Sickling collapse: What is it?

Hidden condition can cause death in student-athletes

By Jennifer Waugh - The Morning Show anchor, I-Team reporter

JACKSONVILLE, Fla. - As fall sports begin, parents need to be aware of the risks that come with sports activities and how to protect their children.

According to the Jacksonville Sports Medicine Program, a recent review of non-traumatic sports deaths in high school and college athletes revealed the top four killers (in order of occurrence):

  1. Cardiovascular conditions
  2. Hyperthermia (heatstroke)
  3. Acute Rhabdomyolysis, tied to the sickle cell trait
  4. Asthma

Acute Exertional Rhabdomyolysis is the least understood of these conditions. It condition occurs in athletes who carry the sickle cell trait and participate in extreme heat and intense exercise.

What is Sickle cell?

Sickle cell is an inherited disease. It's a genetic condition when the blood cell component, known as hemoglobin, which carries the oxygen, is mutated.

"When you have two mutated genes, that hemoglobin doesn't work so well at carrying the oxygen to the body. So imagine a red blood cell that sort of curves in on itself, or sickles, clogs up a lot of arteries and causes a lot of problems," said Dr. Nick Peterkin, of Baptist Medical Center.

While most people know if they have the disease, there are many people who are unaware that they could have the trait or gene. A person with this trait typically does not show any symptoms.

How dangerous is it to have the sickle cell trait?

The most recent sickling death was in 2006, when a freshman defensive back at Rice University collapsed after running 16 sprints of 100 yards each. He died the next morning. Up to 13 college football players have died of sickling collapse.

The danger is when a sickle cell trait carrier exercises. Sickling players may be on the field only briefly, sprinting only 800-1,600 meters and collapse. Sickling can also occur during repetitive running of hills or stadium steps, during intense sustained strength training, if the tempo increases late in the intense one-hour drills or at the end of practice when players run "gassers."

Sickling can even occur rarely in a game, as when a running back is in constant action during a long, frantic drive down the field.

Sickling collapse is not limited to football. It has occurred in distance racing and has killed or nearly killed several college or high school basketball players (two were women) in training, typically during "suicide sprints" on the court, laps on a track or a long training run.

Who is at greatest risk?

One in eight people of African decent can be a carrier of sickle cell.

"It is very common among people of African decent, Mediterranean or from the Middle East," Peterkin said. "While they should have been screened for the sickle cell trait at birth, some may not know they even carry the trait."

Symptoms and prevention of Sickling collapse?

Hydration is key.

"You want to stay hydrated, you want to take your water breaks," Peterkin said. "You need to know the symptoms like muscle cramping and muscle pain, and unusual cases of headache and blurry vision."

Sickling collapse is one of several risks to student-athletes that will be discussed Saturday from 4-6 p.m. at Raines High School. Several medical experts from the community will be at the Chartwell's All-Star Series and Jacksonville Sports Medicine Program Injury Prevention Zone before the Raines football game. Admission is free, but a ticket to the game is $7.

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