The Dangerous Myth of Sweating It Out Alcohol, sleep loss and stimulants can create a dangerous combination before training or games

In hockey culture, there has always been a long-standing tradition of pushing boundaries both on and off the ice.

It is important to make one thing absolutely clear: this article is not suggesting that Arizona State hockey player Matthew Mayich consumed alcohol, failed to sleep, became dehydrated, used energy drinks, or experienced any of these circumstances before his collapse. There is no basis for making that accusation, and the cause of his medical emergency should be determined by the appropriate medical professionals.

But his situation does raise a broader question worth asking throughout junior and college hockey. How much do we really understand about what young athletes are putting their bodies through before they arrive at morning conditioning or games? The combination of alcohol, inadequate sleep, dehydration and high-caffeine energy drinks is not some obscure or hypothetical scenario in hockey culture. It is a very real combination that many people in the sport have seen, experienced or witnessed.

Whether you are playing in the USHL, the CHL or elsewhere in junior hockey, the work-hard, play-hard mentality is everywhere. Celebrating a big weekend sweep with teammates or staying up late during a road trip can be viewed as harmless fun.

There has also been a long-standing belief that a young, elite athlete can simply “sweat it out” during the next morning's conditioning session or games.

That belief deserves another look.

Sports medicine has identified several factors that can increase an athlete's vulnerability to exertional heat illness, including dehydration, inadequate sleep or rest, excessive exertion and exercising in hot or humid conditions. The American College of Sports Medicine specifically lists poor hydration and inadequate sleep or rest among contributing risk factors.

Put several of those factors together, add alcohol consumption the night before and then introduce large amounts of caffeine or other stimulants the next morning, and the situation can become considerably more complicated.

The important point is not that every athlete who drinks, loses sleep or consumes an energy drink is going to suffer a catastrophic event.

It is that young athletes can be placing additional stress on a body that is already trying to recover before they ever begin their workout or game.

The potential problem begins the night before training.

Alcohol can contribute to dehydration by increasing urine production. Even if an athlete feels completely sober the next morning, that does not necessarily mean the body has fully recovered from the previous night's activity.

Dehydration matters because exercise already places enormous demands on the cardiovascular system.

During intense exercise, the heart must deliver oxygen-rich blood to working muscles while the body is simultaneously attempting to move heat toward the skin so it can be dissipated.

When an athlete begins exercise inadequately hydrated, that system is already operating under additional strain.

The NCAA Sport Science Institute notes that adequate hydration before, during and after physical activity is critical for safe participation, and specifically warns that intense exercise, hot and humid conditions, and dehydration can increase the risk of exertional heat injury.

That is particularly important during demanding dryland sessions.

The second piece of the equation is sleep.

A late night followed by only a few hours of poor-quality sleep is not simply a matter of being tired.

Sleep is an important component of athletic recovery, and inadequate sleep or rest is recognized as a contributing risk factor for exertional heat illness.

An athlete who has not adequately recovered may begin training with greater physiological stress before the first sprint, lift or conditioning drill.

That matters because the body is already going to experience increasing cardiovascular and thermal strain as exercise intensity rises.

And the athlete may not recognize how compromised he actually is.

This is one of the biggest dangers surrounding young athletes. They are conditioned to push through discomfort. Fatigue is often interpreted as something to overcome rather than something that may require attention.

In hockey, that mentality can be reinforced from a very young age.

Then comes the morning solution many young athletes reach for when they feel exhausted.

The energy drink.

Caffeine can increase alertness and temporarily make an athlete feel more awake. That feeling, however, should not be confused with physiological recovery.

The athlete may feel ready to go while the body is still dealing with the consequences of alcohol, inadequate sleep and dehydration.

The NCAA has specifically advised athletes with sickle cell trait to avoid high-caffeine energy drinks or other stimulants because they may contribute to dehydration.

That does not mean an energy drink automatically causes heat illness.

It means stimulants should not be viewed as a substitute for hydration, nutrition or sleep.

That distinction is important.

A tired athlete can drink a highly caffeinated beverage, feel more alert and then mistake that increased alertness for being physically prepared for an extremely demanding workout.

The workout does not become easier.

The athlete simply may be less aware of how fatigued he actually is.

This is where the combination becomes concerning.

Imagine an athlete who spent the previous night drinking, slept only a few hours, wakes up dehydrated and then consumes a high-caffeine energy drink because he needs to get through a difficult morning conditioning session.

Now place that athlete in a hot or humid environment.

The problem is no longer simply a hangover.

It is the accumulation of multiple stressors at the same time.

The athlete is attempting to exercise at an extremely high intensity while his body is trying to maintain blood pressure, deliver oxygen to working muscles and regulate core temperature.

The harder the athlete works, the more metabolic heat the body produces.

And when environmental conditions make it harder to dissipate that heat, the margin for error becomes smaller.

The ACSM identifies excessive physical exertion, poor hydration, inadequate sleep or rest, hot or humid conditions and insufficient acclimatization among the factors that can contribute to exertional heat illness.

None of these factors has to exist in isolation.

They can compound one another.

The most serious consequence is exertional heat stroke.

This is not simply being tired or overheated.

It is a medical emergency.

Once an athlete develops exertional heat stroke, immediate recognition, removal from activity and aggressive cooling are critical. ACSM guidance emphasizes prompt recognition and management of exertional heat illness, while its youth-sports guidance stresses that deteriorating performance or early signs of heat illness should be enough to stop participation and seek appropriate medical attention.

That is why the response to an athlete who suddenly becomes confused, collapses, has a seizure or demonstrates a dramatic change in physical condition cannot be, “He just needs to tough it out.”

The athlete needs medical attention.

Immediately.

And the goal should be to prevent that emergency from occurring in the first place.

Every junior hockey player has been told that he is an athlete.

He has been told to work harder, skate faster, lift more and finish the drill.

There is nothing wrong with that mentality when it is applied intelligently.

But being an elite athlete does not make someone immune to physiology.

A 19-year-old hockey player can be incredibly fit and still become vulnerable to heat illness if he begins a demanding workout dehydrated, poorly rested, inadequately acclimatized or otherwise compromised.

The solution is not to eliminate the social culture that makes junior hockey special.

It is to educate players about the difference between recovering from a night out and simply feeling good enough to practice.

“Sweat it out” should not be considered a recovery strategy.

Hydration is not optional.

Sleep is not optional.

Recovery is not optional.

And an energy drink is not a substitute for any of them.

Junior hockey programs, coaches, strength and conditioning staffs, athletic trainers and players themselves should make these conversations part of the culture.

Because the toughest player in the room is not necessarily the one who finishes the workout when his body is telling him to stop.

Sometimes, the smartest player is the one who recognizes that something is wrong before it becomes an emergency.