Keys to hydration this summer

Jana Mortellaro, MS, OTR/L, CHT and Angie Fluitt OTR/L, CHT

Working up a good sweat when you exercise lets you know you’re working hard, but it’s also a sign you’re losing water — water that needs to be replaced. Dehydration, a dangerous loss of body fluids, should be considered during hot days and especially with extended sun exposure.

Those who exercise or play outdoors are most at risk for dehydration. The best way to prevent dehydration is to drink water often throughout the day, especially before an outdoor activity. Water not only regulates your body temperature, it also helps lubricate joints and transport nutrients. If not properly hydrated, your body can’t function properly.

Signs of dehydration include fatigue, loss of appetite, flushed skin, inability to tolerate heat, lightheadedness, dark-colored urine, and a dry cough. Thirst is a sign that you’re already getting dehydrated.

Tourist with backpack hiking in mountains at Lake Tahoe.
Provided / Getty Images

You want to prep before you take your first workout step. In fact, no matter what time you exercise, it’s important to hydrate throughout the day.

A good rule of thumb is to drink two cups of water in the hours before exercise, and then another cup 20 minutes in advance. During exercise, drink up to one cup every 10 to 20 minutes or so. After the workout, have a cup of water within half an hour. You can tell if you’re properly hydrated if your urine is light in color. The darker the color, the more dehydrated you are.

If not managed properly, dehydration can develop into heat exhaustion or heat stroke. Heat exhaustion is marked by heavy sweating, fainting, headache, and vomiting. It can occur in hot and/or humid conditions, and particularly affects heat-unacclimatized and/or dehydrated individuals, which is why hydration is so important, especially at higher elevations.

If you suspect yourself or somebody else to be suffering from heat exhaustion, move to a shaded area, remove excess clothing, rehydrate, elevate legs above heart, and try to cool the skin with available tools such as a water bottle. Left untreated, heat exhaustion can develop into heat stroke.

Heat stroke, on the other hand, is a medical emergency that can lead to multi-organ system failure unless promptly recognized and treated. It is different from heat exhaustion as the core body temperature rises to dangerous levels (>105°) and behavioral changes can occur. Symptoms include absence of sweating, collapse, aggressiveness, confusion, seizures, loss of balance, hallucinations, and hyperventilation. In the case of heat stroke, call 911 immediately.

To avoid heat-related illness on the trails this summer, prioritize your hydration routine. Drink plenty of fluids before and during outdoor activities, especially on hot days. Speak to your provider about extra precautions you can take to protect yourself against heat stroke.

Jana Mortellaro, MS, OTR/L, CHT and Angie Fluitt OTR/L, CHT provide care with Barton Rehabilitation Services. Barton Health’s comprehensive sports medicine program integrates renowned orthopedics, rehabilitation, and performance training to keep patients and community members living a healthy, active lifestyle. For more information, visit

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