Exertional Rhabdomyolysis: What you need to know.

Approximately 26,000 instances of rhabdomyolysis are reported annually in the United States (1). Athletic Trainers, personal trainers, physical education teachers, and coaches should be aware that exertional rhabdomyolysis (ER) is the most common form of rhabdomyolysis (2). Exertional rhabdomyolysis refers to muscle cell damage caused by prolonged intense exercise, during which the energy supply to muscles is insufficient to meet the demands. This leads to the leaking of muscle contents into the bloodstream that can cause organ failure and death (3). Generally, this medical condition affects individuals who participate in novel and intense exercise to which they are unaccustomed (4). Stressful ambient conditions (heat, humidity etc…) may lead to dehydration and exacerbation of ER (3). Specifically, the literature has addressed a common triad of symptoms present in patients suffering from ER. They are muscle pain, muscle weakness, and dark colored urine (5,6,7,8,9). It is important that individuals know their exercise level and gradually increase exercise duration and intensity. If you notice any signs or symptoms of ER, it is a medical emergency and should be referred to a medical health provider for adequate medical treatment.

  1. Graves, E.J. & Gillum, B.S. (1997). Detailed diagnoses and procedures, National Hospital Discharge Survey, 1995. Vital Health Stat, 13:1-146.
  2. Cleary, M.A., Sadowski, K.A., Lee, S.Y., Miller, G.L., & Nichols, A.W. (2008). Exertional Rhabdomyolysis in an adolescent athlete during preseason conditioning: a perfect storm. Curr Sports Med Rep. Nov-Dec;7(6):328-31. doi: 10.1249/JSR.0b013e31818f0317
  3. Eichner, R. (2013). Exertional Rhabdomyolysis. NCAA Sports Medicine Handbook. 1-6.
  4. Santos, J. (1999). Exertional rhabdomyolysis: potentially life-threatening consequence of intense exercise. JAAPA, 12(7):46–49,53–55.
  5. Chen, C.Y., Lin, Y.R, Zhao, L.L., Yang,W.C., Chang, Y.J., Wu, K.H., & Wu, H.P. Clinical spectrum of rhabdomyolysis presented to pediatric emergency department. Journal BMC Pediatrics.
  6. Mannix, R., Tan, M.L., Wright, R., & Baskin, M. (2006): Acute pediatric rhabdomyolysis: causes and rates of renal failure. Pediatrics, 118:2119–2125.
  7. Clozel, M., Anand, R., Cooper, C.,& Morrow, J. (1978). Resolution of muscle calcification in rhabdomyolysis and acute renal failure. Ann Intern Med, 89:928-930.
  8. Elsayed, E.F., & Reilly, R.F. (2005). Rhabdomyolysis: A Review, with emphasis on the pediatric population. Medicine (Baltimore).Nov;84(6):377-85.
  9. Moghtader, J., Brady, W.J., & Bonadio, W (2009). Exertional Rhabdomyolysis in an adolescent athlete. J Strength Cond Res., Jul;23(4):1055-9. doi: 10.1519/JSC.0b013e3181ad316b.


View as a PDF