Sports Participation and Sickle Cell

September 07, 2008

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Sports Participation and Sickle Cell

by Lewis Hsu, M.D., Ph.D.
reviewed by Laura Jana, M.D., F.A.A.P.

How can my child with sickle cell tell whether pain has been caused by a sports injury or by the disease?

Sickle cell pains show up in certain places in the body because of blocked blood flow (vaso-occlusion) to those areas. Generally, pain affects the long bones and the vertebrae of adolescents with sickle cell, and the shin is a common location as well. Active youngsters need to pay particular attention to the hip, as damage to the ball of the hip joint (avascular necrosis) is extremely common in young adults with sickle cell and can be accelerated by repetitive injury from high-impact sports. If your child experiences pain in the hip or knee (which actually may be caused by hip problems), promptly see an orthopedist with sickle cell experience.

What will help make sports participation a more comfortable experience for my child?

Common triggers for increased sickle cell pain are dehydration, temperature extremes (both cold and heat), low oxygen, exhaustion, infection, and stress.

Keep your child well hydrated. He will always need to drink more than his peers who don't have sickle cell disease, and he needs to drink even more when physically active.

Be aware that anemia limits your child's endurance level, and being physically active will bring on the transition to anaerobic (low-oxygen) metabolism more quickly than in somebody without anemia. Anaerobic metabolism results in lactic acidosis, which causes cramping. Make sure that he takes a rest break every 20 minutes or so to reduce lactic acidosis.

If my child suffers a sprain or a strain during sports, how should I handle it?

In general, avoid using ice on musculoskeletal injuries, such as a jammed finger or a sprained ankle. Instead, apply a cool--not cold--compress to reduce the risk of constricting the blood vessels (vasoconstriction), which can aggravate pain in the area.

What sports are best suited to my child?

Look for activities that require concentration and skill rather than endurance. Golf, martial arts, skateboarding, bowling, table tennis, and fencing are all good bets. Swimming also is recommended because it's easy on the hip joints. Just take care to ensure that your child doesn't get chilled either in or out of the water, as it can trigger sickle cell pain.

Are any sports forbidden?

No. However, your child isn't likely to enjoy "extreme" or endurance sports (long-distance competitive racing, for example), which push the body to exhaustion and cause dehydration. Sports that involve cold temperatures (skiing, sky diving) or low oxygen (mountain climbing) will probably trigger sickle cell pain.

Is it OK to encourage my child to try out different activities and find his own limits?

Taking a more open, flexible approach has its pluses, but you and your child should be realistic about his options. Sports that demand a high level of endurance, such as basketball, probably won't work out over the long term. Many children with sickle cell who start out participating in such sports typically switch from the competitive level to a more recreational level in junior high or high school.

What sports might worsen my child's medical conditions?

If your child has avascular necrosis of the hip, sports that involve repetitive jumping (basketball, dance, and gymnastics, to name a few) may cause further injury to the hip joint. If he has a very enlarged spleen, contact sports (football, hockey, lacrosse, etc.) present a risk of rupturing the organ, but the level of danger depends on the level of sports competition. Most elementary-school-age children can't hit hard enough to actually damage the spleen.

A doctor familiar with sickle cell disease can help athletes--and potential athletes--further sort through these specific issues.


RELATED INFORMATION

			Sickle Cell Pain: Avoiding Dehydration, Exhaustion and Temperature Extremes
			The Importance of Fluids for Children with Sickle Cell Disease
			Sickle Cell Disease

Created February 04, 2001
Reviewed February 04, 2001

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