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How to avoid hypothermia and frostbite when exercising in the cold

Flickr CC photo by Peiyu Liu

Flickr CC photo by Peiyu Liu

When Mother Nature hands us extreme cold temperatures that dip below 0 degrees, it’s best to just stay indoors. But for those avid exercisers who will step outside this winter to run, walk or hike, I offer a few recommendations to avoid hypothermia and frostbite.

Yesterday, I had the chance to speak with WAKR morning show host Ray Horner about this advice. The key is to stay warm, dry and hydrated, and to dress in the proper layers.

Below is an audio file and transcript of our discussion.

0:00

HORNER: Now on board with us is our good friend, Dr. Joe Congeni from Sports Medicine Center at Akron Children’s Hospital. Joe, what about being outdoors today; how dangerous is it?

DR. CONGENI: Yeah, it’s dangerous, no question. You know, we’re going to talk real briefly here about exercising in the cold, but days like today are just so extreme. So when there’s any choice of not being outside today, obviously, on days like today, that’s the best choice.

Dr. Joe Congeni

Dr. Joe Congeni

But [let’s] talk a little about exercising in the cold because in the coming weeks and months it’s still going to be very cold — maybe not as extreme as today. And, you know, that we have a lot of runners and people that exercise outside, walkers and hikers. They’re in a good routine and they want to continue to exercise, and so just a few things.

The 2 types of injuries we worry about in the cold, Ray, are hypothermia and then injuries to the skin, frostbite. And like everything else in medicine, you know, there are degrees of how bad these injuries can be.

Hypothermia goes mild, moderate and severe. When it’s the most severe cases, people get to body temperatures, core temperatures, of 90 to 94 degrees. Below 90 degrees, it can be life-threatening.

When you get into that moderate to severe [stage], people will have loss of orientation and depressed respirations, and even heart arrhythmias and, ultimately, comas and deaths.

We know throughout the Midwest there may be some people that even experience those things in the coming days. So, certainly, for exercisers knowing about hypothermia [is critical].

The second is frostbite. It is superficial, deep, and then the last is when there is tissue death, you know, where we have necrosis and we actually have to have amputation of extremities. So, we want to avoid that.

There’s a real good wind chill chart that we use as far as exercising in the cold, just like there is when we exercise in the heat. On a day like today, it’s about a 5-minute period that exposed skin would be at risk for the beginning process of frostbite.

But, for other days that people are exercising in the cold in the next 2 or 3 months, Ray, there are a few recommendations. And, you know, in general terms we talk about stay warm, stay dry, layering in clothes and hydrate.

I just want to go a little deeper on the [subject] of layering clothes. As far as layering, if you’re going to exercise in the cold like today, you’re going to want to wear for the inner-most layer something like polyester that will keep you dry and wick away any sweat or moisture. You definitely don’t want to allow a lot of sweating, so the inner-most layer should be a polyester that leads to evaporation.

The middle layer should be your insulation layer of something like fleece or wool. And the outside layer if you’re exercising out in the cold should we waterproof and windproof.

So when we’re talking about layering, those are kinda the ways to layer. And also … of course, you have to cover all the extremities and the head — that’s where we lose a lot of heat.

Another thing for exercising in the cold is covering your mouth. A lot of people I see exercising don’t have a scarf or a mask on and that’s really important in keeping your core temperature up where it needs to be to avoid hypothermia.

One interesting thing I came across, too, is don’t overdress. So, people who wear too many layers and are sweating before they go outside, they’re going to run into problems of dropping that core temperature because of the sweat.

And so from that standpoint, those are a few recommendations for people that will be exercising in the next few days, in the next few months in the cold.

But, as far as a day like today with extremes like we’re gonna have, the recommendation is stay inside.

HORNER: Alright, Joe, great stuff as always. We’ll catch up with you tomorrow, okay?

DR. CONGENI: Okay, sounds good, Ray. Thanks.

HORNER: Thank you, Joe. Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital. You heard him talk about the cold weather, but he said, today stay indoors.

About Dr. Joe Congeni - Director of Sports Medicine

Dr. Joe Congeni is the Director, Sports Medicine; Clinical Co-Director, Center for Orthopedics and Sports Medicine at Akron Children's Hospital. For the past 25 years, Dr. Congeni has been the “go to” source for national and local media looking for information about pediatric sports medicine.