Chapter 4 – Fitness Principles

Additional Safety Concerns

As activity rates among North Americans increase, specifically outdoor activities, safety concerns also rise. Unfortunately, the physical infrastructure of many North American cities does not accommodate active lifestyles. Limited financial resources and de-emphasis on public health means local and state/provincial governments are unlikely to allocate funds for building roads with sidewalks, creating walking trails that surround parks, or adding bike lanes. In addition, time constraints and inconvenience make it challenging for participants to travel to areas where these amenities are available. As a result, exercise participants share roads and use isolated trails/pathways, inherently increasing the safety risks of being active.

A key principle in outdoor safety is to recognize and avoid the extremes. For example, avoid roads that experience heavy traffic or are extremely isolated. Avoid heavy populated areas as well as places where no one is around. Do not exercise in the early morning or late at night, during extreme cold or extreme heat. To minimize safety risks during these types of environmental conditions, do not use headphones that could prevent you from hearing well and remaining alert, do not exercise alone, prepare for adequate hydration in the heat, and use warm clothing in extreme cold to avoid frostbite. Extreme conditions require extra vigilance on your part.

A second key principle, whether outdoor or indoor, is to simply use common sense. While this caveat seems obvious, it gets ignored far too often. Always remember the purpose of your exercise is for enjoyment and improved health. If these objectives could be compromised by going for a run at noon in stifling heat, or lifting large amounts of weight without a spotter, you should reconsider your plan. Before exercising in what could be risky conditions, ask yourself, “Is there a safer option available?”

Lastly, be aware of the terrain and weather conditions. Walking or jogging on trails is a wonderful way to enjoy nature, but exposed roots and rocks present a hazard for staying upright. Wet, muddy, or icy conditions are additional variables to avoid in order to complete your exercise session without an accident.

Environmental Conditions

When exercising outdoors, you must consider the elements and other factors that could place you at increased risk of injury or illness.

Heat-Related Illness

Heat-related illnesses, such as heat cramps, heat exhaustion, and heat stroke, contributed to 1714 deaths in the United States in 2022. A report released by the Center for Disease Control stated that deaths from heat-related illnesses occurring every year account for more deaths than tornadoes, hurricanes, and lightning combined. Of those deaths, most were male, older adults.

The number one risk factor associated with heat-related illness is hydration, the starting point of all heat-related illness. Unfortunately, sweat loss can occur at a faster rate than a person can replace with fluids during exercise, especially at high intensities. Even when trying to hydrate, ingestion of large amounts of fluids during exercise can lead to stomach discomfort. What does this mean? Hydration must begin before exercise and must become part of your daily routine.

Several practical methods of monitoring hydration levels can assist in preventing illness. One simple method, while not fool proof, is to simply monitor the color of your urine. In a hydrated state, urination will occur frequently (every 2–3 hours) and urine will have very little color. In a dehydrated state, urination occurs infrequently in low volume and will become more yellow in color.

Another simple method involves weighing yourself before and after a workout. This is a great way to see firsthand how much water weight is lost during an exercise session primarily as a result of sweat. Your goal is to maintain your pre- and post-body weight by drinking fluids during and after the workout to restore what was lost. This method, when combined with urine-monitoring, can provide a fairly accurate assessment of hydration levels.

The best preventative measure for maintaining a hydrated state is simply drinking plenty of water throughout the day. In previous years, recommendations for the amount of water to drink were a one size fits all of about 48–64 oz/1.5-2L per day, per person. In an effort to individualize hydration, experts now recommend basing fluid intake on individual size, gender, activity levels, and climate. Generally, 0.5-1 ounce/15-30ml per pound of body weight is recommended. For a 150-pound/68kg  individual, this would mean 75–150 ounces/2.2-4.4L of water per day! While there is still considerable debate over the exact amounts, no one disputes the importance of continually monitoring your hydration using one of the techniques described previously. Insufficient hydration leads to poor performance, poor health, and potentially serious illness.

It should be noted that electrolyte “sport” drinks, such as Gatorade and PowerAde, are often used to maintain hydration. While they can be effective, these types of drinks were designed to replace electrolytes (potassium, sodium, chloride) that are lost through sweating during physical activity. In addition, they contain carbohydrates to assist in maintaining energy during activities of long duration. If the activity planned is shorter than 60 minutes in duration, water is still the recommended fluid. For activities beyond 60 minutes, a sports drink should be used.

Cold-Related Illnesses

Much like extremely hot environmental conditions, cold weather can create conditions equally as dangerous if you fail to take proper precautions. To minimize the risk of cold-related illness, you must prevent the loss of too much body heat. The three major concerns related to cold-related illnesses are hypothermia, frost-nip, and frost bite.

As with heat-related illness, the objective of preventing cold-related illness is to maintain the proper body temperature of between 37-37.7 Celsius/98.6-99.9 degrees Fahrenheit. If body temperature falls below 37C/98.6F, multiple symptoms may appear, indicating the need to take action. Some of those symptoms include:

  • shivering
  • numbness and stiffness of joints and appendages
  • loss of dexterity and/or poor coordination
  • peeling or blistering of skin, especially to exposed areas
  • discoloration of the skin in the extremities

When walking or jogging in the cold, it is important to take the necessary steps to avoid problems that can arise from the environmental conditions.

  • Hydration is key. Cold air is usually drier air, which leads to moisture loss through breathing and evaporation. Staying hydrated is key in maintaining blood flow and regulating temperature.
  • Stay dry. Heat loss occurs 25x faster in water than on dry land. As such, keeping shoes and socks dry and clothing from accumulating too much sweat will allow for more effective body temperature regulation.
  • Dress appropriately. Because of the movement involved, the body will produce heat during the exercise session. Therefore, the key point is to direct moisture (sweat) away from the skin. This is controlled most effectively by layering your clothing. A base layer of moisture-wicking fabric should be used against the skin while additional layers should be breathable. This will channel moisture away from the skin, and any additional layers of clothing, without it becoming saturated in sweat. If exercising on a windy day, use clothing that protects from the wind and is adjustable so you can breathe.
  • Cover the extremities. Those parts of the body farthest away from the heart (toes, fingers, and ears) tend to get coldest first. Take the appropriate steps to cover those areas by using gloves, moisture-wicking socks, and a winter cap to cover your head.

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Fitness for Paramedics: A Guide for Students at Cambrian College, 2nd Edition Copyright © 2024 by Lynn Kabaroff and Martin Dubuc is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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