Exertional Sickling

There continues to be a great deal of controversy surrounding sickle cell trait and its association with exercise-related morbidity and sudden death - Bruce L. Mitchell

Exertional Sickling

image by: LaMar Anderson

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Exercising Caution: Intensive Athletic Activity Could Be Fatal to Those with Sickle-Cell Trait

At 5:30 A.M. on February 19, 2010, 20-year-old Bennie F. Abram started his first day of football practice as a junior at the University of Mississippi. Several hours later he collapsed and died. Last month Abram’s family settled their wrongful-death lawsuit with Ole Miss, receiving $275,000 from the National Collegiate Athletic Association (NCAA) and $50,000 from the university.

Later in 2010, 20-year-old Jospin Milandu and 15-year-old Oliver Louis also died unexpectedly while working out with their teams. Autopsies of all three revealed one striking commonality: long, sickle-shaped blood cells that indicated they had at least one mutation for sickle-cell anemia, a genetic condition…

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How Do You Prevent Exertional Sickling?

Exertional sickling is a medical emergency occurring in athletes carrying the sickle cell trait. When the red blood cells(RBC) change shape or “sickle” this causes a build up of RBCs in small blood vessels, leading to decreased blood flow. The drop in blood flow leads to a breakdown of muscle tissue and cell death, known as fulminant rhabdomyolysis.

Recognizing Sickle Cell Trait versus Exertional Heat Illness

Given the potential risk of exertional sickling as a result of participation in competitive athletics it is important for athletic trainers, coaches and parents when an athlete may be in distress due to sickle cell trait complications. Making this more challenging is the potential for exertional sickling and sickling collapse to be confused with exertional heat illness. The ability to differentiate between the two will allow for proper emergency medical management decisions for the athlete in distress.

Reducing risk in sports: Sickle cell trait and sports

Although being involved in sports poses some risk, those carrying the sickle cell trait are often able to participate with proper education and precautions.

Exercising Caution: Intensive Athletic Activity Could Be Fatal to Those with Sickle-Cell Trait

Scientists are studying why some athletes with a sickle-cell mutation face a greater risk of sudden death.

Exertional Sickling: Potentially Life-Threatening Condition for Youth with Sickle Cell Trait

Exertional sickling collapse is an intensity syndrome. The common denominator is a "perfect storm" of irrational or unduly intense exercise, sustained for at least a few minutes; an intensity beyond the fitness level and/or physical limits of the athlete with sickle cell trait on that day in that setting.

Exertional sickling: questions and controversy

We believe that the lack of a consensus on the approach to ECAST poses an opportunity for additional research in both the understanding of the pathophysiology and of the risks linked to SCT, as well as the clinical approach to prevention, diagnosis and treatment of ECAST.

Sickle Cell Trait & Athletes

The National Athletic Trainers’ Association has created an infographic handout on sickle cell and athletes.

Sickle Cell Trait and Sudden Death

Sickle cell trait has long been considered a benign condition but continues to be the leading cause of death in young African Americans in military basic training and civilian organized sports. There continues to be a great deal of controversy surrounding sickle cell trait and its association with exercise-related morbidity and sudden death.

Sickle Cell Trait: What You Need to Know

For an individual who has SCT and completing intense exercise the biggest concern is a condition called exertional sickling (and the resulting sickling collapse). In exertional sickling the intense exercise causes normal the sickle shaped blood cells to “logjam” the blood vessels, slowing oxygen transport to the muscles.