General Recommendations to Prevent Illnesses in Cold Environments

The Challenge

The primary challenge for snow sports athletes is maintaining high-level performance while mitigating the physiological strain imposed by cold, dry, and windy environments. Inhaling large volumes of freezing, dry air poses significant risk to respiratory health, frequently leading to Exercise-Induced Bronchoconstriction ("ski asthma"), and affecting up to 50% of winter endurance athletes. Athletes also face thermoregulatory failure: once clothing becomes wet from sweating, the body cools rapidly, increasing hypothermia risk.

Practical Strategies

Clothing management is fundamental. Athletes should adopt a "thermo-behavioural" approach: selecting wicking, breathable fabrics like merino wool that prevent moisture retention, and changing base layers between warm-ups and competition to avoid post-exercise cooling. Covering exposed skin, forehead, cheeks, nose, and neck, regulates thermal comfort and reduces autonomic respiratory responses.

Heat maintenance requires combining active warm-ups with passive heating strategies. Muscle temperature gained during warm-up is lost rapidly in cold environments upon cessation of movement; heated lower-body garments or heavy insulation during transition periods between warm-up and competition start help preserve readiness.

Respiratory protection through heat and moisture exchange devices (masks or specialised scarves) during warm-ups helps humidify inhaled air and protect airway health.

Nutritional preparation ensures adequate glycogen stores before competing. When energy runs low, exercise intensity drops, and with it, metabolic heat production, increasing hypothermia risk.

Habituation and experimentation during training allows athletes to adapt to cold environments (reducing sympathetic activation and preserving blood flow) while discovering which layering combinations work best for their individual thermal responses.

Finally, coaches should monitor environmental limits strictly, cancelling or moving training indoors when temperatures drop below −15°C to preserve long-term athlete health.

Warming Up in the Cold - Respiratory Protection

A primary medical goal of the warm-up in cold environments is to mitigate respiratory illness, specifically Exercise-Induced Bronchoconstriction and "race cough." Strategic warm-up protocols can protect airway health while preparing the body for competition.

Inducing the Refractory Period

A specific warm-up protocol can act as a preventive measure. Performing 10–15 minutes of moderate-intensity warm-up can induce a "refractory period" during which the airways become temporarily less sensitive to cold, dry air. This reduces bronchoconstriction severity during subsequent high-intensity competition. Athletes should extend warm-up duration 10–15 minutes longer than usual in cold conditions, beginning at a slower pace to allow the respiratory system to adapt gradually.

Heat and Moisture Exchangers

To protect against respiratory illness from inhaling cold, dry air, athletes often use Heat and Moisture Exchangers (HMEs): masks, scarves, or mouthpieces during warm-up, even when racing without them. HMEs humidify and warm inhaled air, providing necessary airway protection in borderline conditions. However, athletes should be aware that sudden exposure of pre-warmed airways to freezing air at the start line could potentially trigger a "thermal shock" response, the very reaction they are trying to prevent.

Managing the Restitution Phase

Preventing cold-related illness requires managing body temperature during the critical "restitution" or transition period between warm-up and event start. A standard active warm-up is insufficient if the athlete cools rapidly while waiting. Effective preparation combines active warm-up with passive heating strategies, such as heated lower-body garments during transition, to prevent rapid muscle temperature loss.

Managing sweat accumulation is equally vital. High-intensity warm-ups cause sweating; if moisture remains against the skin during the inactive transition, it can freeze or cause rapid cooling. Athletes should change base layers between warm-up and competition to ensure they begin with dry insulation against the skin.