National Athletic Trainer’s Association Precautions and Treatment

No sickle-trait athlete is ever disqualified, because simple precautions seem to suffice. For the athlete with sickle cell trait, the following guidelines should be adhered to:

 1.Build up slowly in training with paced progressions, allowing longer periods of rest and recovery between repetitions.

 2.Encourage participation in preseason strength and conditioning programs to enhance the preparedness of athletes for performance testing which should be sports-specific. Athletes with sickle cell trait should be excluded from participation in performance tests such as mile runs, serial sprints, etc., as several deaths have occurred from participation in this setting.

 3. Cessation of activity with onset of symptoms [muscle ‘cramping’, pain, swelling, weakness, tenderness; inability to “catch breath”, fatigue].

4.If sickle-trait athletes can set their own pace, they seem to do fine.

 5.All athletes should participate in a year-round, periodized strength and conditioning program that is consistent with individual needs, goals, abilities and sport-specific demands. Athletes with sickle cell trait who perform repetitive high-speed sprints and/or interval training that induces high levels of lactic acid should be allowed extended recovery between repetitions since this type of conditioning poses special risk to these athletes.

 6.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 stress

-Emphasize hydration

-Control asthma

-No workout if an athlete with sickle trait is ill

-Watch closely the athlete with sickle cell trait who is new to altitude. Modify training and have supplemental oxygen available for competitions.

 7.Educate to create an environment that encourages athletes with sickle cell trait to report any symptoms immediately; any signs or symptoms such as fatigue, difficulty breathing, leg or low back pain, or leg or low back cramping in an athlete with sickle cell trait should be assumed to be sickling.

 In the event of a sickling collapse, treat it as a medical emergency by doing the following:

 1.Check vital signs.

2.Administer high-flow oxygen, 15 l pm (if available), with a non-rebreather face mask.

3.Cool the athlete, if necessary.

4.If the athlete is obtunded or as vital signs decline, call 911, attach an AED, start an IV, and get the athlete to the hospital fast.

5.Tell the doctors to expect explosive rhabdomyolysis and grave metabolic complications.

6.Proactively prepare by having an Emergency Action Plan and appropriate emergency equipment for all practices and competitions.

 Source: NATA Consensus Development Document  *The NATA’s recommendations posted on the NATA website and are provided for your information only. Providing this information to you does not translate to an endorsement of these recommendations by the SCDAA or the Sickle Cell Foundation of Georgia, Inc.