Overview of Sickle Cell Trait
This is an inherited condition of abnormal hemoglobin production. This condition rarely results in a sickling crisis and is managed differently from sickle cell disease. An exertional sickling crisis usually occurs when athletes or military personnel with this condition overexert themselves, resulting in sickling of red blood cells, which causes clotting and ischemic rhabdomyolysis.1 Most individuals with sickle cell trait do not have painful crises and can participate in regular recreational and competitive activities, but abnormalities of red blood cell parameters may influence their aerobic exercise tolerance.2,3 Dehydration, viral illness, abrupt changes in altitude, and exercising in heat conditions are risk factors for developing exertional sickling.1,4
Comorbidities to Consider
Keys to Examination of Clients
If sickling crises occurs, monitor hemoglobin levels and renal function before allowing a return to strenuous training and competitive activities.4
Screen athletes for this condition so that if a crisis occurs, it can be identified and treated as a medical emergency.
Recommended Baseline Testing of Fitness Levels
Type: Aerobic and recreational activities
Intensity: No limitations
Frequency: No limitations
Clients can choose to participate in any type of recreational or competitive pursuits, but they should have proper conditioning to participate in activities and should be counseled on how to recognize symptoms of a sickling crisis.1 Counsel them to avoid all-out exertion of any activity for longer than 3 minutes and to use rest periods with full recovery when performing interval training.1 Clients should properly hydrate during exercise and adjust training programs for hot and humid conditions. They should be counseled to increase their training programs slowly to acclimatize to temperature, humidity, and altitude.1
ER. Sickle Cell Trait. J Sports Rehabil 16(3);197–203, 2007.
et al. Physiological responses of sickle cell trait carriers during exercise. Sports Med 38(11):931–946, 2008.
et al. Blood rheology abnormalities and vascular cell adhesion mechanisms in sickle cell trait carriers during exercise. Clin Hemorheol Microcirc 39:179–184, 2008.
KC. Exertional rhabdomyolysis and ...