“Having the sickle cell trait does not exclude an athlete from participating in sports, however, the training staff and coaches need to take precautions to ensure the athlete is not put in dangerous situations.”    Geno Atkins Cincinnati Bengals National Football League

Fall sports season has arrived and just in time for Sickle Cell Awareness Month!

Athletes at all levels, including high school, collegiate, Olympic and professional, can be affected with sickle cell trait. It’s important for athletes to be aware of their sickle cell trait status and take proper precautions during their training and conditioning so they can enjoy a successful and healthy athletic career.

What is Sickle Cell Trait?

Sickle cell trait is not a disease; it is inherited from a person’s parents. People who inherit one sickle cell gene and one normal gene have sickle cell trait. People with sickle cell trait usually do not have any of the symptoms of sickle cell disease, but they can pass the trait on to their children. Sickle cell trait affects people of many races and ethnicities, including those of African, Asian, Hispanic, Mediterranean, and Middle Eastern descent.

Should athletes be tested for sickle cell trait?

It is important for all Americans, including those involved in competitive athletics, to know whether they have sickle cell trait. If athletes do not know whether they have sickle cell trait, they should get voluntary testing to find out. However, counseling and/or testing for sickle cell should be done in a confidential manner, by a physician, and should occur before training and competition so athletes can understand the medical and genetic consequences of having sickle cell trait. If a screening test is positive for sickle cell trait, the athlete should consult with a genetic counselor or their physician to learn how it can affect their life, including health, athletics and family planning.

What are the complications for athletes with sickle cell trait?

According to the National Collegiate Athletic Association and the National Athletic Trainer’s Association, complications from sickle cell trait have been documented in various sports and training, including football, distance racing and during “suicide sprints” on the court, laps on a track, or a long training run. Some people with sickle cell trait are more likely than  those without sickle cell trait to experience  heat stroke and muscle breakdown when doing intense exercise, such as competitive sports or military training under unfavorable conditions or temperatures (very high or low).

In their extreme form and in rare cases, the following conditions could be harmful for people with sickle cell trait:

• Increased pressure in the atmosphere (e.g., while scuba diving)
• Low oxygen levels in the air (e.g., when mountain climbing, exercising extremely hard in military boot camp, or training for an athletic competition)
• Dehydration (e.g., too little water in the body)
• High altitudes (e.g., flying, mountain climbing, or visiting a city at a high altitude).

When athletes are pushed to their physical limits, sickle cell trait can be a threat to the athlete’s health. Pushing a person with sickle cell trait to exert beyond this point for “toughness” or discipline can lead to a fatal collapse.

What precautions should athletes with sickle cell trait take?

Athletes with sickle cell trait should be allowed to participate in competitive sports. People with sickle cell trait can play and participate in other intense activities (e.g., military training). However, they should take steps to help prevent problems, like drinking plenty of water and resting often.

People with sickle cell trait who participate in competitive or team sports (i.e. student athletes) should be careful when doing training or conditioning activities. To prevent illness it is important to:

• Set your own pace and build your intensity slowly
• Rest often in between repetitive sets and drills
• Drink plenty of water before, during and after training and conditioning activities
• Keep the body temperature cool when exercising in hot and humid temperatures by misting the body with water or going to an air conditioned area during breaks or rest periods
• Immediately seek medical care when feeling ill.

Additional Resources

CDC

• Learn more about sickle cell trait http://www.cdc.gov/ncbddd/sicklecell/traits.html
• Find out more about genetic counseling http://www.cdc.gov/ncbddd/pediatricgenetics/genetic_counseling.html
• Get some facts about sickle cell disease http://www.cdc.gov/ncbddd/sicklecell/facts.html
• Read Geno Atkins story, an NFL player for the Cincinnati Bengals who has sickle cell trait http://www.cdc.gov/Features/SickleGenoAtkins/

National Athletic Trainer’s Association

• Fact Sheet: Preventing Sudden Death in Collegiate Conditioning Sessions: Best Practices and Recommendations. http://www.nata.org/sites/default/files/factsheet.pdf
• Consensus Statement: Sickle Cell Trait and the Athlete http://www.nata.org/sites/default/files/SickleCellTraitAndTheAthlete.pdf

National Collegiate Athletic Association

• Sickle Cell Trait Web Page http://www.ncaa.org/wps/wcm/connect/public/NCAA/Health+and+Safety/Sickle+Cell/

By Dr. Althea Grant, BDO Sickle Cell Expert

Althea Grant, PhD, is Chief of the Epidemiology and Surveillance Branch in the Division of Blood Disorders of the National Center on Birth Defects and Developmental Disabilities. Dr. Grant has specifically been recognized for her contribution to developing public health programs and resources for sickle cell disease and sickle cell trait.

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