Another athlete dies too soon

Just a week after I wrote this piece about heart failure and athletes dying young, another student-athlete has died. Neate has more on the tragic death of 19-year-old Ereck Plancher, a receiver at the University of Central Florida.

As the Orlando Sentinel's Andrea Adelson writes<, , this is anything but an isolated incident. "The same story seems to play out every year: a seemingly healthy college football player dies suddenly as the result of a workout, and there are no immediate answers why," she wrote. "The last year there were no noncontact college football deaths was 1999. Since 1966, there have there have only been seven years when there were no noncontact college football deaths." The Sentinel also provides a list of athletes who have died recently after workouts.

Those are some scary numbers, up there with the ones I found from the Minneapolis Heart Institute Foundation's national registry of young athlete deaths. Their researchers estimate there are 125 athletes under 35 who die every year, mostly due to heart failure.

The real problem is there aren't any easy solutions. Defibrillators are one of the best methods for preventing these deaths, but UCF had one, and using it didn't make a difference. Initial autopsy reports were inconclusive, as they always seem to be: no one's figured out exactly what killed Mickey Renaud yet either. The school gives its players a physical exam, but it's unclear how much that helps either, as many conditions go undetected. As Dr. Andrew Pipe, the medical director of the University of Ottawa Heart Institute Minto Prevention and Rehabilitation Centre, told me last week, even physical exams for all athletes haven't been proven effective yet.

Italy has a law that anyone who participates in competitive sport must undergo a physical examination. Pipe said that would be difficult to implement in Canada due to the doctor shortage, but even compulsory physicals don’t necessarily reduce deaths.
“In Italy, there’s a surplus of doctors, so there clearly are ways in which that can be accomplished,” he said. “The question has been raised and has been looked at very carefully as to whether that is likely to actually reduce the incidence of these kind of deaths, and there’s an ongoing debate about that.”

Even electrocardiogram testing, as is done at some universities, is problematic due to the high number of false positives generated. Dr. Willem Meeuwisse, a professor at the University of Calgary’s Sport Medicine Centre and a clinical physician who was the Calgary Flames’ team doctor for six years, told me this brings in the question of if we're willing to ban healthy people to ensure no one dies.

“The numbers tell us the risk of a sudden cardiac death in that age group [under 35] is probably one in 200,000," he said. "We know with the current methods we have, with screening with ECGs, you probably have about a two per cent positive rate. If the rate of sudden deaths is that low, almost all of those are false positives. If you use ECG and then find an abnormality and say you can’t play sports, the question is, are you willing to exclude 2,000 healthy people from playing sports to catch the one that might have a sudden death?"

That is the $64,000 question. Personally, I think it's better to let the 2,000 people play. Universal electrocardiogram testing would be great if it was cheaper, just to give people an idea of they might be at risk, but using that to ban people from the sport they love is a poor idea in my mind. The other thing is, as Pipe and Meeuwisse both pointed out, people can get a better idea of if they're at risk of heart problems just from their family histories. Technology may be the answer in the future, especially with the new echocardiograms that provide a much better picture of the heart's functionality via sound waves than an electrocardiogram does. At the moment, it isn't providing any solutions, though.

One thing that can be addressed is the need for and the intensity of these off-season training sessions. As the Sentinel's Mike Bianchi wrote, these workouts have caused too many deaths over the years.

"Almost always it happens during offseason workouts," he wrote. "This is the time of year when football players are programmed to give absolutely everything they have. To leave it all out on the field.To pay the ultimate price. Sadly, yet another one did just that Tuesday when UCF freshman wide receiver Ereck Plancher passed out after completing a conditioning drill." Bianchi later quotes former UCF wide receiver Jimmy Fryzel, who said, "The offseason workouts are usually hell. That's when you have to really push yourself to get better." The question begs asking, how much pushing is too much?

One other point is that these deaths should perhaps scare people from working themselves too hard in athletic training, but they shouldn't stop people from training altogether. As Pipe told me, the majority of young athletes are far better off than those who don't play sports. "Overall, there’s a death rate of about 1 per 200,000 young athletes," he said. "These are very tragic, but relatively rare events, which understandably get a considerable amount of publicity. Ironically, we should also recognize that for the majority of young people in Canada today, a sedentary lifestyle is far more hazardous than participating in sport."

In the end, all the analysis and rationalization can only take you so far, though: it can't get you away from the stark reality of a life full of potential that didn't have to end. As Bianchi wrote. "An athlete dying young -- is there anything more devastating than unrealized hopes and an unexplored future lying motionless on a cold floor?" I'm not sure there is.