Category: Orthopedics
Posted: 9/28/2024 by Brian Corwell, MD
(Updated: 10/10/2024)
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A northeast university was recently in the news when several members of the lacrosse team were hospitalized with rhabdomyolysis. 9 of 50 players who participated in the workout required hospitalization. This occurred after a single intense 45-minute workout led by an alum and recent graduate of the Navy Seal training program.
It was surprising to many that young, fit, athletes would be so affected from a single workout.
Nontraumatic exertional rhabdomyolysis occurs following intense physical activity especially in untrained individuals or those unaccustomed to the particular activity (for example a group of runners performing an intense HIIT workout).
Prolonged strenuous activity can result in rhabdomyolysis even in trained individuals in the absence of known risk factors or prior history.
Increased risk when natural cooling mechanisms are affected such as when the individual is taking medications with anticholinergic properties, or the individual is wearing heavy military gear or football equipment.
Increased risk with sickle cell trait.
Increased risk when that activity is performed in environments of severe heat and humidity.
Exercise routines that have a heavy eccentric focus increases risk of rhabdomyolysis.
An Eccentric exercise involves slow lengthening of muscles under load
Examples: the lowering phase of a barbell while performing a bench press or the downward phase of a pull up
Helpful kinetics:
Following the exertional event, the serum CK will rise within 2-12 hours, reaching its maximum in 1-3 days.
CK has a serum half-life of approximately 36 hours.
CK levels decrease at approximately 40% per day.