The actual science behind smelling salts and how it helps in injury recovery


Last Updated December 20th, 2021

The background of smelling salts

Smelling salts are one of the most common items that are used for both medical and non-medical purposes. Many players use smelling salts to energize themselves during a match and they are not prohibited in football, hockey and powerlifting.

In many cases, they are also being used to revive and athlete who has received an injury, even though the detail of the same has not been verified scientifically. Most smelling salts are a mixture of ammonium carbonate and some perfumes which are sniffed by an individual.

Many trainers feel that smelling salts provide a burst of energy and also helps in improving focus. On the other hand, some feel that these salts have no beneficial health effects and when used on an unconscious person, these salts can cause involuntary reflex movements that may worsen the injury.

The history of smelling salts 

It was the Romans who started using smelling salts to “awaken” the senses and its use is mentioned by philosopher Pliny the Elder, in his work Natural History. Ammonium carbonate was also used by bakers prior to the advent of baking soda and was called “baker’s ammonia”.  

Smelling salts were largely used in the Victorian period by doctors and the actual use of “spirits of ammonia” date back to the 13th century. They were used to revive fatigued athletes or profusely beaten boxers by passing the salts under their nose and tickling their necks by feathers. In the later years, the use of smelling salts was banned in boxing. These salts were also used to revive women who have fainted and were termed as “lady revivers”.

During the Second World War, the British Red Cross and St. John Ambulance recommended smelling salts to be kept in first aid boxes. Present-day smelling salts are composed of diluted ammonia dissolved in a mixture of water and alcohol. They come in glass vials, which are broken, inhaled and discarded. Recent statistics indicate that around 80 percent of the NFL players make use of smelling salts.

While many doctors think that these salts cause a withdrawal symptom, long term adverse effects are yet to be discovered. In the past decade, many players have admitted that smelling salts raised their adrenaline levels by a large percentage. This is however debated by physicians due to lack of scientific evidence. Many consider this to be a form of a placebo effect.

How do smelling salts help in recovery

The oldest use of smelling salts was to help in the recovery of a patient who has fainted. Fainting is generally caused by the lack of blood flow in the brain which results in a short supply of oxygen. One of the major causes of fainting is low blood pressure which can be caused by a variety of factors. Another reason is related to breathing problems.

As a person falls down while fainting, that action in itself can help in the recovery process. This is because in the lying position, the heart does not need to act as hard to pump blood to the brain.

Concussion helmetIn cases when the patient is having breathing problems, smelling salts can be useful through their action. They reactivate the sympathetic nervous system, elevate blood pressure and heart rate. In many cases, fainting is caused by the stimulation of the vagus nerve and it cannot be treated by inhalation of smelling salts.

The caustic fumes of ammonia irritate the mucous linings of the air passage, which generates a breathing reflex due to an aggressive reaction of the body. This reflex makes the body breathe deeply so that the passage can be cleared from the stinging chemical. Deeper inhalations send more oxygen to the brain which helps in the recovery of the patient.

In general, for any patient who is feeling faint, the doctors advise them to lie down and breathe deeply so that the blood flow and oxygen levels can return to normal.

In many cases athletes use smelling salt to recover from an injury or to enhance alertness. It is not clear whether smelling salts can actually help in case of a concussion, as such an injury is not caused by oxygen deprivation. Whether the salt can enhance reaction time or has other cognitive benefits, is still something that needs to be scientifically established.

Myth_concussionPhysicians have explained the action of smelling salts as a form of chain reaction that starts with deeper breathing. The faster breathing rate elevates the heart rate so that the oxygen and carbon-di-oxide levels can be maintained correctly. This activates the sympathetic nervous system which controls the fight-or-flight response that takes over during emergency situations.

The entire chain of events can increase the overall strength of the athlete, even though it reduces the fine motor skills to some extent. If players feel more confident after inhaling smelling salts, it will definitely have a positive impact on their performance.

Are there any negative effects of smelling salts?

The use of smelling salts does not seem to have any short term or long term adverse effects on the body. Ammonia is a toxic and corrosive gas and when inhaled in large quantities, it can harm the body in many ways. Most commercially available versions of the salt direct the vial to be held at a distance of 10 to 15 centimetres from the nostril.

This is probably to minimise the burning effect produced on the nasal mucous membrane from the ammonia. The use of smelling salts to revive patients who have a brain injury can be more dangerous. Even if the patient is revived, the action of the salt may hide the seriousness of the injury which can result in complications down the line.

An athlete who is feeling dizzy after having taken a hard hit on the head and wants to continue playing by sniffing a salt is taking a big risk. Since it overrides the basic warning systems in the body, these salts have been banned in boxing.

Even though no studies have pointed out their negative effects, no studies have declared these salts safe either. Doctors feel that younger athletes are more at risk by using these salts rather than older and experienced ones. Younger athletes do not have the experience levels to sacrifice their motor skills in exchange for strength and are more likely to injure themselves.

The other adverse effect of this salt is to reduce decision-making skills, which can affect the overall performance of the athlete. This may make them push through the safety limits resulting in injuries. For an unconscious athlete, the jerky reaction that smelling salts generate can aggravate a head or spine injury.

With growing knowledge about injuries and concussions, the use of smelling salts in medicine has come down by a large extent. It is still a subject of debate whether it really has some benefits or not.

Are smelling salts legal?

The use of performance enhancing drugs in illegal is sports, but when it comes to smelling salts, the laws are not that strict. Ammonia is one performance enhancer that is not banned in sports and this is probably due to the lack of studies that establishes its effects. A whole range of powerlifters and weightlifters use these salts in the gym and even during competition.

This supposedly helps them to apply more strength and brings about an adrenaline rush for lifting heavier weights. The fact that these salts have no proven downsides, makes them a popular choice for many athletes.

The safe use of smelling salts

Like any other supplement, it is essential to use smelling salts in a safe manner, if you use them at all. The first thing to do is to consult your doctor so that you can be sure that you do not have any physical conditions that can be aggravated by the using of smelling salts.

Those with respiratory problems like asthma, should be careful before using smelling salts. Higher doses can result in headaches and allergic reactions, though rare, can occur in some cases. These salts should not be used randomly but in controlled situations, under the guidance of a health professional. Injudicious use of these salts may delay the right treatment of an injured athlete which is not recommended.

Many experts suggest the use of alternative methods like deep breathing techniques before a game to reduce stress levels and optimize performance. The salts should also be used in a manner that has been provided by the manufacturer. It is best to clarify doubts from a professional regarding the use of smelling salts before you start using them in search of benefits.

While smelling salts can be very risky to use a seriously injured person, they can be used under guidance to gain some energy before a sporting event.

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