Anemia -- The HandicapThe “Invisible” Handicap

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Offline Andy Battaglia

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Anemia -- The HandicapThe “Invisible” Handicap
« on: June 27, 2010, 04:08:43 PM »
Anemia -- The HandicapThe “Invisible” Handicap
By Mr. Frank La Grassa, N.Y.C. Firefighter

I am anemic. I was diagnosed at age 36 when the New York City Fire Department detected it in a routine medical exam. Prior to this diagnosis, recollections of my high school experiences left me feeling uncomfortable, like I wasn't the athlete I should have been. Post diagnosis, I now realize that anemia was the reason I had low vitality and was short-winded. I thought, not wanting "to go", and not being able ―"to go" - as hard, as long, as often - meant there was a deficiency in my character and toughness. In the years after high school, driven by shame, I pushed in my workouts and acquired a 38 resting pulse. Obtaining a 38 resting pulse was not my objective, however. I had no interest in achieving that level of conditioning. I worked intensely simply to be like my teammates had been in high school. Needless to say, learning about my anemia and how it had affected me, was uplifting; and having a 38 resting pulse was at times helpful. In retrospect, a little less "good pulse" and a little more self-esteem would have been preferable. This experience along with the experiences of my son, who is also anemic and his dedicated coaches, have inspired me to write this article.
"He'd be toast!" John Underwood, former NCAA All-American distance runner, responding to the question, "Could an athlete with 10.3 grams of hemoglobin run distance races?" Anemia is a condition where blood, because of lower than normal levels of hemoglobin, is less able to transport oxygen to the muscles, resulting in symptoms such as low vitality and shortness of breath, thus having a significant impact on endurance activities.
In conversation about this article, Dr. Vincent Vigorita, M D, orthopedic pathologist, and professor of pathology and orthopedic surgery, SUNY Downstate Medical Center, Brooklyn, New York, offered "As a pathologist who knows what affects stamina, and, as former college lacrosse player and distance swimmer who knows why you need stamina, I feel both comfortable and obligated to assert that because of anemia's symptom of short-windedness, all else being equal, it is physiologically impossible for an anemic athlete competing in a high endurance sport to compete with the same optimal speed, quickness, agility, strength, and reflexes of his non-anemic opponent. Muscles fail without oxygen. Anemia, ‗the invisible handicap‘, hides, otherwise superior ability. Low vitality, another symptom of anemia, hides superior effort. There are days when all athletes suffer, when they are a little extra tired; with low vitality for the anemic athlete, the feeling of exhaustion can become an everyday occurrence."
Before going any further, it should be pointed out, that there is, what is called, SPORTS ANEMIA. It is an anemia that occurs when blood volume increases as a way for the body to adapt to the initiation of more physical activity. With this increase in blood volume, the hemoglobin measurement, being a proportion measurement, becomes smaller, giving the false impression of a drop in the actual amount of hemoglobin. It's a false, perceived anemia. The drop in hemoglobin is one to one and a half grams, and the drop lasts only about one month, or as long as it takes for the increased physical activity to become routine. It causes no impairment of oxygen transport because the reduced proportionate hemoglobin is offset by the greater perfusion (perfusion is the process of nutritive delivery of arterial blood to a capillary bed in the biological tissue from increased blood volume).
Therefore, when assessing athletes, be aware of anemia's symptoms; they can be invisible and misleading. Low vitality will make the anemic athlete appear to be putting forth less of an effort, when he is actually making a greater effort. Every physical act requires a greater strain when one has less energy and when one feels fatigue more easily and more often. With low vitality, the anemic athlete, who has an equal amount of commitment as his teammates, just might want to "...cut a practice..." Or, as Dr. Tommy Boone, former chairman of exercise physiology at the College of St. Scholastica in Duluth, Minnesota, points out "
...Hence athletes who are anemic are often challenged to deal with the physical demands of athletics without adequate oxygen. Often these athletes suffer severe fatigue. Only those with great determination and persistence survive in athletics...".
Short-windedness will, when the anemic athlete is competing in a highly endurance-dependent sport, make the anemic athlete appear to be less athletic. In the contests of endurance-dependent sports the body struggles to provide oxygen to the muscles. This struggle becomes greater as the contests progress. This struggle diminishes speed, quickness, agility, strength, and reflexes. While all athletes suffer this diminishment, as the body battles to keep up with the muscles demand for oxygen, the anemic athlete suffers more because his muscles become deprived of oxygen quicker: it's hemoglobin that transports oxygen to the muscles and it's hemoglobin in sufficient amounts which the anemic athlete lacks. Don't confuse less hemoglobin with less athleticism. An anemic wrestler, in matches against opponents who are equal to him in every way, but who are not anemic, will see early leads dissolve into losses. The longer a match continues the more the anemic wrestler's short-windedness becomes the deciding factor. When he loses, is it because he had less athleticism or because, through no fault of his own, he had less wind? After all, if he were that athlete with only 10.3 grams of hemoglobin referred to in the John Underwood quote, for him the third period is the fourth. According to exercise physiologists and what is known about stamina and oxygen transport, a 19% change in hemoglobin results in an 8% to 16% change in time to exhaustion.
More seriously, anemia's short-windedness will, when the anemic athlete is athletically superior and is perceived as such, make the anemic athlete appear to not be able to" reach down " and "give when there's seemingly nothing left to give", when in fact he is giving it all he is worth. This happens because of the tendency in sports to not correlate superior athleticism and short-windedness. When the athletically superior, faster, superbly conditioned - PROUD - but short-winded anemic halfback every day finishes, by the 18th windsprint, second to the tackles, he appears not short-winded, but rather of weak will. Perhaps he is; perhaps that halfback has not learned how to ―reach down ", as being anemic certainly doesn't mean one automatically has strength of will. Very possibly, though, if he is a disciplined worker, and bent over gasping, he has hit anemia‘s "invisible" physiological wall of short-windedness.
In conclusion, coaches need to care enough to set the bar high. Challenge your athletes to be disciplined, conditioned, skilled, and tough. However, as you do, if possible, try not to confuse less vitality with laziness, short-windedness with less athleticism, and a lack of blood with a lack of "heart".
Andy

All we are saying is give thals a chance.

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Offline Andy Battaglia

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Re: Anemia -- The HandicapThe “Invisible” Handicap
« Reply #1 on: June 27, 2010, 04:13:45 PM »
Thank you for the article, Frank.

Pete Sampras, one of the greatest, if not the greatest, of all tennis players is a thalassemia minor, a fact he kept hidden while he was playing professionally. Pete's strategy was to dispatch opponents as quickly as possible, so that he did not have to deal with opponents when his energy level began to wane. Of course, this is not possible in many sports that are timed, so we need to make coaches aware that those who suffer from a chronic state of anemia are not "dogging it" but simply don't have anything left to "reach down for" and that this needs to be taken into account when coaching athletes with anemia.
Andy

All we are saying is give thals a chance.

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Offline Andy Battaglia

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Re: Anemia -- The HandicapThe “Invisible” Handicap
« Reply #2 on: June 27, 2010, 04:36:01 PM »
The link to where the orginal article can be found. The newsletter is a pdf file so give it a moment to open.

 http://www.nysahperd.org/news/Winter_2010_NYSAHPERD_Newsletter.pdf
Andy

All we are saying is give thals a chance.

Re: Anemia -- The HandicapThe “Invisible” Handicap
« Reply #3 on: August 31, 2010, 08:27:14 PM »
That's a great article. I've always looked back on my sports career with disappointment. I always got the 'Coaches Award' for the best spirit, attitude and effort but never was an MVP. This article helps me realize that I really did achieve a lot; a lot that others don't and reminds me to observe and help my children more proactively.

 

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