For some athletes, playing on grass or in the woods is just part of the game. Outdoor athletes in the Northeast can be exposed to ticks that transmit Lyme disease, especially since this region has a high incidence of Lyme transmission.
Lyme disease, also called borreliosis, is one of several tick-borne illnesses. It is a bacterial infection transmitted by deer ticks and in North America it is the most commonly transmitted disease between animals. Athletes who train or compete in wooded environments in those regions with the highest likelihood of transmission are at increased risk of contracting Lyme disease. When the infected deer tick bites, it sometimes leaves evidence of Lyme transmission with a classic bull’s-eye rash and, at best, the victim can see the tick. But often there is no rash, and the juvenile tick, which is about the size of poppy seed, is very difficult to see if it even remains on the skin.
Lyme disease can be tricky to diagnose in its early stages because of its varying symptoms, from general malaise and fatigue to chronic joint pain and inflammation or even headaches or cognitive impairments. Masquerading as other ailments such as musculoskeletal strain, arthritis or fibromyalgia syndrome, a Lyme diagnosis is easily missed. Since early antibiotic treatment often results in full recovery for most patients, early diagnosis is critical. However, for some people, a chronic condition with joint pain, swelling and fatigue may persist for several months before subsiding. Untreated, Lyme disease may progress, causing joint arthritis, nerve degeneration and heart disease.
Outdoor athletes can defend themselves by applying DEET insect repellant on the skin or permethrin to clothing. It is also important to perform a thorough skin check, especially at folds such as armpits or behind the ears. Also check under clothing seams. If a tick is found attached, use fine tweezers to remove it, grasping the mouth of the tick right against the skin. Antiseptic should be applied to the site of the bite. It is important to inform one’s doctor about a bite and prepare for a blood test. The tick itself can be placed in a zippered plastic bag for the doctor. Otherwise it should be killed with a flame, alcohol or toilet flush. Clothing should be washed thoroughly and dried with a high-heat setting for a longer duration. Pets that venture outdoors should also be protected and checked as they can carry ticks indoors.
Lyme disease is on the rise here in the Northeast. Anyone in contact with the wooded outdoors who develops suspicious joint pain, insidious joint swelling, malaise or peculiar pain symptoms must consider Lyme disease as a possibility and discuss it with their health care provider. This includes outdoor athletes who have pain or swelling not attributable to an obvious sport-related injury. Spine and sports medicine is no longer just about sprains and strains. Athletes, coaches and health care providers alike who are in-the-know about Lyme disease can catch it early and spare a lot of suffering. For more information, visit the Center for Disease Control and Prevention’s website at cdc.gov/lyme.