Sickle cell is a mutation of a gene which causes the hemoglobin to change the shape of red blood cells into a “quarter moon” shape, or sickle1. This blood cell sickling poses potentially life-threatening problems to anyone with the gene, but especially to athletes. Sickle cell anemia can cause conditions such as acute exertional rhabdomyolysis, which in-turn can lead to kidney failure and death. Sickle cells can also lead to organ damage, reduced blood flow, and stroke1, which are all potentially fatal.
When it comes to sickle cell, there is the trait and the anemia. Sickle cell trait is the inheritance of one sickle cell gene, and one normal hemoglobin gene. Sickle cell anemia is the inheritance of the sickle cell gene from both parents. Sickle cell trait should be monitored, but generally does not cause problems. Sickle cell anemia, however, has a much greater chance of putting people at risk for exertional illnesses.
Sickle cell is especially dangerous in sports do to the exertion of athletes causing a rapid depletion of oxygen in the blood. When the blood cells are not carrying oxygen, they are susceptible to “log-jamming”2 in the vascular system, leading to ischemia, or lack of blood flow2.
Signs and Symptoms of a Sickling Collapse
• Sickling collapses may occur early in a workout.
• Usually during high-intensity, sustained training
• Seen usually with maximal exertion over a short term period2
Features of Sickling2
• People that are sickling will slump to the ground with weakness in their muscles
• They will lie still but otherwise look normal
• Players caught early and treated will recover swiftly
For athletes suffering from sickle cell, vital signs should be checked, high-flow oxygen should be administered, and EMS should be activated2.
To prevent any issues for an athlete with sickle cell, the athlete should build up slowly with training and should participate in conditioning programs to stay in shape. Sickle cell athletes should not participate in performance tests, such as mile runs or suicide sprints, as these have a high risk of sickling. Generally, when sickle cell athletes are allowed to set their own pace, they don’t usually have any problems.
REFERENCES
1 Sickle cell anemia. (2014, June 11). Retrieved 2015, from http://www.mayoclinic.org/diseases-conditions/sickle-cell-anemia/basics/definition/con-20019348
2 Consensus Statement: Sickle Cell Trait and the Athlete. (n.d.). Retrieved 2015, from http://www.nata.org/sites/default/files/SickleCellTraitAndTheAthlete.pdf
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