Genetic Testing for Sports Injuries

The recent NFC championship game proved, I think, this truth: a true champion is not dead until the final whistle blows. The Seahawks  won in dramatic fashion over the Packers, my favorite team.  As many commentators noted, Seattle played horribly for 58 minutes, but were stellar for the last two; and that was all that mattered in the end.

As a fan, my initial reaction is to think “we gave it away.”  But that is a disservice to the champions.  The Seahawks never lay down, and they seized the moment when it presented itself.

Still…..as a fan, I wonder–if Aaron Rodgers’ calf were 100%, would we have pulled away more decisively earlier in the game?  The field goals in the red zone: would they have been touchdowns instead if our quarterback had his usual mobility?

Does Rodgers carry a valuable SNP in the genes of his gastrocnemius? I hope so!

Well, we Packer fans have an offseason to think about ‘what ifs,’ and the Packers medical staff has an offseason to rehab Rodgers’ injury and think about secondary prevention.  Perhaps the Packers will want to think about doing some genetic testing as part of their assessment. Management and the medical staff may want, at least, to take a look at our lead editorial for the January 2015 issue:  “The Dawning Age of Genetic Testing for Sports Injuries.”

We have written about ‘genes’ and sports in the pages of this blog:  a very popular post last year was “The Sports Gene:  how Olympians are made (or born),” a review of David Epstein’s excellent book, The Sports Gene:  Inside the Science of Extraordinary Athletic Performance. As those titles would indicate, the focus on the sports/gene intersection in those pieces was more on sports performance than sports injury.

The ‘intersection’ of sports injury and genes has come up in the pages of the CJSM journal itself:  Genetics:  Does it Play a Role in Tendinopathy? and an investigation into genotypes and the risk for concussion in college athletes  are among the offerings we’ve had on this subject in recent years.

In the January lead editorial, Gabrielle Goodlin and her co-authors from Stanford do an excellent job in a short space of reviewing a great deal of what evidence already exists in this world, as well as pointing out directions where this work may be headed.   For instance, there is a certain, single nucleotide polymorphism (SNP) in the COL1A1 gene which confers increased tensile strength in tendons and ligaments.  4% of athletes carry two copies of the T allele and, consequently, have a markedly decreased incidence of achilles tendinopathy and ACL rupture. Lindsey Vonn and Kobe Bryant may want to look into this as they try, respectively, to avoid recurrent ACL and achilles tendon ruptures.

Goodlin et al. also make a direct connection between sports injury prevention and sports performance, noting that an injured athlete is a non-performing athlete; if one is on crutches on the sideline, there is little you are contributing to the team.  The authors note, furthermore, the extraordinary expense that such sports injuries pose to health care systems as well as professional teams:  when one is talking about athletes like Aaron Rodgers, Kobe Bryant, Lindsey Vonn…one is talking about millions of dollars.  The authors reference the extraordinary figure of $1.6 billion in payroll lost in Major League Baseball between 2008 and 2013 because of injuries to players!!!!!

To return to my case example of Aaron Rodgers’ calf, I would think there may be collagen genes and variants important in determining his susceptibility to reinjury of his gastroc/soleus complex.  This spring, when the NBA championships were going on and Lebron James was struggling with Exercise-Associated Muscle Cramping (EAMC),  I wrote a post referencing a CJSM study on the genetic underpinnings of EAMC; collagen genes are implicated in that condition.  Maybe some are relevant to those recovering from ‘tennis leg’?

This lead editorial, as well as the entire current CJSM, is well worth the read.  Enjoy!

And to those Seahawks who beat ‘my’ Packers last weekend:  good luck in the Super Bowl!  You may not want to wait until the last two minutes to pick up steam in this one…..I hear Tom Brady is playing injury-free.