Jan 29, 2015
Session Recap: Rhabdomyolysis

One topic that has been receiving increased attention from athletic trainers is rhabdomyolysis. On Wednesday morning, Matt Radelet, PA-C, ATC, Physician’s Assistant at the University of Orthopedic Specialists led a special topic presentation on the issue. He summarizes what he covered below.

We talked about rhabdomyolysis, which we referred to as exertional rhabdomyolysis, which is a condition that can occur in athletics. It occurs when there’s significant breakdown of muscle tissue. A lot of times, this is a result of a crush-injury, like a car crash. However, another way it can happen is in athletics, usually when a really unusual amount of strenuous activity is done.

The condition can be exacerbated by dehydration and hyperthermia in athletics, so there have been a lot of cases recently reported in the media about this happening after athletes have engaged in an unusually strenuous workout–especially when it’s hot and humid outside, when they tend to be a little dehydrated. It’s serious because if the condition advances far enough, it can result in cardiac problems, the loss of kidney function, and even death in extreme cases.

I talked about how it’s diagnosed and treated. Then we had an open-mic discussion about the condition, and we threw around some ideas about communicating with the strength and conditioning staff, coaches, and the athletic director about its importance. I was surprised–I asked for a show of hands to see how many had been involved with athletes who had rhabdo. In a room with about 150 people, almost half of them raised their hands. I wasn’t expecting so many to have had experience with it, but it gave a lot material for the discussion.

One of most important take-home messages is to look for signs and symptoms, which look like heat illness. With an athlete is suffering from what seems to be heat exhaustion or heat stroke, athletic trainers need to keep in mind the other signs and symptoms of rhabdo, some of which include vomiting, nausea, and malaise. Really dark urine is a hallmark, and once an athlete reports that symptom, it’s time to take action get them to a physician.

That’s the other big take-home message: athletic trainers really need a high level of communication with physicians and to get them involved early There are some lab values that come in, so physicians will always be involved. And it’s better to get them involved at the beginning, because the best possible treatment is to catch it early.

To read more about rhabdomyolysis, check out the article Too Much Too Soon, which appeared in the December 2010 issue of T&C.

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