American College of Sports Medicine position stand: prevention of cold injuries during exercise

Med Sci Sports Exerc. 2006 Nov;38(11):2012-29. doi: 10.1249/01.mss.0000241641.75101.64.


It is the position of the American College of Sports Medicine that exercise can be performed safely in most cold-weather environments without incurring cold-weather injuries. The key to prevention is use of a comprehensive risk management strategy that: a) identifies/assesses the cold hazard; b) identifies/assesses contributing factors for cold-weather injuries; c) develops controls to mitigate cold stress/strain; d) implements controls into formal plans; and e) utilizes administrative oversight to ensure controls are enforced or modified. The American College of Sports Medicine recommends that: 1) coaches/athletes/medical personnel know the signs/symptoms and risk factors for hypothermia, frostbite, and non-freezing cold injuries, identify individuals susceptible to cold injuries, and have the latest up-to-date information about current and future weather conditions before conducting training sessions or competitions; 2) cold-weather clothing be chosen based on each individual's requirements and that standardized clothing ensembles not be mandated for entire groups; 3) the wind-chill temperature index be used to estimate the relative risk of frostbite and that heightened surveillance of exercisers be used at wind-chill temperatures below -27 degrees C (-18 degrees F); and 4) individuals with asthma and cardiovascular disease can exercise in cold environments, but should be monitored closely.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Adaptation, Physiological
  • Athletic Injuries / physiopathology
  • Athletic Injuries / prevention & control*
  • Cold Temperature / adverse effects*
  • Frostbite / physiopathology
  • Frostbite / prevention & control*
  • Humans
  • Hypothermia / physiopathology
  • Hypothermia / prevention & control*
  • Risk Factors
  • Shivering / physiology
  • Vasoconstriction / physiology
  • Vasodilation / physiology