Jan 29, 2015
Bulletin Board

NCAA Recommends Sickle Cell Testing–Is a Mandate On the Way?

In June, the NCAA released a new recommendation calling on member schools that don’t already test athletes for sickle cell trait to begin doing so. And if the association adopts proposed legislation, that testing could soon become mandatory.

The recommendation was handed down by the NCAA’s Committee on Competitive Safeguards and Medical Aspects of Sports, and follows similar calls for more testing from the NATA and the College of American Pathologists. To help programs understand sickle cell trait and the danger it poses to athletes, the NCAA will also produce a video about the condition, which will be posted online and made available to all member institutions.

“The recommendation will help because it gives us a very important point of information,” Scott Anderson, ATC, Head Athletic Trainer at the University of Oklahoma and co-chair of the NATA’s sickle cell task force, told the Orlando Sentinel. “Certainly from my perspective and my role in raising awareness toward sickle cell trait in the athlete, it makes absolute sense that we would have this [recommendation].”

While the NCAA hopes its latest step will spur more schools to begin testing voluntarily (a recent NATA survey found that 36 percent of Division I Football Bowl Subdivision members still don’t test), a proposal from Rice University is aiming to force their hand. Rice will soon introduce legislation that would make testing mandatory for NCAA institutions, and it could be voted on as early as next year.

Both the NCAA’s recommendation and Rice’s forthcoming proposal are part of the settlement in a wrongful death lawsuit brought by the family of Rice football player Dale Lloyd II, who died in Sept. 2006 following a team workout. The medical examiner’s report linked Lloyd’s death to sickle cell trait, which Rice did not test for at the time.

Sickle cell trait testing is inexpensive–typically around $5 for an initial test and $35 for a confirmation. Athletes found to have the condition can still participate in any sport, but extra safeguards are recommended, such as special emphasis on hydration, progressive acclimatization, and adequate rest and recovery between bouts of effort. The NATA released a consensus statement on sickle cell trait in 2007, identifying it as the third-leading cause of non-traumatic sports deaths in high school and college athletes.

To download the NATA’s sickle cell trait consensus statement, which contains information and advice on managing the condition, go to: www.nata.org/statements/consensus/sicklecell.pdf.

Menstrual Cycle Affects Knee Joint Laxity

A recent study from kinesiology researchers at the University of Calgary found that a relationship does exist between a woman’s monthly hormone cycle and the laxity of her knee joints. However, this laxity occurs at different points in the cycle for different women, which may be why earlier research found little evidence of such a link.

In the study, published as a series of papers in the British Journal of Sports Medicine and the American Journal of Sports Medicine, 26 women were monitored through the entire course of their monthly cycles. At each phase, the women performed a battery of athletic movements, such as quick jumps and sharp cuts. The researchers found that 14 subjects exhibited the greatest amount of laxity during ovulation, 10 showed it during the follicular phase (the roughly eight days immediately before ovulation), and two others had laxest joints in the luteal phase (the roughly 11 days immediately after ovulation). Based on these results, the researchers concluded there is a direct (though inconsistent) relationship between increased knee laxity and hormonal phase, suggesting that women are at greater risk for knee injuries at certain times during their monthly cycle.

“What this shows us is that the connection between the hormonal cycle and knee laxity is not a cookie-cutter relationship,” Darren Stefanyshyn, PhD, Professor of Kinesiology at Calgary and one of the study’s lead authors, said in a statement. “Individuals have significant differences and I think that finding out why these differences occur could go a long way to helping athletes understand if they are more at risk and perhaps designing interventions to help prevent injury.”

A New Warning About Nitrite Doping

Sports medicine professionals can add yet another drug to the list of potentially harmful performance-enhancing substances. Designed to treat heart and blood disorders, nitrites are also found in prescription drugs that treat erectile dysfunction, and according to several recent reports, they are fast gaining favor in the sports world as a performance enhancer.

Currently, nitrites are not on the list of substances banned by the NCAA or any international athletic governing body, so they aren’t looked for in doping tests. But Declan Naughton, PhD, Professor of Biomolecular Sciences at Kingston University in England, warns that nitrite use–which some athletes believe improves blood flow to muscles during activity–could prove dangerous and even fatal.

“Nitrite has enormous potential as a treatment for diseases characterized by inadequate blood supply, but if taken in supplement form without clinical supervision, nitrite may lead to a number of serious side effects, including cardiovascular collapse, coma, convulsions, and death,” Naughton told attendees during a May conference at Kingston called The Dark Side of Sport: Chemical Enhancement of Athletic Performance. “Based on current research on the levels of abuse of performance enhancing drugs by athletes, the future uptake of this drug by the athletic community is of real concern.”

Andrea Petroczi, PhD, a public health researcher at Kingston, backed up Naughton’s concerns about athletes using nitrites. She recently examined the UK Sport Drug Information Database, a system that gives athletes, coaches, and team physicians access to information on pharmaceutical use, and found that in the months leading up to the 2008 Beijing Olympics, checks on medication for erectile dysfunction nearly doubled compared to the previous two years.

The take-home message from this latest warning is simple: Athletes should be cautioned about the dangers of seeking performance enhancement through pharmaceuticals. In addition, they should be reminded that just because a substance is not banned by their sport’s governing body, that does not mean it’s safe for unsupervised experimentation.

Sports Med Group Returning Fees, Working Pro Bono

In these tough economic times, many schools could use a helping hand. That’s exactly what Delaware Valley High School in Philadelphia recently received from the group that provides its athletic training coverage. Recognizing that the school is facing financial troubles, Orthopedic Associates of the Greater Lehigh Valley, based in Phillipsburg, N.J., and Easton, Pa., decided to work for free.

In addition to waiving its coverage fee for the upcoming year, Orthopedic Associates also donated $6,000 to the school–a figure that represents what Delaware Valley had paid for services during the 2008-09 school year. Nicholas Avallone, MD, an orthopedic surgeon at the clinic who provides game coverage to the school’s football team, presented a check to the Delaware Valley school board in June.

Avallone, who played football at Princeton University, told the Hunterdon County Democrat that when schools are struggling to pay their bills, he considers pro bono work to be part of his duty to the community. “Taking care of the kids is a top priority for us as physicians,” he said. “We’re fortunate to be a busy practice and can give back to the community we’re serving. I enjoy doing this very much… It’s a passion of mine to take care of athletes.”

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