Return-to-Competition Progression After Exertional Heat Stroke in an Adolescent Runner: A Case Report

Area of Science:

• Sports Medicine
• Environmental Physiology
• Exercise Science

Background:

• Exertional heat stroke (EHS) poses a significant risk to athletes, particularly in hot and humid environments.
• Young athletes indigenous to the tropics may be vulnerable to EHS during intense physical activity.
• Understanding thermoregulatory responses is crucial for safe return-to-competition protocols.

Observation:

• A 14-year-old runner experienced EHS during a 10-km race in a tropical climate, exhibiting dizziness, stumbling, and loss of consciousness.
• Post-collapse, elevated hepatic transaminases indicated hepatic injury.
• The athlete underwent a phased return-to-competition program involving gradual exercise progression in varying climates and field-based evaluations.

Findings:

• A novel field-based protocol was developed to simulate tropical training conditions and assess thermoregulation.
• Thermoregulatory responses were monitored during simulated exercise-heat stress, guiding training progression.
• The athlete demonstrated improved heat tolerance, normalized blood values, and was cleared for competition.

Implications:

• This case report introduces a practical, field-based method for evaluating young athletes post-EHS in heat.
• The protocol aids in safely managing the return to competition for athletes training in tropical climates.
• This approach can inform clinical practice and sports science research on exercise-heat stress management.