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Dehydration still occurs in cold weather. Athletes need to replace their fluid in cold environments just as much as they would need to in a hot environment. Even if you don’t feel as though your limbs are noticeably cold, colder temperatures can impact your nerve chemistry and the way your muscles perform.

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When cold, your body will do whatever it takes to make sure your core body temperature is consistent, allowing the limb muscles to lose the most heat by limiting blood flow to them. This internal regulation process makes the muscles in your legs and arms more prone to injury in cold weather.

Symptoms:

Sudden Muscle pain

Muscle spasm

Sore to the touch

pain that may ease with res

weakness

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Frostnip occurs during high winds and/or severe cold temperatures. Prolonged exposure of of the skin to high winds.

Skin will appear:

cold

painless

blisters may appear.

Frostnip can affect areas like the, ears, nose, cheeks, and toes.

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Applying from pressure to the affected area

Blowing hot breath on the eares (do not produce friction)

If fingertips are affected place hands in the armpits

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Chilblain is prolonged and constant exposure to cold for more than an hour with the temperature being 50 degrees or less.

Symptoms may include:

skin reddening

swelling

tingling

pain in the toes or fingers

dry skin

This illness is the result of a problem with peripheral circulation.

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Do your joints and muscles crave the warmer weather? Of course they do. They are more flexible and comfortable in the warmth of the sun, whereas the winter chill makes them stiff, uncomfortable, and more susceptible to injury. Exactly how does cold weather affect sports injuries?

Cold Weather Puts Extra Demands On Our Body

The cold interferes with our body functioning normally because it needs more energy to maintain a normal body temperature. It takes additional energy to keep our muscles functioning and the cold temps can limit blood flow to these extremities. This makes our muscles perform much less effectively.

When this occurs, our normal reaction time is slower, and we become more prone to injury especially playing sports. Our muscles, ligaments, and tendons are at a higher risk of sprains, strains, pulls, and tears.

In addition, the cold temperatures can make existing injuries worse because we tend to tense up and tighten our muscles.

How And Why Do These Injuries Happen?

When our muscles and ligaments are cold several things can compound the possibility of injury.

They include the following:

It becomes easier to overexert (and not notice) in the winter causing exhaustion.

Exhaustion results in muscle fatigue and a set up for injury.

The natural shiver response and reduced circulation can increase the risk of injuries.

Cold muscles have less stamina and don't have the strength to resist injury.

Precautions To Avoid Sports Injuries In Winter

Weather-related joint pain is common among those with arthritis conditions. Our joints contain sensory nerves called baroreceptors which respond to changes in the barometric pressure. If you feel achy, take it easy and maybe not engage in a difficult or lengthy routine.

Stay hydrated even if you don't feel thirsty.

Warm up. This is just as important, if not more so, in the winter. An improperly warmed up shoulder joint won't have the normal range of motion. Not surprising that rotator cuff injuries are more common in winter.

Change into dry clothes after a winter work out.

Use proper gear at all times: gloves, breathable layers, hats.

Contact OrthoNY at (518) 489-2663, or request an appointment online, if you have sustained an injury or for additional ways to prevent winter sports injuries.

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how does cold weather affect sports injuries? | orthony

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How Does Cold Weather Affect Sports Injuries? | OrthoNY, Orthopedic Care, Albany, Malta, Clifton Park, Delmar and Latham, NY

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How Does Cold Weather Affect Sports Injuries? | OrthoNY, Orthopedic Care, Albany, Malta, Clifton Park, Delmar and Latham, NY

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This winter alone, I have had more athletes miss weeks of training due to a respiratory infection or flu than in my previous 18 years of coaching. It has been a doozy of a flu season so far. The fact is, hard training will suppress your immune system, leaving you susceptible to opportunistic infections. Getting sick and missing two weeks of training due to an illness is a real setback for any athlete. Endurance athletes need strategies to prevent illness as well as manage illness when they are unlucky enough to get sick. They also need comeback strategies to segue successfully back into training without a relapse.

Prevention

Unless you live in a bubble, you will be exposed to infections. Minimizing the risk of contracting them is the name of the game. Hard training sessions suppress your immune system for a period of 3 to 72 hours. This period of impaired immunity is known as the "open window." Being hyper-vigilant with prevention techniques during this "open window" period is advised. In other words, avoid going to big department stores or babysitting your runny-nosed nieces after a long hard ride.

Guidelines for prevention of illness for endurance athletes:

Execute all your recovery tasks post-training to minimize exercise-induced immune suppression.

Maintain optimal nutrition to enhance general health and maintain vitamin and mineral stores, particularly Vitamin D status.

Avoid crash diets and rapid weight loss.

Avoid over-training and chronic fatigue with a careful, progressive training plan.

Minimize contact with sick people, especially during your "open window". Minimize time spent in public places with large crowds, especially during your "open window".

Keep a distance from people coughing and sneezing. If possible, ask them to wear a mask.

Wash your hands before eating or after contact with sick people, public places and bathrooms.

Carry hand sanitizer to use when hand washing is inconvenient.

Avoid touching your mouth, nose and eyes with your hands.

Use clean, disposable tissues to wipe your mouth or blow your nose, and put soiled tissues in the trash immediately.

Do not share food or drink with anybody, especially cute children with runny noses!

Use a face mask to protect your respiratory membranes from being directly exposed to very cold and dry air during strenuous exercise.

Wear appropriate clothing to avoid getting overly cold and wet.

Consistently get at least seven hours of sleep per night.

Keep life stress to a minimum.

Follow immunonutritional support guidelines (see below) to minimize training-induced immune suppression, and to bolster immunity.

Immunonutritional Support

Several nutritional supplements and strategies have been shown to bolster immunity.

Carbohydrates

Bonking during training is bad news for your immune system. Ensuring adequate carbohydrate fueling during and after heavy or prolonged exertion helps dampen immune inflammatory responses and counteract exercise-induced immune dysfunction. In short, carb up to stay resilient.

Quercetin

Quercetin supplementation of 1,000 mg/day reduces illness rates in exercise-stressed athletes. Combining quercetin supplementation with green tea extract and fish oil can further augment immune function and reduce the incidence of upper respiratory tract infections in athletes.

Probiotics

Lactobacillus probiotics can augment some aspects of immune function and reduce illness rates in exercise-stressed athletes.

Recovering From Illness

The bugs are out there and, despite your best prevention efforts, you may still fall sick. Most endurance athletes are tough as nails and would rather train through almost any illness than rest and get off-plan. That is a bad idea! Training through a viral infection can have serious negative outcomes, including mononucleosis, pneumonia, or myocarditis, an infection of the heart caused by common cold viruses. It is better to back off for a few days rather than blow up your common cold into one of these serious conditions. Remind yourself that you can't build fitness on a sick body.

Just how sick do you have to be before holding off on training becomes the correct decision? Any illness symptoms are reason enough to avoid training hard. I am okay with my clients completing a recovery-paced training session, keeping heart rate in zone 1, if all symptoms are above the neck. These include a mild sore throat, stuffy nose and headaches. Light exercise may be helpful in this instance.

Stop training and take a day off from all activity other than gentle stretching if you have any below-the-neck symptoms. These include a very sore throat, fever, fluid in your lungs, coughing, body chills and aches, exhaustion, diarrhea, or vomiting.

While you are sick, rest, drink plenty of hot fluids, and seek comfort from over-the-counter cold remedies. The vast majority of colds derive from a virus, so taking antibiotics is rarely helpful. Antibiotics will weaken your immune system further by destroying bacteria-both good and bad-in your gut, where a portion of your immune system resides. If your illness symptoms deteriorate rapidly or continue for more than three days, consult your physician.

Returning to Training Following an Illness

Here are some guidelines for getting back on track after being sick:

Wait one day after below-the-neck symptoms have resolved before resuming any training.

After that, resume training with a day consisting of one recovery-paced session.

Continue training at a recovery pace until all above-the-neck symptoms disappear.

Stop training and return to rest if any below-the-neck symptoms return.

If you were sick for three days or less, resume your training plan after your one "wait day" plus one recovery day.

If you were sick for more than three days, resume training with one "wait day" and two or more recovery days. After two or more successful recovery days, gradually ramp up your duration first, then intensity, to full training loads over the course of four to seven days.

Use a face mask to protect respiratory mucous membranes if exercising in very cold temperatures following a respiratory infection.

So there you have it. Avoid the bugs at all costs, rest when you do get sick, and come back to full training gradually. It all sounds like the stuff your mom told you to do when you were eight years old, right?

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The Athlete's Survival Guide to the Cold and Flu Season | TrainingPeaks

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Hard training sessions suppress your immune system for a period of 3 to 72 hours. Prevent illness and keep training by following these guidelines.

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Removing wet or restrictive clothing

Coover affected area with warm, loose, dry material

If blisters are present leave them be

Monitoring the affected are to se sign of returning circulation and sensation

This can be prevented by simply avoiding overexposure of the skin in cold environments.

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Like many other sports in the colder seasons Track deso not require protective clothing. Leaving athletes susceptible to hypothermia.

Some of the causes of hypothermia include: failure to warm up sufficiently, becoming chilled from inactivity for varying periods of time, and low temperatures while experiencing damp or wet clothes in a windy environment.

Symptoms:

Shivering

lack of coordination

Drowsiness

Slurred Speech

Confusion

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Activate EMS

Immediately move the athlete to a warm room or shelter

Remove any wet clothing

Warm the athlete with multiple layers of cloth or blankets

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Frostbite is tissue damage as a result of cold exposure of temperatures of below 0 degrees.

Two types of frostbite:

Superficial: only involving the skin and subcutaneous tissue

Symptoms:

Blister

swelling

pain

tingling

burning

numbness

Deep: affects all layers of the skin as well as tissues below the skin. Tissue will become blotchy red, swollen, painful, and possibly gangrenous.

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Learn how to prevent cold injury to the skin when outdoors in freezing temperatures and how to treat and recover from frostbite.

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If the individual has a dep frostbite hospitalization is required.

Other treatments include:

Gradual rewarming of the skin

After skin thaws protection of the wound (sterile sheets, towels or dressing to protect the skin

Debridement or removal of the dead or infected tissue (only done by licensed professional)

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Stop activity especially if cramp spreads

Stretching the affected area.

Massaging the affected

Apply heat or ice.

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Diagnosis

Diagnosing frostbite is based on your signs and symptoms, skin appearance, and a review of recent activities in which you were exposed to cold.

Your doctor may order X-rays, a bone scan or an MRI to help determine the severity of the frostbite and check for bone or muscle damage.

Mayo Clinic Minute: Why the risk of frostbite is greater than you think

As winter drags on and temperatures drop way down, your risk of cold-related injury like frostbite can go way up.

"Literally think of it as freezing of the tissues," Dr. Sanj Kakar Mayo Clinic Orthopedic hand and wrist surgeon says frostbite is more common than many people think.

"We tend to see frostbite, for example, when the temperature is 5 degrees Fahrenheit with minimal windchill," Dr. Kakar explains.

If the windchill drops below negative 15 degrees Fahrenheit, not unheard of in the northern half of the U.S., frostbite can set in within half an hour.

The most vulnerable areas of frostbite are your nose, ears, fingers and toes.

"Initially [with] the milder forms, you can get some pain and some numbness of the tips, but the skin can change its color," Dr. Kakar says. "It can be red. It can be white. Or it can be blue. And you can get these blisters on your hands. And it can be a very serious injury."

The worst cases, the tissue can die, and you may need surgery to remove it.

So who's most at risk?

"[Those most at risk are] certain patients with diabetes, patients who have previous history of frostbite are prone to it, the elderly or your very young children, and also, for example, if you're dehydrated," he says.

Treatment

Mild frostbite (frostnip) can be treated at home with first-aid care. For all other frostbite, after appropriate first aid and assessment for hypothermia, medical treatment may involve rewarming, medications, wound care, surgery and various therapies, depending on the severity of the injury.

Rewarming of the skin. If the skin hasn't been rewarmed already, your doctor will rewarm the area using a warm-water bath for 15 to 30 minutes. The skin may turn soft. You may be encouraged to gently move the affected area as it rewarms.

Oral pain medicine. Because the rewarming process can be painful, your doctor will likely give you a drug to ease the pain.

Protecting the injury. Once the skin thaws, your doctor may loosely wrap the area with sterile sheets, towels or dressings to protect the skin. Or the doctor may protect your fingers or toes as they thaw by gently separating them from each other. And you may need to elevate the affected area to reduce swelling.

Removal of damaged tissue (debridement). To heal properly, frostbitten skin needs to be free of damaged, dead or infected tissue. To better distinguish between healthy and dead tissue, your doctor may wait 1 to 3 months before removing damaged tissue.

Whirlpool therapy or physical therapy. Soaking in a whirlpool bath (hydrotherapy) can aid healing by keeping skin clean and naturally removing dead tissue. You may be encouraged to gently move the affected area.

Infection-fighting drugs. If the skin or blisters appear infected, your doctor may prescribe oral antibiotics.

Clot-busting drugs. You may receive an intravenous (IV) injection of a drug that helps restore blood flow (thrombolytic), such as tissue plasminogen activator (TPA). Studies of people with severe frostbite show that TPA lowers the risk of amputation. But these drugs can cause serious bleeding and are typically used only in the most serious situations and within 24 hours of exposure.

Wound care. A variety of wound care techniques may be used, depending on the extent of injury.

Surgery. People who have experienced severe frostbite may in time need surgery or amputation to remove dead or decaying tissue.

Hyperbaric oxygen therapy. Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized room. Some patients show improved symptoms after this therapy. But more study is needed.

Lifestyle and home remedies

To care for your skin after frostbite:

Take all medications - antibiotics or pain medicine - as prescribed by your doctor. For milder cases of frostbite, a nonprescription pain reliever can help reduce pain and inflammation.

For superficial frostbite that has been rewarmed, some people find it soothing to apply aloe vera gel or lotion to the affected area several times a day.

Get out of the cold and wind. Don't thaw or warm the affected area if it might refreeze. Remove wet clothes once you're indoors. Seek emergency medical care.

Remove rings or other tight items. Try to do this before the affected area swells.

Don't walk on frostbitten feet, if possible

Don't apply direct heat or rub the area.

Don't break blisters that may develop. Blisters act like a bandage. Allow blisters to break on their own.

Preparing for your appointment

Call your doctor if you suspect you have frostbite or hypothermia. Depending on the severity of your symptoms, you may be told to go to an emergency room.

If you have time before your appointment, use the information below to get ready for your medical evaluation.

What you can do

List any signs and symptoms you've been experiencing and for how long. It will help your doctor to have as many details as possible about your cold exposure and to know if your signs and symptoms have changed or progressed.

List your key medical information, including any other conditions with which you've been diagnosed. Also list all medications you're taking, including nonprescription medications and supplements.

Make a note of the date of your last tetanus shot. Frostbite increases the risk of tetanus. If you haven't been vaccinated or if your last shot was more than 10 years ago, your doctor may recommend that you be vaccinated.

List questions to ask your doctor. Being prepared will help you make the most of the time you have with your doctor.

For frostbite, some basic questions to ask your doctor include:

Are tests needed to confirm the diagnosis?

What are my treatment options and the pros and cons for each?

What results can I expect?

What skin care routines do you recommend while the frostbite heals?

What kind of follow-up, if any, should I expect?

What changes in my skin should I look for?

Don't hesitate to ask any other questions that occur to you.

Show references

1. Goldsmith LA, et al., eds. Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. https://accessmedicine.mhmedical.com. Accessed June 30, 2014.

2. Zafren K, et al. Frostbite. https://www.uptodate.com/contents/search. Accessed July 13, 2018.

3. AskMayoExpert. Frostbite. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.

4. Frostbite. Centers for Disease Control and Prevention. https://www.cdc.gov/disasters/winter/staysafe/frostbite.html. Accessed July 13, 2018.

5. Walls RM, et al., eds. Frostbite and nonfreezing cold injuries. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed July 13, 2018.

6. McIntosh SE, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite. Wilderness & Environmental Medicine. 2011;22:156.

7. Bergeron MF, et al. International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes. British Journal of Sports Medicine. 2012;46:770.

8. Miller T. Preparing for cold weather exercise. Performance Training Journal. 2010;3:1.

9. Briggs JK. Frostbite. In: Triage Protocols for Aging Adults. Wolters Kluwer; 2019.

10. Thompson DA. Frostbite. In: Adult Telephone Protocols: Office Version. 4th ed. American Academy of Pediatrics; 2019.

11. Kelly AP, et al. Biology of wounds and wound care. In: Taylor and Kelly's Dermatology for Skin of Color. 2nd ed. McGraw-Hill Education; 2016. https://accessmedicine.mhmedical.com. Accessed May 27, 2021.

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Learn how to prevent cold injury to the skin when outdoors in freezing temperatures and how to treat and recover from frostbite.

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Athletes with a large muscle mass

Children

Older Adults

Individuals with poor fitness levels

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Clothing that does not restrict movement

Stay hydrated

Education

Awareness of the type of weather before participating in outside activities

Warm up suits should be worn before exercise, during activity breaks, or rest periods

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Muscle and tendon strains and ligament sprains send millions of people to the doctor each year. About 2 million people alone sprain their ankle. But there are also wrist sprains, back strains, ACL tears, and any number of other sprains and strains.

Sprains and strains cause pain and loss of range of motion. They force employees to miss work and athletes to take time off from their sport.

Many sprains and strains heal on their own, with rest. But some need surgery or physical therapy to help rehab and prevent future injuries.

Contact UPMC Orthopaedic Care

To request an appointment or for additional information, please call 1-866-987-6784 or submit a form online.

What Are Sprains and Strains (Muscle Tears)?

What is the difference between a sprain and strain?

The words sprain and strain sound alike, but they're two different things.

Sprains - occur when you stretch a ligament attached to a joint.

Strains (or torn muscles) - occur when you stretch a muscle or tendon too far or put too much pressure on it.

What are the types of sprains and strains?

The most common types of sprains are ankle sprains, knee sprains, and wrist sprains. You can sprain other areas, but those joints tend to be the most prone to sprains.

Doctors grade sprains based on how bad the injury is. There are three grades:

Grade 1 sprain: This is a mild sprain with some damage to the ligament. With rest and ice, it may heal on its own.

Grade 2 sprain: This is a moderate sprain, which means there could be a partial tear of the ligament. The joint is somewhat unstable and might need immobilization, such as with a walking boot or wrist splint.

Grade 3 sprain: This is a complete tear of the ligament, which can mean the joint is very unstable. The worst grade 3 sprains may need surgery to repair a torn ligament.

Strains are like sprains in that they range from mild to severe. You can overstretch a muscle or tendon and heal with ice and rest. Or you can partially or completely tear a tendon and maybe need surgery.

What Causes Sprains and Strains?

Causes and risk factors of sprains and strains may include:

Starting an intense exercise program too quickly.

Continuing to do physical work when very tired.

Wearing high-heeled shoes or footwear that doesn't fit well.

Picking up something heavy.

Not using proper lifting techniques.

These types of injuries are common in athletes. But they can happen when any of us overuses or puts too much stress on our joints and muscles.

Sprained ligaments and strained muscles become inflamed as your body responds to the injury. This can cause spasms.

Sprain and strain prevention

Regular exercise can reduce your risk of sprains and strains, as can warming up the body before you exercise. The research on stretching before exercise isn't conclusive, but many health experts recommend it.

Why Choose UPMC Orthopaedic Care for a Sprain or Strain (Muscle Tear)?

U.S. News and World Report ranks us as one of the best orthopaedic programs in the nation.

Here are a few of the reasons why:

Experts in sports medicine. As experts in preventing and treating sports-related injuries, we know the issues athletes face. We know you want to stay active and keep playing the sport you love. We use the most advanced treatments and therapies to make that happen.

Interconnected services. We offer one place for all your orthopaedic needs. Our doctors, nurses, and physical therapists provide complete care - from diagnosis through recovery and rehab. We coordinate all of your care, so all you have to focus on is getting better.

Many ways to rehab. We have more than 60 locations throughout the region where you can go for outpatient rehab.

Unmatched in research. We're leaders in the western Pa. region for NIH-funded orthopaedic research and clinical trials. We're always seeking better ways to diagnose and treat issues such as sprains (muscle tears) and strains.

Specialty programs. With specialists in each type of orthopaedic injury and condition, we have the experts to cater to your specific needs. The Hip Preservation Program at UPMC Orthopaedic care specializes in hip problems from the mild to the severe, including hip sprains.

Learn more about sprains and strains

UPMC's HealthBeat Blog:

What Are the Symptoms of Sprains and Strains (Muscle Tears)?

Sprains and strains can happen almost anywhere in your body, including your lower back.

Both can cause a lot of pain.

Symptoms of a sprain

Sprains can happen when a joint twists in a weird position or bends too far. For example, an ankle sprain occurs because your ankle has twisted, and the ligaments attached around that joint stretch too much.

Symptoms of a sprain include:

Swelling and tenderness of the joint.

Bruising.

Stiffness.

If your joint looks out of place or your symptoms don't go away in a few days, you should see a doctor.

Strain (muscle tear) symptoms

Symptoms of a strain may include:

Sudden muscle pain, often from a certain movement or injury.

Muscle spasm.

Muscle that's sore to the touch.

Pain that may ease with rest.

Muscle weakness.

A mild muscle strain may cause some pain and weakness.

Severe muscle strains involve much (or even complete) tearing. People often hear the muscle "pop" when the injury happens. This may result in extreme pain and not being able to use that muscle.

A severe muscle strain injury is an emergency. You should see a doctor right away.

How Do You Diagnose a Sprain or Strain?

To diagnose a sprain or strain, your doctor will do an exam and ask how it happened. During the exam, your doctor will touch the injured area, check for swelling, and test your range of motion.

Your doctor will also take a medical history to see if you've had the same injury before and what medicines you're taking.
You may need tests to confirm a sprain or strain diagnosis:

Sprains - X-rays to make sure you don't have a fracture. You can't see ligaments on X-rays, but doctors may want to look at the joint itself.

Strains - X-rays to rule out a fracture, even though you can't see soft tissue like muscles or tendons on an X-ray. Your doctor may order an MRI or ultrasound to determine the extent of the damage to your muscle.

Learn more about tests to diagnose sprains and strains

The link below will open a new browser window.

UPMC's HealthBeat Blog:

Sprain and Strain (Muscle Tear) Treatments

Severe sprains and strains need medical attention right away. But for less severe ones, you may first try home care. As a rule, this means RICE:

Rest: Take time off from doing anything that causes pain. For example, if your ankle is sore and feels like it has a mild sprain, stay off it for a few days.

Ice: Ice the area for 15 to 20 minutes several times each day for the first few days of your injury.

Compression: Use an elastic bandage to wrap the area (this helps with swelling).

Elevation: Prop up your feet, legs, arms/wrist to keep the injured area above your heart.

Unless your doctor has told you not to, you can also take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). This includes ibuprofen, naproxen, and aspirin.

What are the treatment options for a sprain?

While a sprain heals, your doctor will probably tell you to:

Take NSAIDs for pain.

Keep the injury elevated.

Apply ice packs and/or compression bandages to the sprained ligament.

Rest.

If your sprain is in your knee or ankle, you may need to use crutches for a short time. It can take three to four weeks for a moderate sprain to heal.

For severe sprains, you may need:

A cast or splint to keep the affected joint still.

Surgery to repair the damaged ligament. This has a longer recovery, and may include physical therapy to regain strength.

What are the treatment options for a strain?

Treatment options for strains vary by how severe the injury is.

Doctors can treat mild strains much like they treat sprains:

Mild strains can take three to six weeks to heal (meaning you don't feel pain or muscle weakness any more).

Severe strains may require surgery if the muscle is too damaged to heal properly on its own.

Your doctor may also refer you to a physical therapist to slowly increase the strength in that muscle to avoid further injury.

Contact UPMC Orthopaedic Care

To request an appointment or for more information, please call 1-866-987-6784 or submit a form online.

Learn more about sprain and strain treatments and recovery

The links below will open a new browser window.

UPMC's HealthBeat Blog:

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Sprain (Muscle Tear) and Strain Symptoms and Treatment | UPMC

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Sprains and strains occur when you stretch a ligament or muscle, respectively. Learn more about the causes and treatment options for sprains and strains.