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Lassana Diarra was preparing for the 2010 World Cup in South Africa.
The midfielder, who has played for Chelsea, Arsenal and Portsmouth in the Premier League, was returning from a difficult first season at Real Madrid. In the 2009–10 season, he made 30 appearances in all competitions for Manuel Pellegrini’s side, which finished second in La Liga, three points behind Barcelona. They were also eliminated in the Champions League round of 16 against Lyon.
After a disappointing club campaign, 25-year-old Diarra joined the France national team. Thierry Henry, Franck Ribéry, Hugo Lloris, Nicolas Anelka, Karim Benzema — Pre-competition training camp. Tignes was the chosen destination due to its high altitude mimicking conditions in South Africa.
But on May 22, 2010, his hopes of playing on the world stage were dashed.
“In addition to his intestinal pains that occurred on the glacier at Tignes, examinations revealed evidence of an unpredictable illness requiring rest for an indeterminate period of time.”read a statement from the French Football Federation.
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) defines sickle cell disease, the most common of which is called sickle cell anemia, as a group of genetic disorders that affect hemoglobin (the main protein that carries oxygen in red blood cells). In sickle cell disease, red blood cells are altered in shape due to a genetic mutation that affects the hemoglobin molecule, typically giving them a crescent-shaped or “sickle-shaped” appearance. When red blood cells become sickled, they bend or stop moving easily and can block blood flow to the rest of the body.
Symptoms include painful episodes called sickle cell disease, an increased risk of serious infections, and anemia, in which red blood cells are unable to carry enough oxygen throughout the body, which can cause fatigue and difficulty breathing.
Black people are at a much higher risk of sickle cell disease, according to Healthline, a U.S. health information provider. Researchers believe 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 rampant. Having sickle cell trait helps reduce the severity of malaria.
Sickle cell trait is found in 1 in 4 West Africans and 1 in 10 Afro-Caribbeans. It is also found in people of Mediterranean, Asian, and Middle Eastern origin. It is less common in white Europeans.
Sickle cell disease and sickle cell trait are different. This is because people with this trait have only one copy of the altered hemoglobin gene and have few clinical symptoms associated with the disease, whereas people with the disease have two copies.
According to the American Society of Hemotology, more than 100 million people worldwide have the sickle cell trait.
Despite how common the disease is and its sometimes fatal consequences, sickle cell is still a relatively unknown disease and its impact on sports performance is still less known.
A 2014 study conducted by the British Journal of Sports Medicine (BJSM), ‘Case studies of two Premier League footballers with sickle cell trait’, states in part in its conclusions: “Further research in larger populations will be needed. To establish a relationship between reduction homeostasis (defined as maintaining a balance between reduction and oxidation reactions within the cell) and sickle cell characteristics in athletes.”
BJSM did not respond to a request for comment. 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 to Denver, which is high altitude, because I knew from my research that it wasn’t a good idea to play at altitude,” he told the Centers for Disease Control and Prevention (CDC). Centers for Disease Control and Prevention). “I ended up in Cincinnati and played at a very high level without the side effects of my sickle cell trait.”
He added: “Having sickle cell trait does not preclude an athlete from participating in sport. However, training staff and coaches must take precautions to avoid putting athletes in dangerous situations.” In this case, Atkins cited 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 high-profile sportspeople with the disease, and wide receiver John Brown, most recently with the Buffalo Bills, also has the trait.
Dr Mark Gillett, consultant in sports and exercise medicine, says: athletic: “The fact that it was (sickle cell disease) was not recognized in Premier League football or top-tier football. I haven’t really seen much of it. I was surprised that wasn’t the case. I think it would be difficult for a player with full-blown sickle cell disease to compete at that level simply because of the physical demands of the game.
“At the same time, if you have sickle cell trait, you have a type of disease in which some symptoms may appear due to extreme physical stress, altitude or hydration. We may not recognize a player exhibiting this phenomenon when we see it.
“Most Premier League football clubs are very diligent in the way they select players. Players at risk will have created a profile. If you have sickle cell trait, your doctor will know about it. “I think that happens a lot at the grassroots level.”
Altitude is a phrase quoted by then-French national team manager Raymond Domenech when talking about Diarra’s withdrawal from the 2010 World Cup.
“He was physically unprepared and really exhausted,” he said. “This disease was triggered by the altitude. That person had tendencies that we could not have discovered in advance. You will need 15 days of rest to fully recover, and it is certain that you will recover. “It won’t have any impact on the rest of his career, but he is not fit to play in the World Cup.” Diarra did not respond for comment when contacted. athletic.
Diarra (left) speaks with Domenech at France’s training camp before the 2010 World Cup (Franck Fife/AFP via Getty Images)
When asked how top-level teams would react to a player contracting the illness, Gillett said: “If we found that when testing a player, then obviously we would have to group it with other things we look for when evaluating a player. We need to talk to players about this and make sure treatment is optimised.
“This will be a concern for both the players and the club. Especially as the weather gets warmer towards the end of the season, the chances of dehydration increase. Sometimes a game has more impact and means more. It’s definitely an added stress for them. It’s hard enough as a Premier League footballer without having to deal with that. “It will be quite a cause for concern for them.”
The extent of Diarra’s illness was later confirmed by his club at the time, Real Madrid. In a statement, they said Diarra was “currently resting at home on medical advice due to asthenic syndrome secondary to sickle cell anemia, who will undergo hematological studies (study of blood and blood diseases) at a Lyon hospital.”
Valerie Davis, hemochromatosis nurse consultant for the Sickle Cell and Thalassemia Support Project in Wolverhampton, wants football authorities to step up efforts to raise awareness of the disease and educate people about it.
“We need sessions to encourage everyone, regardless of race, to get tested,” she says. “It is often thought that only certain ethnic groups, such as people of African and Caribbean backgrounds, can be affected by the disease. The truth is that it can affect anyone. Anyone with hemoglobin and red blood cells can be affected by sickle cell. It’s least likely for people who don’t come from that background, but it can affect everyone.
“Encouraging everyone involved in sport to get tested could be a start. You can then do more to bring in a specialist to talk about the disease. There has been a stigma around this disease over the years and there shouldn’t be any. This can help emphasize the importance of testing. If someone is the carrier, it’s usually totally fine. With rest, hydration, and nutrition, someone can live a completely normal life.
“Anyone with a good lifestyle is likely to have no problem going far in football. Even if it is affected by a full-blown condition. I would like to encourage football authorities to never reject someone because they are a carrier of the sickle cell gene. But even full-blown conditions with conditioning and support won’t stop them from reaching the top.”
In 2022, former England international Emile Heskey discovered that two of his children had the sickle cell gene. He began donating blood and encouraged other black donors to not only register but also get tested for the disease.
Emile Heskey 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 people of black heritage,” he told the Mirror. “Because they are more likely to donate better-matched blood to treat people with sickle cell disorder.
“Some sickle cell disease patients rely on regular blood transfusions to survive. Donating blood is simple and easy and can save up to three lives.”
Davis shares Heskey’s sentiments about encouraging people to get tested for the disease.
“Many people probably don’t know they carry the sickle cell gene until later in life,” she says. “For example, a woman may only discover during pregnancy that she is a carrier of the gene.
“We are doing our best to educate people individually. Because sometimes people know that there may be a carrier in their family, but often they deny that they are a carrier. Because of the stigma surrounding the disease, some people don’t even get tested.
“Unfortunately the partner refuses to be tested and this is a sad example of how we often see children born with sickle cell. More initiatives are needed to highlight its importance. We ultimately have to explain what can happen if we ignore it.”
A treatment for sickle cell was approved by the U.S. Food and Drug Administration (FDA) in December 2023, making the treatment, called Casgevy from Vertex Pharmaceuticals and CRISPR Therapeutics, 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, as of May 2024, the gene-edited sickle cell treatment has not been approved for use in the National Health Service (NHS). The National Institute for Health and Care Excellence (NICE) did not make a recommendation on gene therapy, saying ‘additional data’ was needed beyond the current proposal.
In September 2024, Pfizer voluntarily withdrew large quantities of its sickle cell treatment drug Voxelotor, which was sold under the brand name Oxbryta, from the global market.
But with talk of Diarra still being sporadic in football, Davis believes the unpredictability of the disease means conversations about sickle cell within sport must continue.
“As with many diseases, the degree of impact on an individual varies but is ultimately limited by the unpredictable nature of the disease, what people can do and when,” she says.
“Sports and football especially require a lot of training and of course a lot of dedication to the sport. People affected or affected by sickle cell cannot always commit because they do not know when they will be affected. “It’s very difficult to commit to sports, especially soccer.”
Progress has been made in the fight to find a cure for the disease and raise awareness of the condition within sport, but more needs to be done.
(Top photo: Franck Fife/AFP via Getty Images, design: Dan Goldfarb)
