Intensely Overworking Muscles Can Lead to a Life-Threatening Condition in Athletes

Thirteen collegiate football players were hospitalized

In January after participating in intense weight training sessions with their team.

Unfortunately, athletes pay the price when coaches cross the line.
Once a rare condition seen in athletes, the diagnosis of rhabdomyolysis is unfortunately becoming more common. As pressure is placed on coaches to win and athletes are pushed to higher volumes of training, the line between conditioning athletes and injuring athletes can be crossed. The data illustrates that the line is being crossed more frequently by today’s competitive coaches.

According to Dr. E. Randy Eichner of the University of Oklahoma, an expert on the causes of rhabdomyolysis, rhabdomyolysis is “too much exercise, too fast, too soon” (Roan, S., 2011). While there are a variety of causes that can trigger rhabdomyolysis, exertional rhabdomyolysis is caused by the release of a protein, myoglobin, into the blood stream after intense muscle training.

The myoglobin accumulates in the blood at such a high level that the kidneys are not able to adequately filter out the myoglobin. This can result in a number of serious conditions including exertional compartment syndrome and kidney failure.

In this case, the athletes had been participating in a rigorous weight training workout at the University of Iowa. The athletes reported to their first day of workouts on January 20 after their winter break.

According to one of the athlete’s parents, the athletes underwent a grueling workout including a session of “100 squats done in rapid succession” (Roan, S., 2011). The athlete then completed another intense workout on the following day for the upper extremities.

After the fourth day, thirteen of the Iowa football players were hospitalized with rhabdomyolysis, the result of rapid destruction of their muscle tissue. While this is typically seen in muscle trauma, crush injuries, physical torture, and severe physical abuse, this type of muscle damage is now being seen in an alarming rate in athletes.

Signs and Symptoms of Rhabdomyolysis

The signs and symptoms of rhabdomyolysis include the following: extreme muscle pain, swelling in the limbs, and dark, tea-colored urine. An athlete experiencing these symptoms needs to get immediate medical attention which may include intravenous fluids and dialysis.

Other factors that can increase the risk of rhabdomyolysis include dehydration and high intense repetitions of eccentric exercises. Eccentric exercises put more strain on the individual muscles which can result in more muscle damage if done incorrectly.

Extreme conditioning in hot temperatures when athletes are not adequately hydrated can also lead to rhabdomyolysis which is what occurred to the 24 football players from the McMinnville High School team after intense upper body workouts. Three of the 24 athletes needed emergency surgery to release the pressure from the swelling in their upper arms.

There appears to be a pattern in both of these circumstances. Both groups of athletes were resuming conditioning after a break and both groups of athletes performed high repetitions of eccentric exercises during their workouts.

Lessons to Learn

Coaches need to be educated as to the causes of rhabdomyolysis and how to prevent it. The primary causes appear to be intense conditioning programs including high repetitions of eccentric strength training exercises in athletes resuming conditioning programs after a break.

Prevention should focus on a gradual increase in strength training programs over time when athletes return to sport after a break with specific attention to initially reducing the numbers of repetitions of high intensity eccentric exercises.

As always, athletes should be educated to stay hydrated and be encouraged to drink as much fluids as needed before, during, and after conditioning to minimize the possibility of life-threatening conditions.

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