Improper use of smelling salts a growing concern

Athletes are always looking for an edge that will improve performance.

Often these efforts are ill-advised and at times harmful. One practice that has become popular among high-level athletes is the use of smelling salts to increase alertness.

Smelling salts consist of spirits of ammonia. The use of smelling salts dates back to the Roman Empire but they became popular during the Victorian era. They were used to help revive women who were fainting.

Syncope or fainting is a loss of consciousness as a result of a slowed heart rate triggered by a vagal reflex. This reflex is often initiated by dehydration, anxiety or pain. Ammonia salts directly irritate the nasal mucosa and elicit a noxious reflex. This causes the heart to beat faster and hopefully counteract the vagal response.

Approximately 50 years ago, they became popular in sports to supposedly counteract the effects of head trauma. Smelling salts became popular in boxing where their use eventually was banned.

Trauma patients often suffer neck injuries that may be undetected. The first response to the noxious smell is to suddenly jerk the head away from the stimulus. This can result in dislocating an injured spine and potential paralysis.

More recently, athletes have begun to use smelling salts with the belief that their use will keep them more alert.

The use of smelling salts is particularly popular among football and hockey players who believe this reflex will counteract the effects of concussion.

Recent estimates report 80 percent of NFL players using smelling salts, according to a recent article in ESPN The Magazine.

It is only natural that athletes at lower levels will follow this practice.

Smelling salts should only be used in limited situations under the guidance of a health professional.

Coaches, parents and athletic trainers are crucial to ending the inappropriate use of smelling salts in young athletes.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport.