterior cruciate ligament connects the leg bone to the knee. The act of suddenly stopping and changing directions or a hard impact to the side of the knee can cause a strain or tear of the ACL. These are one of the most severe sports injuries, but not the most common. A completely torn ligament requires surgery and may cut an athletic career short. If you think you might have an ACL injury, see your doctor immediately.

3.Concussion

Concussions are brain injuries that happen when there is a significant hit to the head. While not all concussions result in a loss consciousness, they do often include nausea, difficulty concentrating, loss of balance, dizziness, amnesia, disorientation, headaches and other symptoms. Athletes who participate in contact sports like football, wrestling, hockey, boxing, and soccer most commonly get concussions. Gymnasts and skiers are also at risk.

It takes about two weeks to a month for a concussion to heal, which is accomplished by resting. The headaches associated with concussions can be subdued with acetaminophen. Receiving multiple concussions can cause permanent damage to the brain. Returning to a contact sport too quickly can result in second-impact syndrome, which is a fatal condition caused by receiving another concussion before the first one heals.

4.Groin Pull

The inner thigh muscle is also called the groin. The muscles in the groin are situated like a fan and are used to help pull the legs together. Sports that require moving in a side-to-side motion like hockey, football, soccer, and baseball, have high instances of groin pulls

These injuries can cause bruising on the inside of the thigh and can take one to two weeks to heal with compression, ice and lots of rest. If there is any swelling around the groin injury, make sure to be checked out by a doctor. Be cautious not to return to normal activity too fast, or you may cause significant problems. Groin pulls can be prevented with proper stretching.

5.Shin Splints

Shin Splints are known for shooting pain down the front of the leg. While it happens most often to runners, shin splints can also occur in people who aren’t used to exercising or who have increased their exercise intensity too quickly. Sometimes shin splints can be a result of a stress fracture in the bone. If resting doesn’t help the pain go away, it’s important to see your doctor and make sure you don’t have a stress fracture. Minor shin splints can be improved with ice, rest and over-the-counter pain medication. Wearing proper shoes, stretching and knowing your limits can help prevent shin splints.

6.Sciatica

Sciatica, which is lower-back pain that reaches down into the legs, can affect athletes who participate in cycling, running, golf, tennis and baseball. Bulging discs and back spasms are other types of lower-back pain that athletes often endure. Sciatica is most commonly caused by improper stretching, but runners can also experience it if they have one leg that is slightly longer than the other. Sciatica and bulging discs require quick medical attention from a doctor, but back spasms can be treated with rest, ice and anti-inflammatory medication.

7.Hamstring Strain

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A strain is a muscle or tendon injury. There are three muscles behind the knee that make up the hamstring. They are most often “pulled” when an athlete is overusing or overstretching the muscle. The pain is caused by tears in the muscles or tendons. Sometimes bruising can occur in pulled hamstrings. Activities like hurdling or falling forward while waterskiing are all common causes of a hamstring strain.

Forgetting to warm-up and lack of flexibility can lead to pulled muscles, especially in the hamstring. One way to prevent injury to your hamstrings is by learning to stop when you are tired. The mechanisms that protect your muscles stop working when your muscles are fatigued.

Hamstrings take a very, very long time to heal. Often between 6 and 12 months because walking causes a lot of stress to an injured hamstring. Gentle stretches can greatly help hamstring strains, as well as resting, ice and anti-inflammatory drugs. If you begin exercising again after pulling a hamstring, stop every once in a while to stretch the muscles. This tip goes for any pulled muscle, as well.

8.Tennis or Golf Elbow

Around 7% of all sports injuries are elbow injuries. Also called epicondylitis, tennis elbow is caused by a repetitive use of the elbow. This repetition creates tiny tears in the elbow’s ligaments. Pain can be experienced on the inside or outside of the elbow, but the outside is the most common. The condition happens in 30- to 60-year-olds.

Rest is the main way to heal this condition. In minor injuries, rest, ice and anti-inflammatory drugs can help improve the elbow. In more persistent cases, a doctor may be needed along with a break from the sport. Forearm strengthening exercises and elbow braces are the best way to prevent elbow injuries.

9.Shoulder Injury

Shoulder injuries, including dislocations, sprains and strains, make up 20% of all sports injuries. Shoulder injuries are caused by overuse. Sports that require overhead movement, like tennis, swimming, weightlifting, baseball, basketball and volleyball, are the most common culprits. Shoulder injuries should be treated with rest, ice, and anti-inflammatory medication. You can prevent shoulder injuries by doing strength-building exercises in the off-season.

10.Patellofemoral Syndrome

About 55% of all sports injuries are knee injuries. Knee injuries also make up 25% of problems treated by orthopedic surgeons. Knee injuries or Patellofemoral syndrome, is caused by the kneecap repeatedly moving against the leg bone. This movement damages the kneecap’s tissues and causes pain. Basketball, cycling, swimming, football, volleyball and running are the most common sports where these injuries occur.

It can take up to 6 weeks for this injury to heal. Low impact exercises are recommended to keep the leg muscles strong. Wearing the right shoes can help reduce the chances of a knee injury. Softer running surfaces like indoor tracks are easier on knees than concrete. Knee injuries should be rested for two days, with ice and anti-inflammatory medicine to help speed the process. Post-injury knees should be properly warmed up before exercise begins and iced for 20 minutes afterward.

Sourced from: https://www.unitypoint.org/livewell/article.aspx?id=591d8cf1-1ee5-4cb3-b662-a5f21f6f13bc