Pushing intense exercise too far can lead to exertional rhabdomyolysis

Military training is regarded as the optimum test of physical fitness.  New workout programs like Cross-Fit, boot camp, P90X and Insanity strive to emulate that training.  Unfortunately, this intense physical drilling has lead to a variety of injuries that can be avoided with proper precautions.

One prominent and life threatening injury is exertional rhabdomyolysis (ER).  ER is the result of dramatic muscle breakdown allowing release of enzymes into the blood stream.  Once these enzymes reach toxic levels, they lead to renal failure and potential death.

Non-physical causes of ER include drugs, illness and physical compression.  Most cases are the result of a combination of physical and non-physical causes.

In a recent lecture at the University of Connecticut, Dr. Francis O’Connor, a military physician and researcher who has been studying ER for many years, reviewed many of his findings of military recruits and their relevance for all athletes.

Most serious cases of ER are experienced in military recruits during basic training.  This finding relates to the inability of athletes to acclimate to a new level of performance.  Gradually increasing exercise tolerance is crucial.

Intense drilling and the use of exercise and dehydration as punishment is another common factor in patients who experience ER.  Coaches and personal trainers must rethink these time-honored practices of pushing athletes beyond their limits to produce physical “toughness.” 

Underlying illness, most notably influenza, is a common predisposing factor to ER.  The typical aches and pains experienced with the flu is actually a form of muscle inflammation and breakdown.  Attempts to use exercise to alleviate this discomfort only escalate the damage.

Supplements designed to improve athletic performance often contain stimulants like DMAA that increase body temperature and blood pressure.  These supplements also diminish an athlete’s ability to recognize physical limits and allow them to push beyond muscle tolerance.

Intense exercise can improve overall fitness but caution will avoid potential tragedy.