Posts Tagged ‘frostbite’

Prevent Cold Weather Illnesses This Winter

Wednesday, January 11th, 2017

Posted January 11, 2017

By Mackenzie Simmons AT, MSEd, ATC

Throughout winter, it is important to be aware of the signs and symptoms of cold weather illnesses, as well as the risk factors and preventative methods. While heat illness usually seems to be on the forefront of environmental issues, cold weather illnesses can cause the same catastrophic results. Athletic Trainers (ATs) and other healthcare professionals need to be knowledgeable in differentiating and diagnosing hypothermia, frostbite, chilblains and trench foot in athletes. A short summary of these cold weather illnesses are listed below.

Hypothermia (mild, moderate or severe) is caused by prolonged exposure to cold, wet or windy conditions, usually during endurance events or outdoor games.


- Core temperature 98.6F to 95F

- Cold extremities

- Shivering

- Pallor


- Core temperature 94F to 90F

- Slowed respiration and pulse

- Cessation of shivering

- Dilated pupils

- Impaired mental function and motor control


- Core temperature below 90F

- Rigidity

- Severely depressed respirations

- Bradycardia

- Usually has fallen into a coma

Frostbite (mild or superficial) occurs when there is an exposure to cold temperatures, often in conjunction with wind or touching cold surfaces


- Area is firm or cold to the touch

- Limited movement

- White or blue-gray colored patches in skin

- Tingling or burning sensation


- Area is hard or cold

- Burning, aching, throbbing or shooting pain

- White, gray, black or purple skin

- Tissue necrosis

Chilblain (or pernio) is caused when the body has prolonged exposure to cold, wet conditions.

- Red or cyanotic lesions

- Tissue necrosis

- Skin sloughing

- Swelling

Trench foot comes from prolonged exposure to cold, wet conditions; it usually occurs with the continued wearing of wet socks, wet shoes or both.

- Burning, tingling or itching

- Loss of sensation

- Cyanotic or blotchy skin

- Blisters or skin fissures

Sometimes, cold weather illnesses cannot be prevented in athletes, but there are risk factors that can predispose an athlete to getting hypothermia, frostbite, chilblain or trench foot. Listed below are a few of the risk factors for cold weather illnesses:

- Lean body composition

- Lower fitness level

- Females

- Older age

- Issues such as cardiac disease, Raynaud’s phenomenon and anorexia

- Previous cold injuries

- Low caloric intake

- Dehydration

- Fatigue

While most risk factors are genetic, there are a few that can be controlled. An AT can encourage athletes to stay properly hydrated and nourished before activity to ensure the body has enough nutrients to efficiently function. Also, make sure the athletes are at the necessary fitness level to perform the event in the cold weather. It is important to encourage the athletes to get a full night of rest leading up to the event so the body is not fatigued.

In addition to controlling the risk factors, the AT can also provide guidance on the proper clothing to wear to the event. When possible, the athlete should keep their hands, feet, toes and ears covered. Also, dressing in layers is essential to keeping warm—the first layer of clothes should allow sweat evaporation, the middle layer for insulation and then the outer layer being water and wind resistant. The AT should also monitor the wind chill before and during the event to make sure the weather is safe for activity.


Cappaert, Thomas A., et al. "National Athletic Trainers' Association position statement: environmental cold injuries." Journal of athletic training 43.6 (2008): 640-658.





Dehydration Precautions in Winter Weather

Friday, November 15th, 2013

Frostbite and hypothermia are not the only health hazards associated with frigidly cold temperatures. People lose a great deal of water from the body in the winter due to respiratory fluid loss through breathing. The body is also working harder under the weight of extra clothing and sweat evaporates quickly in cold, dry air.

Dehydration can occur when athletes don’t take in enough water to compensate for the water lost during routine processes or exercise. Awareness, recognition and education are the ways to help prevent dehydration during cold weather training. The goal is to replace 100% of sweat and electrolytes lost during exercise outdoors. Read more about dehydration and performance and cold weather nutrition and hydration from Jeffrey A. Kline, ATC, NASM-PES.

During warmer weather we are very aware of water loss because of the sweating mechanism our body uses to keep cool, but it is harder to recognize when there is cold weather. Shifting temperatures and not having enough water can cause cramping and increases injuries.

Drinking water or sports drinks before, during and after sports is especially important for children and pre-teens because they have special fluid needs compared to adults, or even teenagers. A good way to monitor proper hydration is to examine urine output - the color should be nearly clear.

As a parent or coach, make sure you take precautions to prevent heat illnesses in children and that they follow recommended sports hydration guidelines. Review the Youth Sports Hydration Guidelines reviewed by Susan Yeargin, PhD, ATC, on

Written By:
Brittney Ryba

12 Safety Tips for the Winter Season - Frostbite

Friday, December 16th, 2011

Spending time outdoors during the winter season is fun, but requires special precautions. Prevention is a major task for the BOC Certified Athletic Trainer. Here are some things to consider ahead of time when planning for outdoor activities in the cold this winter. Remember, the goal is to be active and avoid injury or illness!

3.) Frostbite

Frostbite occurs when there is actual freezing of body tissue. Just as in hypothermia, there are varying levels of frostbite severity; the deeper and more extensive the tissue damage, the more severe the frostbite. The extremities furthest from the core of the body (toes, nose, fingers, etc.) are the most sensitive areas to local temperature change and blood vessel constriction. These distant extremities are not able to sense whether the body's core temperature is adequate or not. This means that even if the core is at an adequate temperature, the blood vessels that supply these cold extremities continue to redirect blood to the core no matter what. This absence of warm blood locally leads to temperature loss in the extremities, which could eventually freeze the tissue, resulting in frostbite.

Common signs and symptoms of frostnip and mild frostbite are:

  • Aching, tingling or burning pain that eventually progresses to decreased sensation or numbness (body part is often described as feeling "wooden")
  • Very red or mottled grey skin of the body part
  • Mild swelling or edema of the body part

To prevent frostbite, people should:

  • Wear gloves and warm socks
  • Cover the face
  • Bring an extra pair of gloves and socks in case the ones you are wearing get damp or wet
  • Check the fingers, toes, and nose every so often for signs of frost nip and frostbite
  • Keep your fingers and toes involved in exercise/moving
  • Take frequent breaks or stay indoors if the wind chill is too severe

Read the previous two safety tips. Continue reading the BOC blog posts throughout the month of December to read the full 12 safety tips for the winter season.