Salem State



A Fact Guide for Coaches SICKLE CELL TRAIT lefttopWhat is Sickle Cell Trait? Background: The sickle gene is common in people who are African-American (1:12). The sickle gene is also present in those of Mediterranean, Middle Eastern, Indian and Caribbean ancestry. It is not a disease. The sickle hemoglobin can change the shape of red cells from round to quarter-moon or “sickle”Facts:Sickle red cells can accumulate in the blood stream during intense exercise. These cells “logjam” blood vessels and lead to collapse from ischemic rhabdomyolysis (the rapid breakdown of muscles starved for blood). Sickling can begin 2-3 minutes of any all-out exertion.Heat, dehydration, altitude and asthma can increase the risk for and worsen sickling, even when exercise is not all out.444500021971000In sickle cell trait, strenuous exercise evokes four forces that in concert foster sickling, 1) severe hypoxemia, 2) metabolic acidosis, 3) hyperthermia in muscles, and 4) red-cell dehydrationSickling collapse is often misdiagnosed and is a medical emergencyThe Realistic Facts ALL Coaches should knowStudent-athletes with sickle cell trait should not be excluded from athletic participationSickling players may be on-field only briefly, sprinting only 800 meters, often early in the season.Sickling can occur during repetitive running of hills, during intense sustained strength training or at the end of practicesSickling can even occur rarely in games if a player is in constant actionlefttopUnlike heat-related or cardiac conditions, athletes with sickle cell trait may present as being fatigued and can often talk, but may be experiencing ischemic pain and weakness in their muscles. Pushing the athlete to continue beyond this point for “toughness” or discipline can lead to a fatal collapse.Sickling is often confused with heat cramping, but, athletes who have had both syndromes know the difference.Heat cramping often has a prodrome of muscle twinges, whereas, sickling has none41986204127500The pain is different- heat cramping pain is more excruciatingWhat stops the athlete is different- heat cramps hobble to a halt with “locked up” muscles, while a sickling player with slump to the ground with weak musclesThe Role of the Coaching Staff: Coaches should know the signs and symptoms of a sickling situation and an athlete in distress. Coaches should conduct appropriate sport specific conditioning based on sound scientific principles.Student athletes can begin to experience symptoms after only 1-3 minutes of sprinting, or in any other full exertion of sustained effort, thus quickly increasing the risk of complications. Many times, these complications occur when athletes are being pushed beyond their physiological limit while already-compromised position.Precautions and TreatmentSlowly build up their intensity while training. Use paced progression and longer recovery times.Have fitness tests scheduled later in the training program, not the first day back from summer or extended break. Evaluate performance once they are acclimated to the stress about to be placed on them.lefttopEncourage participation in preseason strength training sessions (on own) to enhance preparedness and performance testing should be sport specific. Athletes with sickle cell trait should be excluded from participation in performance tests such as mile runs, serial sprints, etc.Cessation of activity with onset of symptoms {muscle “cramping”, pain, swelling, weakness, inability to “catch breath”, fatigue}Provide adequate rest and recovery between repetitions especially during “gassers” and intense “station drills”Ambient heat stress, dehydration, asthma, illness and altitude predispose the athlete with sickle trait to an onset of crisis in physical exertion.Adjust work/rest cycles for environmental heat stressEmphasize hydration. Instruct athletes to refrain from consuming high caffeine energy drinks and supplements or other stimulates as they may contribute to dehydration.Control asthmaWatch closely the athlete with sickle cell trait who is new to altitude. Modify training and have supplemental oxygen available for consumption.Create an environment and rapport with athletes that encourages them to report any symptoms immediately to you and/or medical staff. Leg or low back cramping and/or pain should be assumed to be a sickling response422910055880Planning for an emergency/ collapseIn the event of a sickling collapse, treat it as a medical emergency and do the following:Check vital signs (circulation, airway, breathing)Cool the athlete if necessaryActivate EMS by calling campus police 978-542-6111Obtain AED and utilize if necessaryTell the responders to expect explosive rhabdomyolysis and medical complicationsPlanned emergency response and prompt access to medical care are critical components to ensure adequate response to and athlete who collapses. Knowledge of a student-athletes sickle cell trait status should facilitate prompt and appropriate medical care. Coaches should know the University’s Emergency Action Plan (EAP). All coaches and staff should be certified in first aid and CPR. ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download