Posted in Health, news, Sports

Football medical trend: smelling salts

Many ask what the players are seen sniffing during the football games and why?  The answer:  ammonium carbonate, or smelling salts.  We’ve seen Ezekiel Elliot frequently sniff it before and during the game and others, such as Tom Brady and Peyton Manning (above) have used this remedy for a variety of reasons.  So here are your questions answered.

Kansas City Chiefs v Denver Broncos

What are smelling salts?

Smelling salts release ammonia when diluted and inhaled. They’ve been used for centuries to help those regain consciousness quickly.  The ammonia irritates the lining of the nose, stimulating the trigeminal nerve and triggering the sympathetic nervous system whereby heart rate increases and lung function improves so the level of alertness rises exponentially.

Are smelling salts legal?

Yes, but have been at times banned in boxing.  Ammonium carbonate has been controversial in boxing, not because of its “enhancing” effects, but rather its “masking effects”.  If one is delirious or dizzy after a blow to the head, he should sit out the rest of the match as opposed to sniffing the salts and “waking up” when at risk for serious head injury.

How are they used?

When the salts are diluted they can be inhaled, and most products come in solution form.  They work immediately and many athletes use them before the game and after certain plays if they need a “pick me up”.

How dangerous are smelling salts?

Since the amount of ammonia used is such a minute amount, we’ve rarely seen serious side effects with smelling salts.  Nasal irritation is one of them as the close contact can upset the delicate nasal mucosa.  So players are recommended to hold it at a distance from their nose and not directly next to it.  The solution should not touch the skin and if it does make contact with eyes, it could cause burning and blindness.  Frequent use could possibly induce a tolerance to the salt requiring even more frequent use.  Heavy inhalation can cause lung damage, but again the doses usually used are small.  If someone starts to become flushed in the face, we’re concerned they may have an underlying blood pressure or heart issue.

Are there risks to frequent use of smelling salts?

No, but then again it hasn’t been studied to the degree it needs to.  The other concern when I see a player frequently use smelling salts is the “why?”.  The pre-game “pep up” is understandable but not entirely necessary if one’s adrenaline is already rushing. But after a play when one receives a blow to the head, as in football, it helps wake them up when the player should possibly be pulled out and evaluated under concussion protocol.  Smelling salts, as stated previously, could mask a serious injury.  And if someone has a bleed in the brain, it can accelerate the flow.

Ezekiel Elliot is one of my favorite players (GO COWBOYS!!!). But his frequent blows to the head concerns me, especially when we see him so frequently use smelling salts.  The use of smelling salts has now become a ritual in sports, especially football, but with the recent attention placed on head injuries, I predict players in the future may not be allowed to self-treat, not because of its toxicity but because of its ability to mask a serious issue.


Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network and Board Certified Family Physician


Nationally Syndicated Radio Host, Board Certified Family Medicine Physician, Author

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