Exertional Sickling in Athletes: Etiology and Recognition
Presented by Susan Yeargin and Clint Haggard
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Susan Yeargin receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Clint Haggard has no competing non-financial interests or relationships with regard to the content presented in this course.
Non-Financial: Susan Yeargin serves on the Korey Stringer Institute Medical and Science Advisory Board, and is a faculty member at the University of South Carolina.
Sickle cell trait (SCT) is a genetic condition that affects athletes and other active populations when they engage in exercise. Specifically, it is a common hemoglobinopathy that can have significant mortality or morbidity consequences if the exertional sickling event is not recognized. Clinicians will feel confident in choosing the best screening method for their institution, become aware of the current screening mandates, and learn the foundation of policies to develop regarding SCT testing. Clinicians will also become knowledgeable in the variety of ways exertional sickling can present clinically and how to differentiate it from other conditions. This course relates to athletic trainers who work in different clinical settings (for example, all organized sports and military), board-certified sports physicians, strength and conditioning coaches, and board-certified sports physical therapists who work in any level of organized sport.
Meet your instructors
Susan Yeargin
Susan Yeargin is an associate professor of athletic training at the University of South Carolina. She serves on NATA’s pronouncements and research committees. She was a task force member and author of the “Preseason Heat-Acclimatization Guidelines for Secondary School Athletics” and a coauthor of the recent NATA position…
Clint Haggard
Clint Haggard is in his 12th season at the University of South Carolina. He was named head football athletic trainer on July 22, 2009. Prior to his arrival in Columbia, South Carolina, Haggard served as the assistant athletics director for medical services/head athletic trainer at Rice University, a position he held from 2006…
Chapters & learning objectives
1. Definitions and Genetics
The definitions for sickle cell trait (SCT) and sickle cell disease (SCD) are provided with clear differentiation between the two. The origins of sickle cell hemoglobinopathies are clarified in historical context as well as global prevalance. An explanation of how SCT and SCD are genetically passed down is provided for clinicians to use when educating their patients.
2. Testing
The two most common ways to test for sickle cell trait are described. Advantages and disadvantages of both tests are discussed for clinicians to determine which is the best option for their institution. False positive rates of each test are also provided.
3. Hemoglobin Profiles
The typical hemoglobin profiles given on lab reports are broken down into types and ranges. Atypical profiles are presented to explain their significance in relation to SCT and SCD as well as other possible hemoglobinopathies.
4. Screening
The United States’ national newborn screening mandate for sickle cell hemoglobinopathies is reviewed along with basic information for how to obtain a copy of these records. Organization mandates for SCT screening are discussed in terms of testing and education. Examples of how to integrate SCT screening into institutional policy are provided.
5. Etiology
The etiology and most common circumstances for exertional sickling are examined. The pathophysiology of how an exertional sickling event begins and how it can become a life-threatening emergency is demonstrated. Clinical ramifications of an untreated exertional sickling event are outlined.
6. Epidemiology
Research pertaining to the prevalence of SCT in active populations is presented along with evidence supporting successful training and competition. Risk of death during exercise in individuals with SCT is reported in different clinical settings.
7. Recognition
The definitions of exertional sickling events are described. Signs, symptoms, and vitals to be monitored during a sickling event are reviewed. Exertional sickling symptoms are compared to and differentiated from symptoms of other conditions that are similar.
