Sickle Cell Trait and the Athlete

Sickle cell anemia is a chronic hereditary blood disorder in which red blood cells (RBC) are sickle or crescent shaped instead of round. It is caused by an abnormal type of hemoglobin in the blood. A person may either have sickle cell disease, sickle cell trait, or neither. It is an inherited disease and thus is present from birth and cannot be acquired later in life. Sickle cell is most prevalent in African American, Native American, and Mediterranean populations.

Complications of sickle cell may include, but are not limited to:

• Decreased oxygen transport,
• Shorter RBC lifespan, leading to a deficiency of RBCs,
• Increased risk of thrombi or "clogged" blood vessels,
• Increased risk of rhabdomyolysis (rapid breakdown of muscle tissue due to lack of blood supply). The risk is 200 times greater for people with sickle cell trait and is also the leading cause of death in athletes that have "sickle cell crisis".

Due to the complications of sickle cell it is easy to see that it is important for Athletic Trainers (and athletes) be educated on this blood disease. At LSU, we do a simple blood test on each of our student-athletes during their pre-participation physical exams to screen for both sickle cell trait and sickle cell disease. Having this data can help Athletic Trainers better monitor student-athletes during workouts and respond if that student-athlete ever experiences a sickle cell crisis. Student-athletes with sickle cell trait or disease have increased risk of complications due to the exhaustive nature of practice and competitions. Extensive exhaustive exercise can induce sickling of the RBCs. Heat, dehydration, altitude, and asthma also contribute to increased risk or sickling. Sickle cell collapse is often mistaken for a cardiac problem or heat related problem.

How to Tell the Difference Between Heat Cramping and Sickle Cell Crisis:

• Heat cramping is often preceded by muscle twitches; sickling is not.
• The pain is "different"; heat cramping pain is more excruciating.
• Heat crampers hobble to a halt with "locked up" muscles, while sickling players slump to the ground with weak muscle.
• Heat crampers have visibly contracted, rock hard muscles. Sickling players have muscles that look and feel normal.
• Sickling players caught early and treated right recover faster than players with major heat cramping.

The fact that many people, not just athletes, are active and potentially vulnerable to the complications of sickle cell means education can become important for everyone. All people are screened for sickle cell at birth. However, many do not know the results of these screens. Since sickle cell is an inherited disease, blood screening only needs to be done once and is very easy to do.

If you have any questions regarding sickle cell anemia, please consult with your personal physician. Most physicians are able to provide all of the necessary information that one would need to prevent or reduce the risk of a sickle cell crisis.