Heat Stroke Return-to-Play

When can the individual return to activity?

After an EHS episode occurs, there may be physiological changes, such as heat tolerance, that are temporarily, and occasionally, permanently compromised. Long-term complications and morbidity are directly related to the time that the core body temperature remained above the critical threshold. To safely return an athlete to full participation following an EHS, a specific return-to-play (RTP) strategy should be implemented. The following guidelines are recommended for RTP:

  • Physician clearance prior to return to physical activity. The athlete must be asymptomatic and lab tests must be normal.
  • The length of recovery time is primarily dictated by the severity of the incident.
  • The athlete should avoid exercise for at least one (1) week after the incident.
  • The athlete should begin a gradual RTP protocol in which they are under the direct supervision of an appropriate health-care professional such as an athletic trainer or physician.
  • The type and length of the RTP program may vary among individuals, but a general program may include:
    • Easy-to-moderate exercise in a climate-controlled environment for several days, followed by strenuous exercise in a climate-controlled environment for several days
    • Easy-to-moderate exercise in the heat for several days, followed by strenuous exercise in the heat for several days
    • If applicable to the individuals sport: easy-to-moderate exercise in the heat with equipment for several days, followed by strenuous exercise in the heat with equipment for several days