This article is part of The Athletic’s series to mark British Black History Month. Click here to view the entire collection.
Lassana Diarra was preparing for the 2010 World Cup in South Africa.
The midfielder, who previously played for Chelsea, Arsenal and Portsmouth in the Premier League, was coming off a difficult first season at Real Madrid. In the 2009–10 season, he played 30 games in all competitions for Manuel Pellegrini’s side, who finished second in La Liga, three points behind Barcelona. They were also eliminated in the last 16 of the Champions League against Lyon.
Diarra, 25, joined a France squad that included Thierry Henry, Franck Ribery, Hugo Lloris, Nicolas Anelka and Karim Benzema in a pre-competition training camp, hoping to continue his impressive run with the club. Ta. Tignes was chosen as a destination because of its high altitude and its imitation of conditions in South Africa.
But on May 22, 2010, his hopes of playing on the world stage were dashed.
“In addition to the intestinal pain he developed on the Tignes glacier, tests revealed unexpected signs of illness that warrant an indeterminate period of rest,” the French Football Federation said in a statement.
Diarra’s diagnosis was later confirmed as sickle cell anemia.
Diarra playing for Real Madrid in 2010 (Elisa Estrada/Real Madrid, via Getty Images)
The National Heart, Lung, and Blood Institute (NHLBI) recognizes sickle cell disease (the most common disease is called sickle cell anemia) as a group of genetic disorders that affect hemoglobin, the main protein that carries oxygen to red blood cells. Defined. In sickle cell disease, a genetic mutation that affects the hemoglobin molecule causes red blood cells to have an abnormal shape, usually a crescent or “sickle” shape. When red blood cells become sickled, they can’t bend or move as easily, which can block blood flow to other parts of the body.
Symptoms include painful episodes called sickle cell crisis, increased risk of serious infections, and anemia, where red blood cells can’t carry enough oxygen around the body, causing fatigue and shortness of breath. Possibly.
According to US medical information provider Healthline, black people are at a much higher risk of developing sickle cell disease. Researchers say the reason lies in how the condition evolved over time to protect against malaria, which is most common in sub-Saharan Africa, where sickle cell is endemic. That’s what I think. Having the sickle cell trait helps reduce the severity of malaria.
Sickle cell characteristics are found in one in four West Africans and one in 10 people of Afro-Caribbean descent. It is also found in people from the Mediterranean, Asia, and the Middle East. It is less common in white Europeans.
Sickle cell disease and sickle cell traits are different. People with sickle cell trait have only one copy of the altered hemoglobin gene and have few clinical symptoms associated with the disease, but people with the disease have two copies.
The American Society of Hematology states that more than 100 million people worldwide have sickle cell characteristics.
Despite how common sickle cell is and its sometimes fatal consequences, sickle cell is still a relatively unknown disease and its impact on sports performance is still largely unknown. Not known.
Part of the conclusion of a study conducted by the British Journal of Sports Medicine (BJSM) in 2014, “A Case Study of Two Premiership Soccer Players with Sickle Cell Characteristics,” was that “further research requires Further research with larger cohorts is needed.” “Establishing a relationship between redox homeostasis (defined as the maintenance of a balance between reductive and oxidative reactions within cells) and sickle cell trait in athletes.”
BJSM did not respond to requests for comment from The Athletic.
Geno Atkins, a former defensive tackle for the NFL’s Cincinnati Bengals, spoke about his experience with this trait earlier this year. “I prayed that I wouldn’t be drafted by the University of Denver, which is at high altitude, because I knew from research that playing at high altitude was not good for me,” he told the Centers for Disease Control and Prevention (CDC). “I ended up going to Cincinnati and was able to play at a very high level without the negative effects of the sickle cell trait.”
Furthermore, he added: “Having sickle cell trait does not prevent an athlete from participating in their sport. However, training staff and coaches must take precautions to avoid putting athletes in dangerous situations. In this case, Atkins used the example of training in extreme heat.
Former Bengals defensive tackle Geno Atkins (Ian Johnson/Icon Sportswire via Getty Images)
Professional basketball player Billy Garrett Jr. and former NFL running back Tiki Barber are two prominent athletes with the disease, and more recently Buffalo Bills wide receiver John Brown also has the trait. I have it.
Dr. Mark Gillett, a sports and exercise medicine consultant, told The Athletic: Actually, I haven’t seen it much. I’m surprised you haven’t. I think a player with full-blown sickle cell disease would have a hard time competing at that level just because of the physical demands of the game.
“At the same time, if you have sickle cell trait, you have a type of disease where extreme physical stress, altitude, hydration causes some symptoms. We see players like that. Maybe you just don’t realize it.
“Most Premier League football clubs are very keen on how they select their players. I think players who are at risk would have completed a profile. If they have sickle cell characteristics, the doctor You know that, and I think that happens a lot at the grassroots level.”
Raymond Domenech, the France national team manager at the time, cited Altitude when discussing his decision to withdraw from the 2010 Diarra World Cup.
“He wasn’t physically ready. He was really exhausted,” he said. “This illness was caused by the high altitude. He had a tendency that we could not have detected in advance. He will need 15 days of adequate rest to fully recover, but he will definitely recover. It won’t affect the rest of his career, but he is not fit to play in the World Cup.” Diarra did not respond to inquiries from The Athletic for comment.
Diarra (left) speaks with Domenech during France’s pre-2010 World Cup training camp (Frank Fife/AFP via Getty Images)
When asked how top-level teams would react to a player with the disease, Gillett said: We need to talk to players about it and make sure their treatment is optimized.
“This will be a concern for players and clubs, especially as we approach the end of the season, when the weather gets hotter and dehydration becomes more likely. It’s certainly an added stress for them. It’s hard enough to be a Premier League footballer without having to deal with that.”
The extent of Diarra’s illness was later recognized by his club at the time, Real Madrid. In a statement, Diarra said: “Due to asthenic syndrome secondary to sickle cell anemia, he will undergo hematological studies (the study of blood and blood disorders) at the Lyon Hospital and is currently resting at home on the advice of his doctors. “We are working on it,” he announced.
Valerie Davies, a hemoglobinopathic nurse counselor at Wolverhampton’s Sickle Cell Thalassemia Support Project, said she hoped football authorities would step up efforts to raise awareness of the disease and educate people within the sport. I hope.
“We need sessions encouraging everyone to get tested, regardless of their ethnicity,” she says. “It is often thought that only certain ethnic groups, such as those from Africa or the Caribbean, can be affected by this disease. The truth is that anyone can be affected. Anyone who has hemoglobin and red blood cells can be affected by sickle cell. Although it is least likely for people without such a background, it can affect anyone.
“This could be the start of encouraging everyone who participates in sports to get tested, so they can make further efforts to bring in experts to talk about this disease. For many years, there has been a stigma attached to this disease, but that shouldn’t be the case. This could help highlight the importance of screening if someone is a carrier. Even if you do, it’s usually not a problem; as long as you’re rested, hydrated, and nourished, you can lead a completely normal life.
“If you have a good lifestyle, even people with a career can go far in football without any problems, even if they are affected by serious conditions. We recommend never rejecting an athlete on the basis of being a carrier of the red blood cell gene, but even a full-fledged condition with conditioning and support will not prevent him from reaching the top.
In 2022, former England international Emile Heskey discovered that two of his children carry the sickle cell gene. He started donating blood and encouraged other black blood donors to not only register but also get tested for symptoms.
Emile Heskey has revealed that two of his children have sickle cell trait (Mike Egerton/PA Images via Getty Images)
“We need a whole new generation of blood donors, especially those of black descent,” he told the Mirror. “Because we are more likely to donate blood that is more compatible to treat patients with sickle cell disease.
“Some sickle cell patients rely on regular blood transfusions to stay alive. Donating blood is simple and easy and can save up to three lives.”
Davis echoes Heskey’s sentiments in encouraging people to get tested for the disease.
“Many people don’t know they have the sickle cell gene until probably later in life,” she says. “For example, a woman may only discover that she is a carrier of a gene during pregnancy.
“We are committed to educating people on an individual basis, because even though they know there may be carriers in their family, they do not know that they are carriers themselves. This is because they are often in denial. There is a stigma surrounding this condition, so some people don’t go for testing.
“Unfortunately, it is a sad case that partners refuse screening and we frequently see the birth of children affected by sickle cell disease. More work needs to be done to highlight its importance. . It ultimately needs to be explained what happens if it is ignored.”
A sickle cell cure treatment was approved by the Food and Drug Administration (FDA) in December 2023, making Vertex Pharmaceuticals and CRISPR Therapeutics’ treatment called “Casgevy” the first drug approved in the United States. . The same treatment was approved in the UK in November 2023, with experts calling it a “historic moment for the sickle cell community”.
However, in May 2024, the gene-editing sickle cell drug was not approved for use in the National Health Service (NHS). The National Institute for Health and Care Excellence (NICE) did not recommend gene therapy treatment, saying it needed “additional data” beyond current proposals.
In September 2024, Pfizer voluntarily recalled large quantities of its sickle cell disease drug Voclotor, sold under the brand name Oxbrita, from the global market.
But with stories like Diarra’s still sporadic in the football world, Davis says the unpredictability of the condition means the discussion about sickle cell must continue within the sport. I think it means.
“As with many diseases, it affects individuals to varying degrees, but the unpredictable nature of this disease ultimately limits what people can do and when they can do it,” she said. says.
“Especially in sports and football, it takes a lot of training and of course a lot of commitment to the sport. People who are affected by sickle cell don’t necessarily know when they’re going to be affected, so they can’t necessarily be held responsible. Not really. It’s very difficult to be passionate about sports, especially soccer.”
Progress has been made in the fight to find a cure for the disease and raise awareness of the disease in the sports world, but more needs to be done.
(Top photo: Franck Fife/AFP via Getty Images, design: Dan Goldfarb)
