Perspectives on Exertional Rhabdomyolysis

Abstract

Exertional (exercise-induced) rhabdomyolysis is a potentially life threatening condition that has been the subject of research, intense discussion, and media attention. The causes of rhabdomyolysis are numerous and can include direct muscle injury, unaccustomed exercise, ischemia, extreme temperatures, electrolyte abnormalities, endocrinologic conditions, genetic disorders, autoimmune disorders, infections, drugs, toxins, and venoms. The objective of this article is to review the literature on exertional rhabdomyolysis, identify precipitating factors, and examine the role of the dietary supplement creatine monohydrate. PubMed and SPORTDiscus databases were searched using the terms rhabdomyolysis, muscle damage, creatine, creatine supplementation, creatine monohydrate, and phosphocreatine. Additionally, the references of papers identified through this search were examined for relevant studies. A meta-analysis was not performed. Although the prevalence of rhabdomyolysis is low, instances still occur where exercise is improperly prescribed or used as punishment, or incomplete medical history is taken, and exertional rhabdomyolysis occurs. Creatine monohydrate does not appear to be a precipitating factor for exertional rhabdomyolysis. Healthcare professionals should be able to recognize the basic signs of exertional rhabdomyolysis so prompt treatment can be administered. For the risk of rhabdomyolysis to remain low, exercise testing and prescription must be properly conducted based on professional standards.

Damage and the repeated bout effect of arm, leg, and trunk muscles induced by eccentric resistance exercises

“…11,15 However, it is known that some factors increase the risk of rhabdomyolysis such as underlying diseases such as McArdle disease and myopathies, dehydration, supplement or drug use (eg, statins), environmental heat stress, or sickle cell trait. 17 In the present study, no participants seemed to have these risk factors. It should be noted that similar exercises to those of the present study could be performed by people in a gym.…”

“…When severe muscle damage is induced by eccentric exercises, there is a potential risk of exertional rhabdomyolysis. [15][16][17] It is possible that performing bilateral eccentric exercises targeting several different muscles in one session increases a risk of exertional rhabdomyolysis. However, no previous study has reported the magnitude of increases in CK activity and Mb concentration in the blood after performing several eccentric resistance exercises in one session.…”

Perfil de lesões em praticantes de CrossFit: revisão sistemática

“…Rhabdomyolysis is a condition not exclusive of CrossFit, since other sports, if performed strenuously, can also cause it. It usually occurs due to poor exercise prescription or execution without adequate supervision 46 , factor of which is also associated with injuries in CrossFit, as verified in the study by Weisenthal et al 22 , where the injury rate was significantly decreased with the involvement of the instructor.…”

Muskelstølhet og rabdomyolyse

“…Det synes å vaere en viss genetisk disposisjon for å utvikle rabdomyolyse (24,25), men den viktigste faktoren er hvordan man trener. Derfor skal man vaere spesielt forsiktig når man igangsetter trening som innebaerer stort eksentrisk muskelarbeid.…”