Differential Sweat And Urine Electrolyte Reponses In Collegiate Football Players With Sickle Cell Trait

American football athletes are frequently hypohydrated before and during activity. Hypohydration increases the risk of exertional sickling in student-athletes with sickle cell trait (SCT). The authors examined weight charts from the 2010/2011 to 2018/2019 seasons at one Division I institution to determine if differences in percentage body mass losses (%BML) exist between those with and without SCT. Seventeen student-athletes with SCT and 17 matched-controls were included. A Bonferroni correction was applied to account for multiple comparisons (0.05/8), resulting in p < .006 considered significant. There was a significant difference for %BML between groups (SCT: 0.84 ± 0.65% vs. control: 1.21 ± 0.71%; p = .002) but not for the number of days %BML exceeded 2% (SCT: 0 ± 1 vs. control: 1 ± 1; p = .016). Implementation of proper hydration strategies minimized %BML in athletes with SCT, decreasing the risk of hypohydration and exertional sickling. The same strategies ensured all players remained below threshold to optimize performance and reduce heat illness risk.

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NCAA Football Off-Season Training: Unanswered Prayers… A Prayer Answered

Journal of Athletic Training ◽

10.4085/1062-6050-52.3.02 ◽

2017 ◽

Vol 52 (2) ◽

pp. 145-148 ◽

Cited By ~ 10

Author(s):

Scott Anderson

Keyword(s):

Sickle Cell ◽

Best Practice ◽

National Collegiate Athletic Association ◽

Sickle Cell Trait ◽

Exercise Physiology ◽

Heat Stroke ◽

Football Players ◽

Sport Training ◽

Training Standards ◽

Collegiate Football

Off-season training in year-round collegiate football is purported to be performance enhancing. Absent principles of exercise physiology, excesses in sport-training regimens pose risk to the participant athletes. Since 2000, 33 National Collegiate Athletic Association (NCAA) football players have died in sport: 27 nontraumatic deaths and 6 traumatic deaths, a ratio of 4.5 nontraumatic deaths for every traumatic death. On average, 2 NCAA football players die per season. Best practices, consensus guidelines, and precautions are ignored, elevating the risk. However, standards exist that will, if heeded, prevent nontraumatic death in athletes training for sport. Sickle cell trait status knowledge and tailored precautions are preventing deaths from exertional collapse associated with sickle cell trait. Adherence to established principles of exercise physiology and best-practice training standards, which is long overdue, will help to prevent not only deaths from exertional collapse associated with sickle cell trait but also sudden cardiac, exertional heat stroke, and asthma deaths.

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Perceived Energy and Well Being in Collegiate Football Players with and without Sickle Cell Trait

Medicine & Science in Sports & Exercise ◽

10.1249/01.mss.0000561480.12514.a1 ◽

2019 ◽

Vol 51 (Supplement) ◽

pp. 324

Author(s):

Matt Martone ◽

Shelly Mullenix ◽

Nathan Lemoine ◽

Jack Marucci ◽

Derek Calvert ◽

...

Keyword(s):

Sickle Cell ◽

Sickle Cell Trait ◽

Well Being ◽

Football Players ◽

Collegiate Football

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NCAA Division I American football players with sickle cell trait have altered hematological responses and hydration status

Scientific Reports ◽

10.1038/s41598-021-81473-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Haoyan Wang ◽

Matt Martone ◽

Michael E. Owens ◽

Nathan P. Lemoine ◽

Jack Marucci ◽

...

Keyword(s):

Uric Acid ◽

Specific Gravity ◽

Sickle Cell ◽

Ncaa Division I ◽

Sickle Cell Trait ◽

American Football ◽

Division I ◽

Urine Specific Gravity ◽

Hydration Status ◽

Football Players

AbstractSickle cell trait (SCT) is a risk factor of collapse and sudden death in athletes. We conducted a longitudinal study to determine the hematological responses and hydration status in NCAA Division I American football players with SCT. The study took place over 2 years with 6 SCT and 6 position-matched controls (CON) in year 1; and 4 SCT and 4 CON in year 2. In year 2, three of the four SCT players were recruited and re-enrolled with new position-matched controls (total sample data = 10 SCT and 10 CON). Blood samples were taken at three visits: pre-camp, post-camp, and post-season to examine hemoglobin variants, complete blood counts, and chemistry panel 26. Hydration status was assessed by measuring body weight change, urine specific gravity, and urine and sweat electrolyte concentrations during the pre-season training camp. All SCT players were confirmed to have SCT (HbS = 37.9 ± 2.4%) and had greater red cell distribution width (RDW) compared to CON across all visits. Serum uric acid was higher in SCT (7.3 ± 1.0 mg/dL) compared to CON (6.1 ± 0.6 mg/dL; p = 0.001). Furthermore, serum creatine kinase levels were greater in SCT (1617.0 ± 1034.8 IU/L) at pre-camp compared to CON (1037.4 ± 602.8 IU/L; p = 0.03). SCT players exhibited lower pre- and post-practice urine electrolytes and urine specific gravity (SCT pre: 1.019 ± 0.005 vs. CON pre: 1.026 ± 0.008 p < 0.001; SCT post: 1.020 ± 0.005 vs. CON post: 1.030 ± 0.008 p < 0.01), whereas sweat sodium concentrations were higher in SCT players (55.4 ± 13.6 mmol/L) compared to CON (45.5 ± 10.6 mmol/L; p < 0.001). Given the evidence, greater uric acid and CPK levels in SCT players compared to CON may be an early indicator of altered kidney function and muscle damage, which could be added into NCAA guidelines for surveillance among SCT players. Consistent education and reinforcement of the importance of adequate fluid balance during exercise are critical for both SCT and CON players.

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Acute Lumbar Paraspinal Myonecrosis in Football Players with Sickle Cell Trait

Medicine & Science in Sports & Exercise ◽

10.1249/mss.0000000000001167 ◽

2017 ◽

Vol 49 (4) ◽

pp. 627-632 ◽

Cited By ~ 1

Author(s):

E. RANDY EICHNER ◽

BROCK SCHNEBEL ◽

SCOTT ANDERSON ◽

JAMES R. CLUGSTON ◽

MATTHEW HEATH HALE ◽

...

Keyword(s):

Sickle Cell ◽

Sickle Cell Trait ◽

Football Players

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Exertional Sickling in Football Players with Sickle Cell Trait

Football Injuries ◽

10.1007/978-3-030-54875-9_16 ◽

2021 ◽

pp. 311-322

Author(s):

Scott Anderson ◽

E. Randy Eichner

Keyword(s):

Sickle Cell ◽

Sickle Cell Trait ◽

Football Players

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Sickle Cell Trait

Journal of Sport Rehabilitation ◽

10.1123/jsr.16.3.197 ◽

2007 ◽

Vol 16 (3) ◽

pp. 197-203 ◽

Cited By ~ 31

Author(s):

E. Randy Eichner

Keyword(s):

Blood Vessels ◽

Sickle Cell ◽

Sickle Cell Trait ◽

Exercise Physiology ◽

Warning Signs ◽

Medical Emergency ◽

Football Players ◽

Intense Exercise ◽

Sickle Cells ◽

The Past

Sickle cell trait can pose a grave risk for some athletes. In the past few years, exertional sickling has killed nine athletes, including five college football players in training. Exercise-physiology research shows how and why sickle red cells can accumulate in the bloodstream during intense exercise bouts. Sickle cells can “logjam” blood vessels and lead to collapse from ischemic rhabdomyolysis. Diverse clinical and metabolic problems from explosive rhabdomyolysis can threaten life. Sickling can begin in 2-3 minutes of any all-out exertion, or during sustained intense exertion – and can reach grave levels very soon thereafter if the athlete struggles on or is urged on by coaches despite warning signs. Heat, dehydration, altitude, and asthma can increase the risk for and worsen sickling. This exertional sickling syndrome, however, is unique and in the field can be distinguished from heat illnesses. Sickling collapse is a medical emergency. Fortunately, screening and precautions can prevent sickling collapse and enable sickle-trait athletes to thrive in their sports.

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