Sickle cell trait: The silent killer
The task force recommended the following:

Athletes should gradually increase their training, allowing longer periods of rest and recovery between repetition of exercises. Players should participate in preseason conditioning programs, but they should not be forced to do timed performance tests such as mile runs or 100-yard sprints in rapid succession. If they do the timed drills, the athletes should have long periods of rest between sprints.

Athletes should be instructed to stop if they feel any unusual pain, cramping, swelling, weakness or inability to catch their breath.

Heat stress, dehydration, asthma, illnesses and altitude all can make athletes with sickle cell trait more vulnerable to a sickling collapse. Some supplements and energy drinks can contribute to dehydration, making the athlete more vulnerable to sickle cell trait complications.

Once an athlete begins to show signs of a sickling collapse, the person still can be saved. If the sickled, or warped cells, are exposed to oxygen relatively quickly, they can recover.

"Early and immediate intervention can resolve a small problem," Anderson said.

Coaches and trainers need to be aware that sickle cell trait is unpredictable. Two athletes with the trait can respond differently to the same workouts. And a sickle cell trait carrier can get through an extreme workout on one day and later have problems completing lighter workouts.

A variety of factors, including physical conditioning, hydration levels or a mild cold or allergies might cause one athlete with the trait to struggle more than others.

The task force suggested athletes with sickle cell trait should rest and drink water at the first sign of distress. If the athlete is not recovering, athletic trainers should check vital signs, administer high-flow oxygen and cool the athlete. If the person's vital signs decline, athletic trainers should call 911, attach an automated external defibrillator, start an IV to provide fluids and get the athlete to the hospital quickly.

Despite identifying 16 cases where people have died from trait complications during the past 14 years, Thogmartin said he firmly believes people can live normal lives if they have sickle cell trait.

"If I had it, I would not stop any activity or stop working out," he said. "You have to look at why these cases happen. I'd be careful at high altitudes, I'd be careful if I had a cold and was going on an airplane and I'd understand the steps I should take for treatment.

"But there's a reason these cases happen the most with college football players. There's a reason it happens to the good kids who are trying so hard to please their coaches. There are a lot of people out there with the trait who have self preservation instincts, who stop when they don't feel good. Their bodies recover on their own. It's the people who don't want to give up, who don't want to be anything less than perfect. They're the ones in danger if we don't educate them and their coaches about the trait. They're the ones who are dying."