Frostbite, how to avoid and treat

Whether you're an avid runner or a weekend athlete with a penchant for open-air adventure, frigid winter conditions don't have to put an end to your outdoor fitness endeavors.

If you're in good health (those with respiratory or cardiac problems should check with their doctor before venturing out for winter exercise), and possess enough common sense to dress properly and avoid those really nasty days, winter exercise can be downright invigorating.

"This time of year, a lot of people just don't go out...but I think it's real important to get out now and then, especially in the sunlight," said Judy Kieres-McCormick, fitness center director at the Dundee Township Park District. "But only if you do it safely," she added, noting that the combination of cold and wind chill created when you run or ski, for example, can increase your risk for frostbite.

According to Dr. Ted Patras, assistant director of emergency services at St. Joseph Medical Center in Joliet, "One of the most important things with frostbite is recognizing the symptoms. The first warning sign is usually frostnip, which is that painful, tingling feeling that follows feeling cold. As soon as the area gets numb, you've got the beginnings of frostbite."

Fingers, toes, ears and nose are most commonly affected, Patras said, although male runners should consider wind proof briefs or an extra pair of shorts to protect against frostbite of another sensitive area. Patras said as soon as you feel the signs of frostnip, you should rewarm the area immediately. "If you continue to be out in the cold, superficial frostbite will set in, and it will continue to go deeper and deeper," he warned.

According to Dr., Thomas Long, assistant medical director at St. Joseph Hospital in Elgin, "Frostbite is when the tissue actually freezes-ice crystal form in the cells which kills the cells."

The signs of frostbite, besides numbness, include a firm, white, waxy appearance to the skin, Long said. "Depending on the depth of tissue loss," Long said, "the damage from frostbite can go from the superficial surface of the skin, which one might get from picking up a piece of dry ice and putting it down right away, to deeper tissue loss...which could result in losing toes or half a foot [through amputation]."

Treatment for frostnip involves simply covering the area and getting out of the cold. Frostbite requires gentle rewarming in tepid water (up to 104 degrees) and prompt medical attention," Long said. "But don't rewarm unless you are in a position where the part will not get cold again," he warned. "It's more damaging to rewarm and then refreeze, like if you're stranded or something. If you're in a car, that's different," he added. "Though it would be wise to warm the car up [before driving to the hospital]."

Never rub the area, put snow on it or try to warm it over a dry heat source, Patras said. Here are some additional precautions against frostbite:

Limit your exposure by breaking up your routine into shorter segments.
Make sure skin is covered and wear a hat, which will help prevent your core body temperature from dropping.
Make sure you're well hydrated and well fueled, but avoid a large meal.
Try to head into the wind on your way out so you've got a tail wind when you're fatigued and/or cooling down.
Don't overdress so you sweat excessively, and dress in layers, with polypropylene or some other wicking material as your first layer and a wind-proof, breathable barrier as your outer layer.

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