Prevention and Wellness

Cold Weather Injuries and Athletics

Premier Health Sports Medicine’s Brandon Craig, certified athletic trainer, answers Frequently Asked Questions about cold weather injuries and athletics.

What are the most common cold weather injuries?  

The primary cold weather injuries include hypothermia, frostbite, chilblains and immersion foot.

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How do these injuries occur? How do they differ from one another?

Cold weather injuries occur from being exposed to cold temperatures for long periods. The National Athletic Trainers’ Association describes the most common cold weather injuries in this way: Hypothermia occurs when your core body temperature drops below 95 degrees. Frostbite happens when body tissue freezes, usually after sweating in a cold, dry environment. The sweat cools the skin, creating a localized response in the toes, fingertips or nose. Chilblains are skin sores or bumps that develop after extended exposure to cold, wet conditions. Tissue does not freeze, but the cold inflames small blood vessels in the skin. Immersion foot happens after prolonged exposure to cold, wet environments damages the skin, nerves and muscles but does not freeze any tissue.

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What are the symptoms of cold weather injuries? 

Cold weather injuries can cause swelling, pain and other symptoms, says the National Athletic Trainers’ Association. Signs of hypothermia include shivering, increased blood pressure and fine motor skill impairment. Frostbite causes swelling, redness or a mottled, gray skin appearance, stiffness and momentary tingling or burning. Symptoms of chilblains are small red bumps, swelling, tenderness, itching and pain. Immersion foot leads to burning, tingling or itching, loss of sensation, bluish or blotchy skin, swelling, pain or sensitivity, blisters, skin fissures and maceration (break down of the skin).

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    How is hypothermia treated? 

    The National Athletic Trainers’ Association recommends this treatment for hypothermia. Remove all wet or damp clothing and then insulate the body, including the head, with warm, dry clothing or blankets. Get to a warm shelter protected from wind and rain. Apply heat to the body’s trunk and heat transfer areas of the body (armpits, chest wall and groin). Do not rewarm the extremities, as this could send cold blood to the body’s core and drop the core temperature, causing cardiac arrhythmias or even death. Avoid applying friction massage to the skin. Massage could damage the skin if frostbite is present. 

    How is frostbite treated? 

    To treat frostbite, rewarm the tissue only if there is no chance of refreezing, says the National Athletic Trainers’ Association. A warm bath of gently circulating water is a safe way to rewarm affected tissues. Be sure bath water is 98 degrees or less, to ensure slow rewarming. Immerse the frostbitten areas for 15 to 30 minutes, to thaw tissues. Color and sensation should return and the skin will become pliable.

    How are chilblains treated? 

    The National Athletic Trainers’ Association recommends this treatment if chilblains occur. Remove wet clothing. Gently wash and dry the affected area. Elevate the area and cover with warm, loose, dry clothing or blankets. Do not use lotions, creams or high levels of heat.

    How is immersion foot treated?

    Treatment for immersion foot begins with thoroughly cleaning and drying the feet, according to the National Athletic Trainers’ Association. Apply warm packs or soak the affected area in warm water for approximately five minutes. Put on clean, dry socks. Allow footwear to dry before wearing again.

    Are there other health problems associated with cold weather injuries? 

    Cold weather injuries occur from being exposed to cold temperatures for long periods. The National Athletic Trainers’ Association describes the most common cold weather injuries in this way: Hypothermia occurs when your core body temperature drops below 95 degrees. Frostbite happens when body tissue freezes, usually after sweating in a cold, dry environment. The sweat cools the skin, creating a localized response in the toes, fingertips or nose. Chilblains are skin sores or bumps that develop after extended exposure to cold, wet conditions. Tissue does not freeze, but the cold inflames small blood vessels in the skin. Immersion foot happens after prolonged exposure to cold, wet environments damages the skin, nerves and muscles but does not freeze any tissue.

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    Source: Brandon Craig, certified athletic trainer, Premier Health Sports Medicine, Miami Valley Hospital South; National Athletic Trainers’ Association; U.S. Department of Veterans Affairs

    Content Updated: January 29, 2019

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