For Moms’ Call the Doctor series, we peek behind the medical privacy curtain and get to know the people we entrust our health with, including their motivation, research, career goals, and daily work.
When Dr. Tiana Woolridge was a pediatric resident in Oakland, California, she took care of a teenage athlete in dire shape, sickened by playing in extremely hot weather. “He pushed through with no sense of, Oh, let me modify what I’m doing given the temperature. The coach tells me to push, I’ve got to push.” He wound up developing rhabdomyolysis. “It’s the breakdown of skeletal muscle, which can be really dangerous and cause long-term kidney injury, if not kidney failure.”
More than 27 million kids play organized sports in the United States—and many of them are in preseason training across the country right now at the tail end of a summer of record-breaking heat. Dr. Woolridge’s patient is far from an anomaly. Over 9,000 high school athletes are treated for heat illness every year, and heat illness is the third leading cause of death among this group.
Tell Congress: Protect Youth Athletes From Extreme Heat and Dirty Air
A formative experience
Dr. Woolridge’s athlete was hospitalized for days, receiving IV hydration and having his lab values frequently monitored. “It’s sad. You see this young, healthy kid who did not need his life interrupted in this way for something that could have been life threatening and is entirely preventable,” she recalls. While she wrote a “strongly worded” letter to her patient’s school’s athletic department about the dangers of pushing athletes in hot weather, they never contacted her.
Still, the experience has influenced her work to this day. Dr. Woolridge is now a primary care sports medicine physician at Hospital for Special Surgery in New York. She’s endlessly thinking about best practices to help athletes in a superheated climate. “The cultural aspect of sport is that you just be tough, you push through anything, no matter what. There’s this idea of, I did this when I was a kid, so you should be able to do it too. But the world we are living in is not that world that it was 30 years ago,” she notes. Today, training programs and protocols, breaks, and hydration are sorely needed. “I think there’s a huge opportunity for education for coaches, for trainers, and even doctors.”
Heat illness education roadblocks
Dr. Woolridge didn’t learn much about heat illness before her fellowship. “I went through four years of medical school and three years of pediatric training, and I cannot remember receiving any information on heat-related illness meaningful enough to stick in my mind.” What really cemented her education was helping at marathons during her fellowship as well as working with football coaches and trainers in preseason to identify which athletes were at the highest risk of heat illness. “The first couple of days of preseason no one’s really acclimated to exercising in this level of heat,” she explains.
And yet, in her day-to-day work, how climate and extreme weather impact athletes doesn’t really come up. “I think this is the concern,” she laments. That could have something to do with her current work, which mostly involves straddling the field of nonsurgical bone and joint medicine. “That means people of all ages with either an acute injury, meaning you sprained your ankle, you tweaked your knee all the way to chronic aches and pains and older folks.”
She also provides comprehensive general medical care as the head team doctor for the St. John’s University women’s volleyball team—an especially beloved position as Dr. Woolridge is a former college volleyball player herself. Fun fact: In high school, she also played basketball and is the daughter of NBA star Orlando Woolridge.
In her experience, far too many people still associate hot weather with going to the beach and having fun. “The dangers that come with it are not focused on quite as much. I am in a nuanced setting within sports medicine. There’s the day to day and then there’s working endurance events.”
When she’s helping at the New York City Marathon or the Brooklyn Half Marathon, for example, heat is a huge focus—she sees hundreds of runners in the triage tent. “One of the first things they say is, This is one of the most deadly half marathons,” she notes. It’s held at a time of year—mid to late May—where it’s been cold out, but the day of the race is often one of the first hot days of the year. “All the athletes have been training through the winter. So you have people who are not acclimatized. All of a sudden you max out, push yourself. Death is not uncommon in these endurance events. When people are like, I want to do a marathon, it’s not first of mind that it could be something that’s potentially deadly.”
Raising awareness
The fact that people aren’t thinking about how climate might affect them is precisely why Dr. Woolridge feels passionate about spreading the word about extreme heat, exertion, and illness. Seeing the impacts up close keeps her going. “Some people come in the tent, and they just look confused. You end up taking a temperature, and their core body temperature is like 104 or higher. It’s pretty intense!”
With her firsthand experience of how heat-related illness can quickly spiral if not recognized and treated early, Dr. Woolridge is uniquely positioned to raise awareness about the issue. “You’ve got young kids ending up needing dialysis, kidney transfers,” she says, shaking her head. She’s now starting to incorporate the dangers of extreme heat in her outreach and education work for general physicians, including pediatricians and family medicine physicians, to ensure as many people as possible are prepared. She’s also working directly with schools. “This whole experience has fired me up to increase education and awareness about this issue. In sports medicine, we’re acutely aware of it.”
One thing she’s very clear about is not burdening kids. They should not be left alone to protect themselves in extreme heat. “It’s hard as a kid. I remember being a young athlete and pushing through a lot of things that I probably shouldn’t have because I didn’t want to quote-unquote show weakness.” She believes it’s up to grownups to set protocol for student athletes. “We as physicians would do a disservice to rely on the kids to pull themselves out. It really requires the adults in their lives to be responsible for protecting them.”
Tell Congress: Protect Youth Athletes From Extreme Heat and Dirty Air