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Injury/Illness of the Month

Sickle Cell Testing Mandated by NCAA

Sickle Cell Trait (SCT) is the inheritance of an abnormal gene which can cause deformation ("sickling") of the red blood cell. Approximately one in every 12 African-Americans has sickle cell trait (compared to ~ one in 2,000 to 12,000 white Americans). The gene for sickle cell trait is also present in individuals of Mediterranean, Middle Eastern, Indian, Caribbean and South / Central American ancestry. All newborns in the US are required to be screened for sickle cell.

SCT has been associated with exertional rhabdomyolysis, renal failure, as well as death, and complicating factors include extreme exertion, increased heat, altitude, and dehydration. Over a seven-year span, nine athletes participating in NCAA sports died as a complication of sickle cell trait. It is because of this that the NCAA now mandates testing or proof of testing prior to any practice, competition or conditioning.

Effective for the 2010-2011 academic year, the NCAA is implementing a requirement that participants have sickle cell testing performed, show proof of sickle cell testing, or sign a waiver demonstrating that they understand the importance of testing for sickle cell, decline testing, and thereby release their institution from any liability related to declining testing. This legislation is effective as of August 1, 2010 and is applicable to student-athletes who are beginning their initial year of eligibility and student-athletes trying out for a team, including transfers. Returning student-athletes are not required to be given the test.

Why get tested? This test (a blood test) is relatively easy to perform, and can provide educational information that can be helpful to you both on and off the field. It is helpful to know your sickle cell status and can allow health care professionals to take better care of you. If you were born in the U.S., your testing results may be available in your medical record; please consult your current provider and/or pediatrician. The Department of Health in your birth city can be an alternative source of testing conducted at birth.

What happens if I test positive? Athletes that are sickle cell trait positive are able to participate in sports, often with no modifications whatsoever. Individuals that test positive for sickle cell trait will have a confirmatory test performed, and if positive, will be counseled on what can be done to avoid complications.

Who will know that I test positive? Test results will be kept confidential in accordance with the law and Lafayette College policy, although Lafayette medical staff will need to be aware of your sickle cell status in order to provide optimal care of you during practice, competition and conditioning. Otherwise, your consent will be requested before information is released.

Is it mandatory that I have the sickle cell trait test? The recommendation of Lafayette College Sports Medicine is that every student athlete be tested or show proof of prior testing for sickle cell trait. This testing should be obtained at home prior to the school year. Bring a copy of your test results to your sports physical. Testing will be available on campus at the student athletes' expense. Testing is not mandatory.

Danger of Concussions Recognized by NCAA and Other Sports Organizations

Concussions have become a hot topic in the media recently. The NFL recently put in place a mandate that requires there be a poster about the risks of playing after suffering a concussion in every locker room. A concussion or Mild Traumatic Brain Injury (MTBI) is defined as a blow, impact, collision, or any trauma causing disruption in cerebral function or alteration in mental status.

Signs and symptoms include, but are not limited to: Vomiting, Sensitivity to light, Sadness, Imbalance, Sensitivity to noise, Fatigue Dizziness, Numbness/tingling, Difficulty remembering, nervousness, headache, difficulty concentrating, nausea, drowsiness, loss of consciousness

Student athletes are responsible for reporting their injuries and illnesses to the medical staff; including signs and symptoms of concussions (MTBI's). Signs and symptoms must be reported to the Lafayette College Sports Medicine staff immediately upon onset, before the continuation of any activity. Return to any activity will be determined by the Lafayette College Sports Medicine staff after proper evaluation. Concussions are to be taken lightly, return to play to soon after a concussion can lead to permanent brain damage.

NCAA Drug Testing Exception Policy for ADHD medications

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are common neurobehavioral disorders of childhood that can persist through adolescence and into adulthood. The most common medications used to treat ADD/ADHD are methylphenidate (Ritalin) and amphetamine (Adderal), both which are banned under the NCAA class of stimulants.

Recently, the NCAA has updated their policy regarding medical exceptions of banned drug classes. The NCAA bans performance enhancing drugs to protect the health and safety of student-athletes, and to ensure a level playing field. The NCAA also recognizes that some of these substances may be legitimately used as medication to treat student-athletes with learning disabilities and other medical conditions. The current policy can be found at:

August of 2009, to be considered for medical exception for a medication that contains a banned substance, the student-athlete must provide the required documentation from the prescribing physician:

Documentation of the diagnosis and how it was reached through diagnostic testing

Documentation of the treatment procedure, name of medication and dosage information and a copy of the current prescription

Statement that the student-athlete's medical history exhibits a need for regular use of the drug

List of alternative non-banned medications for the treatment of the condition that have been tried/considered

Statement that the student-athlete and prescribing physician agree that there is no other appropriate alternative medication treatment is available