Exercise in cold environments exerts a unique physiologic stress on the human body, which, under certain conditions, may result in a cold-related injury. Environmental factors are the most important risk factors for the development of hypothermia in athletes. Frostbite occurs as a result of direct cold injury to peripheral tissues. The biggest risk for frostbite is temperature. Trench foot is a result of repeated and constant immersion in cold water. Chilblains are local erythematous or cyanotic skin lesions that develop at ambient air temperatures of 32°F to 60°F after an exposure time of about 1 to 5 h. Cold urticaria is, essentially, an allergic reaction to a cold exposure and can be controlled with avoidance of the cold. There are a number of risk factors and conditions that predispose athletes to cold injury, but exercise in the cold can be done safely with proper education and planning.
Maine Medical Center, Portland, Maine.
Address for correspondence: Allyson Howe, MD, Maine Medical Center, 5 Bucknam Road, Falmouth, ME 04105; E-mail: firstname.lastname@example.org.