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A cluster of exertional rhabdomyolysis affecting a Division I Football team.

Publication ,  Journal Article
Smoot, MK; Amendola, A; Cramer, E; Doyle, C; Kregel, KC; Chiang, H-Y; Cavanaugh, JE; Herwaldt, LA
Published in: Clin J Sport Med
September 2013

OBJECTIVE: To identify risk factors for exertional rhabdomyolysis (ER) among collegiate football athletes. We hypothesized that a back squat workout triggered ER in some players, and that the risk of ER was altered by players' characteristics or other exposures. DESIGN: Case report and case-control study. SETTING: National Collegiate Athletic Association Division I Football Program and an academic medical center. PARTICIPANTS: National Collegiate Athletic Association Division I football players. INDEPENDENT VARIABLES: Characteristics, performance during the implicated workout, and exposures of players. MAIN OUTCOME MEASURES: Exertional rhabdomyolysis was the primary outcome; the hypotheses were formulated before data were collected. RESULTS: Initial serum creatine kinase and creatinine values ranged from 96,987 to 331,044 U/L and from 1.0 to 3.4 mg/dL, respectively. The risk of ER increased as the time and number of sets needed to complete 100 back squats increased [odds ratio (OR), 1.11; 95% confidence interval (CI), 1.03-1.19; P = 0.0051 and OR, 1.33; 95% CI, 1.09-1.63; P = 0.0056, respectively]. Affected players were significantly more likely than unaffected players to report that they went to muscle failure (P = 0.006), did not think they could complete the workout (P = 0.02), and performed extra squats (P = 0.02) during the back squat assignment. For athletes playing skilled or semiskilled positions, the risk of ER increased as the percent body weight lifted increased [OR (corresponding to a 10% increase), 1.77; 95% CI, 1.06-2.94; P = 0.0292]. Drinking protein shakes after the implicated workout was associated with a decreased risk (OR, 0.70; 95% CI, 0.51-0.96; P = 0.0284); the odds decreased about 30% per shake. CONCLUSIONS: Percent body weight lifted, the number of sets, and time needed to complete 100 back squats were significantly associated with increased risk of ER. Affected athletes were more likely to report going to muscle failure, thinking they could complete the workout, and performing extra squats during the back squat assignment. Consuming protein shakes after the implicated workout was associated with a decreased risk. Clinicians, athletes, and athletic program staff must know risk factors for ER and early symptoms of ER.

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Published In

Clin J Sport Med

DOI

EISSN

1536-3724

Publication Date

September 2013

Volume

23

Issue

5

Start / End Page

365 / 372

Location

United States

Related Subject Headings

  • Young Adult
  • Temperature
  • Surveys and Questionnaires
  • Substance Abuse Detection
  • Sport Sciences
  • Rhabdomyolysis
  • Male
  • Iowa
  • Humidity
  • Humans
 

Citation

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Smoot, M. K., Amendola, A., Cramer, E., Doyle, C., Kregel, K. C., Chiang, H.-Y., … Herwaldt, L. A. (2013). A cluster of exertional rhabdomyolysis affecting a Division I Football team. Clin J Sport Med, 23(5), 365–372. https://doi.org/10.1097/JSM.0b013e3182914fe2
Smoot, M Kyle, Annunziato Amendola, Elizabeth Cramer, Christopher Doyle, Kevin C. Kregel, Hsiu-yin Chiang, Joseph E. Cavanaugh, and Loreen A. Herwaldt. “A cluster of exertional rhabdomyolysis affecting a Division I Football team.Clin J Sport Med 23, no. 5 (September 2013): 365–72. https://doi.org/10.1097/JSM.0b013e3182914fe2.
Smoot MK, Amendola A, Cramer E, Doyle C, Kregel KC, Chiang H-Y, et al. A cluster of exertional rhabdomyolysis affecting a Division I Football team. Clin J Sport Med. 2013 Sep;23(5):365–72.
Smoot, M. Kyle, et al. “A cluster of exertional rhabdomyolysis affecting a Division I Football team.Clin J Sport Med, vol. 23, no. 5, Sept. 2013, pp. 365–72. Pubmed, doi:10.1097/JSM.0b013e3182914fe2.
Smoot MK, Amendola A, Cramer E, Doyle C, Kregel KC, Chiang H-Y, Cavanaugh JE, Herwaldt LA. A cluster of exertional rhabdomyolysis affecting a Division I Football team. Clin J Sport Med. 2013 Sep;23(5):365–372.

Published In

Clin J Sport Med

DOI

EISSN

1536-3724

Publication Date

September 2013

Volume

23

Issue

5

Start / End Page

365 / 372

Location

United States

Related Subject Headings

  • Young Adult
  • Temperature
  • Surveys and Questionnaires
  • Substance Abuse Detection
  • Sport Sciences
  • Rhabdomyolysis
  • Male
  • Iowa
  • Humidity
  • Humans