Debating Smelling Salts

December 11, 2018

Smelling salts are not an uncommon find on the sidelines of many professional sports teams. Dallas Cowboys quarterback Dak Prescott says he uses them before every game, and former NHL star Jeremy Roenick was also a fan during his playing days. But what do sports medicine professionals say about the salts?

“In the medical community it is not something that is used. It’s more like folklore medicine,” Erin Manning, MD, Assistant Attending Neurologist at the Hospital for Special Surgery in New York City, told USA Today. “People think it helps them, and sometimes that’s enough to help somebody.”

Though Scott Anderson, ATC, Head Athletic Trainer at the University of Oklahoma, knows of teams who utilize smelling salts “to get guys hyped up,” he told USA Today that it’s not a common practice among medical staffs.

“I don’t know anybody in sports medicine who uses ‘em,” Anderson said.

Dr. Manning further explained that the use of smelling salts is highly inadvisable in cases of concussions, which is a reason for its unpopularity in the sports medicine community.

“It’s not going to change the underlying process of the concussion,” she said. “It’s possible that there could be mild symptoms in the beginning and it could make them harder to find. If it was going to mask symptoms it would be for a very brief period of time.”

Ryan Yelle, DPT, PT, OCS, Regional Clinical Director of Professional Physical Therapy in New York City, seconds Dr. Manning’s notion, explaining that smelling salts could prohibit an athletic trainer or medical professional from knowing the full extent of a player’s injury. According to Yelle, that’s exactly why first responders don’t use them.

“If someone is unconscious and has sustained a more serious injury, possibly to (his) spinal cord,” Yelle said, “having him wake up suddenly and having a jerky (awakening), might injure him further.”

However, not all medical professionals are totally against players using smelling salts. Stan Wong, ATC, a former 16-year athletic trainer in the NHL who now works with USA Hockey, keeps at least 20 smelling salt capsules on hand because his players will often ask for a “sniffer.”

“Put your nose by an open bottle of ammonia and that’s what it’s like. It’s like a hit of Mr. Clean,” Wong said. “Some guys get bug-eyed. It’s a routine pattern, not an addictive pattern. It’s an emotional wake-up (call).”

Roenick agrees, citing his experiences as a player who used them.

“They jolt your mind, your brain. It gets you into the moment,” he said. “It happens a lot in the (NHL).”

Regardless of where people stand on the smelling salt habit, the good news for players who use them is there doesn’t appear to be any negative lasting impact.

“In terms of long-term effects, there really shouldn’t be any,” said Dr. Manning.

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